LindaRN_retired said:Albumin binding above 99% is the whole reason weekly dosing works, and it is also why the trough matters more than the peak.
Bookmarking. The distinction being drawn above is the one nobody else makes. Sending this to two other people who asked me the same thing last week.
From the other side of the consultation, briefly.
Kidney function labs on renal function — good news for anyone concerned about renal effects:
| Marker | Baseline | Month 6 | Ref Range |
|---|---|---|---|
| eGFR | 82 | 95 | >60 |
| Creatinine | 1.2 | 0.9 | 0.7-1.3 |
| BUN | 24 | 16 | 7-20 |
| UACR | 67 | 20 | <30 |
The FLOW trial demonstrated renal protective effects of semaglutide. My nephrologist is encouraged by the UACR improvement especially.
Dr.PathRoch said:Steady state is the thing most people miss.
I will push back on the "any working dose is fine" framing. The maintenance evidence sits overwhelmingly at the top studied dose, and the extension data shows regain tracking dose reduction rather than tracking stopping. Holding low is reasonable; pretending it is evidentially equivalent is not.
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View ResultsDr.RenalNash said:FLOW is the relevant trial and it reported a meaningful reduction in kidney-disease progression and related death in people with type 2 diabetes and…
GFR trending upward on renal function — encouraging for those with mild CKD concerns:
Baseline eGFR: 71 → Month 6: 83 → Month 12: 91
The FLOW trial confirmed renal benefits of semaglutide: 24% reduction in kidney disease progression. My nephrologist is now actively recommending GLP-1 therapy for appropriate CKD patients. This could be a paradigm shift in nephrology.