Obesity is one of the biggest barriers preventing patients with end-stage kidney disease from receiving a life-saving kidney transplant. New research from Saint Louis University School of Medicine and SSM Health physicians reveals that breakthrough weight loss medications could change that—giving more patients a second chance at life.

The study, published in Clinical Transplantation, is among the largest to examine Semaglutide—the active ingredient in popular drugs like Ozempic and Wegovy—in dialysis patients. These individuals are often excluded from transplant waitlists because a high body mass index (BMI) increases surgical risks and impacts outcomes after transplantation.

Key findings:

• Patients lost an average of 20.5 pounds after one year of treatment with Semaglutide.
• Nearly half (48.3%) of those previously ineligible for transplant were activated on the waitlist.
• More than one-third of insulin-dependent patients discontinued insulin therapy entirely.

“Obesity is such a major obstacle in the transplant world,” said lead author Francis G. Wade, M.D., assistant professor of internal medicine at SLU and obesity medicine specialist at SSM Health Saint Louis University Hospital.

“Patients can be otherwise perfect candidates, but if their BMI is too high, they’re often not even considered. These results show that new medical therapies can help bridge that gap.”

The findings come amid a skyrocketing interest in GLP-1 medications, such as Ozempic and Wegovy. While their effectiveness for weight loss in the general population is well documented, this study highlights their potential in a group often overlooked: dialysis patients seeking kidney transplants.

“These results are very encouraging,” said study author Krista Lentine, M.D., Ph.D., associate division director of nephrology at SLU and medical director of living donation at SSM Health Saint Louis University Hospital. “Semaglutide provides a promising, non-surgical option to support weight reduction and help more patients become eligible for transplant.”

The study also found that Semaglutide was generally well-tolerated, with gastrointestinal symptoms being the most common side effect. About 16.7% of patients discontinued treatment due to side effects, and those on peritoneal dialysis were slightly more likely to experience GI issues than those on hemodialysis.

Beyond medication, the research underscores the importance of multidisciplinary care. Patients at SSM Health Saint Louis University Hospital’s Comprehensive Metabolic Center receive integrated support, including nutrition counseling, exercise guidance, and regular follow-up, in addition to their medication.

“As we enter a new era of highly effective weight loss medications, I think we’re going to see a real transformation in transplant medicine,” Wade said. “We’re giving patients options they simply didn’t have before.”