From the Guidelines
Semaglutide can potentially cause urinary difficulties in some patients, although the evidence is limited and mostly anecdotal, with no direct studies assessing this specific side effect. Semaglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist used for type 2 diabetes and weight management, has been associated with various side effects, but urinary symptoms are not commonly reported in the major clinical trials 1. The mechanism by which semaglutide could potentially affect urinary function is not well understood but may relate to its effects on smooth muscle function and autonomic nervous system regulation. GLP-1 receptors are present in the urinary tract, and their activation may influence bladder contractility and urethral tone. Patients with pre-existing urinary issues, enlarged prostate, or those taking medications that affect urination may be at higher risk for experiencing urinary difficulties while taking semaglutide. If urinary difficulties develop, patients should report these symptoms to their healthcare provider promptly, as dosage adjustment or medication changes might be necessary. Most urinary symptoms are likely to be mild and transient, but persistent problems warrant medical evaluation to rule out other causes and ensure appropriate management.
Some studies suggest that semaglutide may have beneficial effects on kidney function, particularly in patients with type 2 diabetes and chronic kidney disease 1. However, these studies did not specifically assess urinary difficulties as an outcome. The most recent and highest-quality study on semaglutide, the FLOW trial, is ongoing and aims to evaluate the effect of semaglutide on kidney outcomes in patients with type 2 diabetes and chronic kidney disease 1. Until more direct evidence is available, healthcare providers should be aware of the potential for urinary difficulties in patients taking semaglutide and monitor them accordingly.
In clinical practice, the benefits of semaglutide in improving glycemic control and reducing cardiovascular risk often outweigh the potential risks, including the rare possibility of urinary difficulties. However, patients should be counseled about the potential for urinary symptoms and encouraged to report any changes in urinary function to their healthcare provider.
Key points to consider:
- Semaglutide may potentially cause urinary difficulties in some patients, although the evidence is limited.
- The mechanism by which semaglutide affects urinary function is not well understood.
- Patients with pre-existing urinary issues or those taking medications that affect urination may be at higher risk.
- Urinary difficulties should be reported to healthcare providers, and dosage adjustment or medication changes may be necessary.
- Semaglutide may have beneficial effects on kidney function in patients with type 2 diabetes and chronic kidney disease.
From the Research
Semaglutide and Urinary Difficulty
- There is no direct evidence in the provided studies that semaglutide causes urinary difficulty 2, 3, 4, 5, 6.
- The studies focus on the effects of semaglutide on kidney function, cardiovascular events, and weight loss in patients with type 2 diabetes and chronic kidney disease.
- Semaglutide has been shown to have kidney-protective effects and reduce the risk of major adverse cardiovascular events in patients with type 2 diabetes and chronic kidney disease 2, 3.
- The studies also report that semaglutide improves albuminuria and kidney function in people with overweight or obesity with or without type 2 diabetes 4.
- However, the studies do not mention urinary difficulty as a potential side effect of semaglutide.
- One study reports that semaglutide is generally well-tolerated, with mostly mild-to-moderate and transient gastrointestinal disturbances, and increases the risk of biliary disease (cholelithiasis) 5.
- Another study found that semaglutide appears to be tolerated by most individuals with chronic kidney disease (CKD) 4 or greater, despite associated gastrointestinal side effects, and leads to an improvement of glycemic control and insulin discontinuation in patients with type 2 diabetes mellitus 6.