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Qin XY, Zhang SP, Cao C, Loh YP, Cheng Y

Renal impairment GLP-1 RAs are generally safe in patients with CKD and have demonstrated nephroprotective effects in the FLOW trial, where semaglutide significantly reduced the composite renal endpoint (hospitalization for acute kidney injury, sustained 50% decline in estimated glomerular filtration rate (eGFR), end-stage kidney disease, or renal death) in patients with type 2 diabetes and CKD [15]

The 40mg formulation is the same molecule at double the concentration of the 20mg pen

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