Efficacy of Semaglutide Combined with Losartan in the Treatment of Diabetic Nephropathy and Its Effects on Renal Function, Blood Glucose Indices, and 24h Urinary Protein Quantification

doi:10.3969/j.issn.1674-3245.2025.02.038

Abstract：Objective: To investigate the efficacy of semaglutide combined with losartan in the treatment of diabetic nephropathy (DN) and its effects on renal function, blood glucose indices, and 24h urinary protein quantification. Methods: A total of 90 patients with DN admitted to Shuyang Renchi Hospital from March 2022 to March 2024 were prospectively selected and randomly divided into a combination group (45 cases) and a control group (45 cases). The control group was treated with losartan, while the combination group received additional semaglutide treatment on top of losartan. Both groups received treatment for 12 consecutive weeks. The therapeutic efficacy of the two groups was compared; changes in blood glucose indicators [glycated hemoglobin (HbAlc), fasting plasma glucose (FPG), postprandial 2-hour glucose (2 h PBG)] were compared; changes in systolic blood pressure (SBP), diastolic blood pressure (DBP), and body mass index (BMI) were compared; changes in renal function indicators [urea nitrogen (BUN), homocysteine (Hcy), serum creatinine (Scr), urinary albumin excretion rate (UAER), and 24h urinary protein quantification (24h UP)] were compared; changes in inflammatory factor indicators [interleukin-1β (IL-1β), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α)] were compared; and the incidence of adverse reactions in both groups was recorded. Results: After treatment, the total effective rate of the combination group was 93.33%, which was higher than the 73.33% of the control group, with a statistically significant difference (χ²=6.480, P<0.05). After treatment, FPG, HbAlc, and 2 h PBG levels in the combination group were lower than those in the control group, with statistically significant differences (t=5.245, 4.767, 5.608, P<0.05); SBP, DBP, and BMI were also lower in the combination group, with statistically significant differences (t=2.666, 3.300, 2.775, P<0.05); BUN, Hcy, Scr, UAER, and 24h UP were lower in the combination group, with statistically significant differences (t=4.517, 5.784, 6.057, 5.122, 21.302, P<0.05); IL-1β, IL-6, and TNF-α levels were also lower in the combination group, with statistically significant differences (t=9.246, 7.807, 7.277, P<0.05). During treatment, there was no statistically significant difference in the incidence of adverse reactions between the two groups (χ²=0.809, P>0.05). Conclusion: Semaglutide combined with losartan shows significant efficacy in patients with DN, effectively controls blood glucose levels, improves renal function, reduces inflammatory responses, and has good safety.