HealthRX.com · Printable medication review sheet
Ozempic with chronic kidney disease: dose step, kidney results and sick-day record
Bring this to kidney or diabetes visits: your current Ozempic step, the kidney results to trend, the medicines that matter when fluids run low, and the plan you agree for days you cannot keep fluids down.
Where you are now
Ozempic dose (mg) and the date you started it
Next planned dose step, if any
Latest eGFR and urine albumin-to-creatinine ratiowith the date of each
Dialysis?no / hemodialysis / peritoneal; usual days
Kidney transplant medicines, if any
Medicines to name at every kidney visit
- ACE inhibitor or ARB blood pressure medicine
- SGLT2 inhibitor (empagliflozin, dapagliflozin, canagliflozin)
- Water pill (diuretic)
- Metformin
- Insulin or a sulfonylurea
- Warfarin or another blood thinner
- Tacrolimus or another transplant medicine
- Phosphate binder or iron tablets
Kidney results by date
Copy numbers from the lab report and note the Ozempic dose you were on that week.
| Date | Ozempic dose that week | Creatinine | eGFR | Urine albumin-to-creatinine ratio | Potassium | Vomiting or diarrhea that week? |
|---|---|---|---|---|---|---|
What the Ozempic label and FLOW say about kidneys
- No Ozempic dose adjustment is recommended for kidney impairment, and no clinically relevant change in semaglutide levels was seen, including in kidney failure.[1]
- For type 2 diabetes with chronic kidney disease, the label's maintenance dose is 1 mg once weekly, reached after at least 4 weeks on 0.5 mg.[1]
- Acute kidney injury, sometimes needing dialysis, has been reported; the label asks for kidney checks when side effects could cause fluid loss, especially while starting or increasing the dose.[1]
- In FLOW, eGFR fell more slowly with semaglutide, by 1.16 mL/min/1.73 m² per year compared with placebo.[2]
- The label notes that the benefit on FLOW's main kidney outcome was not evident in people already taking an SGLT2 inhibitor, though there were few events in that group.[1]
Call your care team the same day
- Nausea, vomiting or diarrhea that does not go away: losing fluids can cause kidney problems.[1]
Sick-day plan you agree
Fill this in with your prescriber; the label does not set a sick-day rule.
When to pause Ozempic, and who to call
Which other medicines to pause on sick days
How much fluid to aim for, and when to seek care
When to recheck creatinine after the next dose change
Questions for the visit
- Am I meant to reach the 1 mg dose for kidney protection, or stay where I am?
- Which kidney results should we trend, and how often while my dose is changing?
- Do any of my blood pressure or water pills need review if I start vomiting or have diarrhea?
- If I am on dialysis, does it matter which day I inject?
- If I take a transplant medicine, should its blood level be checked after starting Ozempic?
Sources for the facts on this sheet
- Novo Nordisk, via DailyMed. Ozempic (semaglutide) injection, for subcutaneous use: prescribing information and Medication Guide. Effective 2026-06-01. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=adec4fd2-6858-4c99-91d4-531f5f2a2d79
- Perkovic V, Tuttle KR, Rossing P, Mahaffey KW, Mann JFE, Bakris G, et al. Effects of Semaglutide on Chronic Kidney Disease in Patients with Type 2 Diabetes. N Engl J Med 2024. PMID 38785209. https://pubmed.ncbi.nlm.nih.gov/38785209/
This sheet records information for a conversation with your prescriber or pharmacist. It does not replace their instructions or the medication's prescribing information.