Kidney stone risk on GLP-1 — my results so far

Short answer first, then the reasoning. 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 chronic kidney disease. The mechanism looks to be a mixture of reduced albuminuria, better glycaemia and blood pressure, and a probable direct anti-inflammatory effect on the glomerulus. Separately, eGFR is genuinely noisy during rapid weight loss — a small early dip is common and usually haemodynamic rather than damage.

Dr.KarenChen 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…

Agreed, and the practical implication is not to over-read a single eGFR during a period of rapid loss and altered hydration. Trend, with UACR beside it.

NicoleRaleigh said:

Two litres a day, no added salt, and a persistent headache that I spent a month attributing to the medication.

This matches mine closely enough to be worth saying so out loud.

From the other side of the consultation, briefly.

Muscle cramps on hydration — anyone else? I was getting severe leg cramps at night, especially calves. Bloodwork showed my both mag and potassium was low.

GLP-1 agonists can cause electrolyte shifts due to reduced food intake and GI effects. Get your electrolytes checked and supplement accordingly. I take magnesium glycinate 400mg + potassium gluconate 99mg daily and cramps are gone.