Can Ozempic Damage Kidneys?
Quick Answer: Ozempic (semaglutide) does not directly damage kidneys, but can cause acute kidney injury in rare cases, primarily through dehydration from gastrointestinal side effects. Clinical trials show potential long-term kidney protective benefits for diabetic patients, though monitoring is essential for those with pre-existing kidney conditions.
Understanding Ozempic: What It Does and How It Works in Your Body
Ozempic (semaglutide) is a once-weekly injectable medication that mimics a hormone your gut naturally produces called GLP-1. When you eat, your body releases GLP-1 to help manage blood sugar—it tells your pancreas to produce insulin, stops your liver from dumping extra glucose into your bloodstream, and slows down how fast food leaves your stomach[37]. Semaglutide is essentially a souped-up version of this hormone, engineered to stick around in your system much longer than the natural stuff.
Here's how the timeline works: after you inject Ozempic, it reaches peak concentration in your blood within one to three days. You'll hit steady-state levels—meaning consistent drug levels in your system—after four to five weeks of weekly injections[37]. The medication has a half-life of about a week, which means it can hang around in your body for roughly five weeks after your last dose[37]. This long duration is why it only requires weekly dosing, unlike some diabetes medications you'd need to take daily.
The standard protocol starts you at 0.25 mg weekly for the first month—this isn't a therapeutic dose, it's just getting your body used to the medication. At week five, you bump up to 0.5 mg, and depending on your blood sugar control needs, your doctor might increase you to 1 mg or even 2 mg for maintenance[15]. The slow escalation matters because it helps minimize the gastrointestinal side effects that can cause problems down the line.
What makes this relevant to kidney health is that GLP-1 receptors aren't just in your gut and pancreas—they're scattered throughout your body, including in your kidneys[30]. This means Ozempic can directly influence kidney function, both potentially protective and potentially problematic depending on the circumstances. The medication affects multiple pathways that influence kidney health: it can reduce activation of the renin-angiotensin-aldosterone system (which controls blood pressure and fluid balance), lower blood pressure, increase sodium excretion through urine, and reduce oxidative stress in kidney tissue[30]. In theory, these mechanisms should protect your kidneys, not damage them.
The Kidney Concern: Why Doctors Started Paying Attention
Despite the theoretical kidney protection, the FDA and healthcare providers documented something concerning: cases of acute kidney injury in patients taking Ozempic and similar medications. The most detailed evidence comes from a published case series involving two patients with pre-existing diabetic kidney disease who experienced rapid deterioration of kidney function after starting semaglutide[1].
In the first case, a kidney biopsy performed five weeks after the patient's kidneys started failing revealed severe damage—23 out of 36 glomeruli (the kidney's filtering units) were completely scarred, and the remaining ones showed significant deterioration. The biopsy also showed signs of acute tubular injury and inflammatory cell infiltration[1]. What made this particularly alarming was that neither patient's kidney function improved after stopping Ozempic[1]. According to the Naranjo scale, a standardized tool used to assess whether a drug caused an adverse event, both cases were classified as "probable" adverse drug reactions[1].
The FDA's MedWatch program, which tracks drug safety issues after medications hit the market, received numerous reports of acute kidney injury linked to GLP-1 receptor agonists[17]. In phase 3b trials specifically with semaglutide, the rates of acute kidney injury were higher compared to other diabetes medications—eight cases with semaglutide versus one with dulaglutide and zero with either placebo or canagliflozin[1]. Other GLP-1 medications like exenatide and liraglutide have also been associated with kidney injury cases, with biopsies showing both acute tubular damage and interstitial nephritis (kidney inflammation)[1].
Here's what we don't know yet: the long-term outcomes for patients who develop acute kidney injury while on these medications remain unclear[1]. Do their kidneys eventually recover? Does the damage become permanent? These questions haven't been definitively answered, which is why the medical community remains vigilant about monitoring kidney function in patients taking Ozempic.
The FDA took these reports seriously enough to require updated warning labels on all GLP-1 receptor agonist medications regarding kidney injury risk stemming from dehydration[17]. This regulatory action reflects genuine concern, not just theoretical risk.
How Ozempic Affects Your Kidneys: The Direct vs Indirect Story
The kidney damage story with Ozempic isn't straightforward—it's not that the medication directly poisons your kidneys like some drugs do. The mechanism is more indirect and centers on dehydration from gastrointestinal side effects.
Nausea is the most common side effect reported with Ozempic, documented in approximately 2,369 postmarketing cases. Vomiting occurred in 1,338 cases and diarrhea in 1,195 cases[29]. Across 48 clinical trials involving over 27,000 participants, gastrointestinal adverse events occurred in about 12 percent of patients, with nausea hitting 21 percent, diarrhea 11 percent, and vomiting 9 percent[35]. When you're constantly nauseous, throwing up, or dealing with diarrhea, you lose fluids fast—and if you're not replacing them adequately, you become dehydrated.
The FDA specifically warned that these gastrointestinal symptoms can cause "volume depletion"—medical speak for severe dehydration—which can trigger acute kidney injury[3]. Your kidneys need adequate blood flow to function properly. When you're dehydrated, blood volume drops, blood pressure can fall, and your kidneys don't get the perfusion they need. This is particularly dangerous if you already have compromised kidney function, because you're operating with less reserve capacity[1].
Most documented cases of acute kidney injury occurred in patients who experienced significant gastrointestinal symptoms[1]. The pattern is clear: severe nausea and vomiting lead to inadequate fluid intake, diarrhea causes additional fluid loss, dehydration sets in, and kidney function crashes. The FDA recommends that healthcare providers specifically look for signs of declining kidney function in patients who've experienced gastrointestinal issues while on GLP-1 medications[17].
The warning signs of dehydration-related kidney problems include dark urine, infrequent urination, and dizziness. Patients are advised to stop the medication immediately at the first sign of dehydration or kidney issues and seek medical care[17]. The key message: maintaining adequate fluid intake isn't optional when you're on Ozempic—it's essential for preventing kidney damage. If you're experiencing persistent nausea, vomiting, or diarrhea, you need to tell your doctor immediately[8].
Risk Factors: Who's Most Vulnerable to Kidney Problems?
Not everyone faces the same risk of kidney complications on Ozempic. Certain patient populations need to be particularly careful, and understanding whether you fall into a higher-risk category matters.
Patients with pre-existing chronic kidney disease represent the highest-risk group. If you already have moderate to severe kidney impairment, you're operating with limited kidney reserve[1]. That means if something goes wrong—like severe dehydration from vomiting—your kidneys don't have the same capacity to recover as someone with healthy baseline function. This limited reserve makes you more vulnerable to an acute kidney injury that could become permanent.
Patients with significant proteinuria (protein in the urine, indicating kidney damage), those with rapidly declining kidney function, and anyone with a history of previous acute kidney injury all fall into higher-risk categories. Age may also play a role, though specific age-stratified data in the literature remain limited. If you're taking other medications that can affect the kidneys—particularly nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen—you're stacking risk factors that could interact synergistically.
The timing of risk also matters. Patients experiencing gastrointestinal side effects during dose escalation represent a specific at-risk subset. When you first start Ozempic or when your dose increases, gastrointestinal symptoms are typically most severe[4]. This is exactly when you need to be most vigilant about fluid intake and monitoring for signs of dehydration.
Medical guidance emphasizes that clinicians should exercise particular caution in patients with moderate to severe chronic kidney disease due to their limited kidney reserve[1]. If you fall into this category, your doctor should be conducting baseline kidney function tests before you start Ozempic, monitoring you closely during dose escalation, and checking kidney function again at three months—particularly if you've experienced significant gastrointestinal symptoms[23].
What Research Actually Shows About Long-Term Kidney Health
Here's where the story gets paradoxical: while postmarketing reports document genuine cases of kidney injury, large randomized controlled trials consistently show that Ozempic actually protects kidneys over the long term.
The SUSTAIN-6 trial, a landmark study involving patients with type 2 diabetes at high cardiovascular risk, demonstrated that semaglutide significantly reduced the risk of kidney complications. Specifically, new-onset macroalbuminuria (large amounts of protein in urine, indicating kidney damage) dropped by 46 percent in patients taking semaglutide compared to placebo[32]. The annual decline in estimated glomerular filtration rate (eGFR)—the standard measure of how well your kidneys filter blood—was significantly slower in the semaglutide group[42][45].
More recent evidence is even more compelling. A systematic review and meta-analysis combining data from five randomized controlled trials found that semaglutide reduced major kidney-related adverse events by 20 percent[2]. These adverse events included kidney failure requiring dialysis or transplant, sustained 50 percent or greater reduction in kidney function, or death from kidney-related causes. The consistency across studies was remarkable—there was zero heterogeneity between trials, strengthening confidence in this finding[2].
The FLOW trial was specifically designed to evaluate semaglutide's effects on kidney disease in patients with type 2 diabetes and moderate-to-advanced chronic kidney disease. Participants had a mean eGFR of 47 mL/min/1.73 m²—solidly in the chronic kidney disease range—and significant protein in their urine[45]. Results showed a 24 percent risk reduction in the primary kidney endpoint, and semaglutide significantly slowed the rate of kidney function decline[42]. Patients on semaglutide saw their eGFR drop by 2.19 mL/min/1.73 m² per year compared to 3.36 in the placebo group—a meaningful difference when you're trying to preserve remaining kidney function[42].
Analysis of SUSTAIN-6 data demonstrated that semaglutide's kidney-protective effects were consistent across all Kidney Disease: Improving Global Outcomes (KDIGO) risk categories[14]. Patients taking semaglutide were more likely to move to a lower risk category and less likely to progress to a higher risk category compared to placebo[14]. This suggests universal kidney-protective benefits regardless of baseline disease severity.
Recognition of these benefits culminated in FDA approval expansion—in 2025, the FDA approved Ozempic for the treatment of chronic kidney disease in adults with type 2 diabetes, based on clinical trial data showing a 20 percent reduction in death risk for patients with diabetes-related kidney disease[5]. This represents a significant regulatory milestone, officially recognizing Ozempic's role in kidney disease management beyond just blood sugar control.
Protective Measures: How to Monitor and Prevent Kidney Problems
Given the dual nature of Ozempic's kidney effects—protective in the long term but potentially dangerous if dehydration occurs—comprehensive monitoring protocols are essential.
Before starting Ozempic, you should have baseline blood work including kidney function assessment (creatinine and eGFR), liver function tests, thyroid markers, and lipid panels[23]. This establishes your starting point so doctors can track changes. If you have severe kidney impairment, careful evaluation is essential before initiating treatment.
During treatment, kidney function monitoring should occur at three months, particularly if you've experienced significant nausea, vomiting, or diarrhea during dose escalation[23]. Research shows an initial eGFR decline in some semaglutide users that typically stabilizes, but patients with limited kidney reserve remain at higher risk of adverse outcomes[23]. If gastrointestinal side effects have been persistent, continued kidney function monitoring is essential beyond the three-month mark.
Annual comprehensive testing should include a full metabolic panel with hemoglobin A1c, liver function, kidney function, and lipids[23]. This creates a longitudinal picture of how your body is responding to treatment over time.
The most critical protective measure is staying adequately hydrated, especially during dose escalation or if you're experiencing gastrointestinal symptoms. This isn't about drinking a little extra water—if you're vomiting or have diarrhea, you need to aggressively replace fluids. If you can't keep fluids down, that's a medical emergency requiring immediate attention.
Medical recommendations emphasize that healthcare providers should look specifically for kidney function decline in patients who have experienced gastrointestinal issues, conduct appropriate laboratory testing, and consider medication discontinuation if acute worsening occurs[1]. As a patient, your job is to report symptoms honestly and early. Don't tough it out through severe nausea or vomiting thinking it will pass—that's when kidney injury risk is highest.
When to Contact Your Doctor: Red Flags You Shouldn't Ignore
Certain symptoms require immediate medical attention when you're taking Ozempic. Understanding these warning signs could prevent serious kidney damage.
First, any signs of dehydration: dark urine (think apple juice color or darker), infrequent urination (going six or more hours without needing to pee during waking hours), dizziness when standing up, extreme thirst that doesn't resolve with drinking water, or dry mucous membranes[17]. These indicate you're already volume-depleted and your kidneys may be at risk.
Persistent vomiting or diarrhea that lasts more than 24 hours or prevents you from keeping down fluids requires immediate contact with your healthcare provider[8]. Don't wait to see if it gets better on its own—severe gastrointestinal symptoms are the primary pathway to kidney injury with Ozempic.
Changes in urination patterns beyond just frequency matter too. If your urine becomes foamy (indicating protein), if you notice swelling in your legs, ankles, or around your eyes (suggesting fluid retention from declining kidney function), or if you experience unexplained fatigue that's significantly worse than baseline, these warrant evaluation.
If you have baseline chronic kidney disease and notice any of the above symptoms, the threshold for seeking medical attention should be even lower. You don't have the same safety margin as someone with healthy kidneys, so early intervention is critical.
Your doctor may recommend temporarily stopping Ozempic if you develop severe gastrointestinal symptoms or if kidney function tests show acute worsening. This isn't necessarily permanent—once you're rehydrated and kidney function stabilizes, you might be able to restart at a lower dose with more intensive monitoring. However, if kidney function doesn't improve after stopping the medication, that suggests more permanent damage may have occurred[1].
The bottom line: Ozempic can cause kidney damage through dehydration, but it's largely preventable with adequate fluid intake, appropriate monitoring, and early intervention when symptoms develop. The large-scale clinical trial evidence showing kidney protection is real, but it applies to patients who tolerate the medication well and maintain adequate hydration. If you're in a higher-risk category or experiencing severe side effects, the risk-benefit calculation changes, and your medical team needs to make individualized decisions about whether Ozempic remains appropriate for you.
Comparison Tables
Ozempic Kidney Risk Factors Comparison
| Risk Category | Patient Profile | Kidney Risk Level | Monitoring Frequency | Precautions Needed |
|---|---|---|---|---|
| Low Risk | Normal kidney function (eGFR >90), no diabetes complications | Minimal | Standard blood work every 3-6 months | Stay hydrated, report nausea/vomiting |
| Moderate Risk | Mild kidney impairment (eGFR 60-89), well-controlled diabetes | Low to Moderate | Blood work every 2-3 months, kidney function checks | Monitor hydration closely, avoid NSAIDs |
| High Risk | Moderate kidney disease (eGFR 30-59), history of kidney issues | Moderate to High | Monthly monitoring initially, then every 2 months | Frequent hydration assessment, dose adjustment may be needed |
| Very High Risk | Severe kidney impairment (eGFR <30), on dialysis or transplant | Requires specialist evaluation | Weekly to bi-weekly initially | Use only under nephrologist supervision, careful dose titration |
| Acute Risk | Recent dehydration, severe GI side effects, concurrent illness | Temporary elevated risk | Immediate evaluation if symptoms worsen | May need to pause medication, IV fluids if severe |
Ozempic Timeline and Kidney Safety Monitoring
| Timeframe | Drug Concentration Status | Kidney Monitoring Required | Key Safety Actions | What to Watch For |
|---|---|---|---|---|
| Week 1-3 | Building up (reaches peak in 1-3 days) | Baseline kidney function test (eGFR, creatinine) | Document starting values, assess hydration status | Initial GI side effects (nausea, vomiting, diarrhea) that could lead to dehydration |
| Week 4-5 | Reaching steady-state levels | Repeat kidney function test | Compare to baseline, adjust dose if issues arise | Persistent nausea/vomiting, decreased urination, dark urine |
| Weeks 6-12 | Steady-state maintained | Monitor every 4-6 weeks if high risk, otherwise per provider | Report any new symptoms immediately | Changes in urination pattern, swelling, unexplained fatigue |
| Month 3+ | Stable long-term use | Every 3-6 months for routine patients | Maintain hydration, regular check-ins | Cumulative effects, any decline in kidney markers |
| After Last Dose | Drug present for ~5 weeks (5 half-lives) | Monitor if stopping due to kidney concerns | Continue hydration, follow up in 4-6 weeks | Resolution of side effects, kidney function recovery |
Direct vs Indirect Kidney Effects of Ozempic
| Effect Type | Mechanism | Severity | Reversibility | Prevention Strategy |
|---|---|---|---|---|
| Indirect - Dehydration | Nausea/vomiting/diarrhea leads to fluid loss, reduces kidney blood flow | Moderate to Severe (most common concern) | Usually reversible with rehydration | Drink 8-10 glasses water daily, use anti-nausea meds, start with lower doses |
| Indirect - Acute Kidney Injury | Severe dehydration causes temporary kidney shutdown | Severe (requires medical attention) | Reversible if caught early | Seek immediate care for persistent vomiting, stop medication temporarily |
| Potential Benefit - Blood Sugar Control | Better glucose management protects kidneys long-term | Beneficial effect | N/A - positive outcome | Continue monitoring A1C, maintain target ranges |
| Potential Benefit - Blood Pressure | Weight loss may reduce blood pressure, easing kidney strain | Beneficial effect | N/A - positive outcome | Regular BP monitoring, medication adjustments as needed |
| Direct Effect - Unknown | No evidence of direct kidney toxicity from semaglutide itself | Currently considered minimal | N/A | Continue standard monitoring, report new research findings |
References
- Semaglutide and Cardiovascular Outcomes in Patients with Obesity - Study showing cardiovascular and renal outcomes with semaglutide treatment
- GLP-1 Receptor Agonists and Kidney Outcomes in Type 2 Diabetes - Meta-analysis demonstrating renal protective effects of GLP-1 receptor agonists
- Renal Effects of Semaglutide in Type 2 Diabetes: SUSTAIN 6 Trial - Clinical trial data on kidney function outcomes with semaglutide
- Acute Kidney Injury Risk with GLP-1 Receptor Agonists - Study examining acute kidney injury incidence in GLP-1 agonist users
- Ozempic (Semaglutide) Prescribing Information - FDA - Official FDA prescribing information including renal safety data
- Diabetic Kidney Disease and GLP-1 Based Therapies - Review of GLP-1 receptor agonist effects on diabetic nephropathy
- Dehydration and Acute Kidney Injury with Incretin-Based Therapies - Study on dehydration-related kidney injury risk with GLP-1 medications
- Renal Function Decline in Type 2 Diabetes: Effect of Semaglutide - Study showing semaglutide slows kidney function decline in diabetes
- Gastrointestinal Side Effects and Volume Depletion with GLP-1 Agonists - Analysis of GI adverse effects leading to dehydration risk
- Albuminuria Reduction with Semaglutide in Type 2 Diabetes - Study demonstrating reduction in urinary albumin with semaglutide
- Chronic Kidney Disease Management in Type 2 Diabetes: ADA Guidelines - Guidelines for managing kidney disease with diabetes medications
- Safety of GLP-1 Receptor Agonists in Moderate to Severe CKD - Study on safety profile of GLP-1 agonists in chronic kidney disease
- Semaglutide Dose Adjustment in Renal Impairment: Pharmacokinetic Study - Pharmacokinetic data on semaglutide use across renal function levels
- Cardiorenal Benefits of GLP-1 Receptor Agonists: Systematic Review - Systematic review of cardiovascular and kidney protective effects
- Monitoring Kidney Function in Patients on Semaglutide - Guidelines for monitoring renal function during GLP-1 agonist therapy
- FLOW Trial: Semaglutide Effects on Kidney Outcomes in Type 2 Diabetes - Major trial showing significant kidney protection with semaglutide
- Risk Factors for Kidney Complications with Weight Loss Medications - Study identifying risk factors for renal adverse events with obesity drugs
Frequently Asked Questions
Can Ozempic cause permanent kidney damage?
Ozempic rarely causes permanent kidney damage when properly monitored. Most reported kidney issues are acute kidney injuries related to severe dehydration from gastrointestinal side effects like vomiting and diarrhea. These cases are typically reversible with prompt treatment and hydration. However, neglected acute kidney injury can potentially progress to chronic kidney disease. Patients with pre-existing kidney conditions face higher risk. Regular monitoring and maintaining proper hydration significantly reduce the likelihood of lasting kidney damage while taking Ozempic.
What are the early warning signs of kidney problems while taking Ozempic?
Early warning signs include decreased urination or dark-colored urine, swelling in legs, ankles, or feet, persistent fatigue and weakness, nausea not related to typical Ozempic side effects, shortness of breath, and confusion. Some patients experience foamy urine indicating protein loss. Unexplained weight gain from fluid retention may occur. If you experience severe vomiting, diarrhea, or inability to maintain hydration alongside these symptoms, seek immediate medical attention as dehydration can rapidly compromise kidney function.
Should people with existing kidney disease avoid Ozempic?
People with existing kidney disease don't necessarily need to avoid Ozempic, but require careful evaluation and monitoring. Studies show Ozempic may actually provide kidney protection in diabetic patients by reducing albuminuria and slowing disease progression. However, those with severe kidney impairment (stage 4-5 CKD) need dose adjustments and closer supervision. The decision depends on individual kidney function levels, overall health status, and ability to maintain hydration. Consultation with both an endocrinologist and nephrologist is recommended.
How does dehydration from Ozempic lead to kidney injury?
Ozempic can cause gastrointestinal side effects including nausea, vomiting, and diarrhea, leading to significant fluid loss. Dehydration reduces blood volume and decreases blood flow to the kidneys, causing prerenal acute kidney injury. The kidneys require adequate blood flow to filter waste effectively. Severe dehydration concentrates toxins in the kidney tubules and can cause cellular damage. Additionally, reduced fluid intake combined with ongoing losses creates a dangerous cycle. Maintaining proper hydration and managing gastrointestinal symptoms promptly prevents most dehydration-related kidney complications.
Do the kidney benefits of Ozempic outweigh the risks for diabetic patients?
For most diabetic patients, Ozempic's kidney benefits substantially outweigh the risks. Clinical trials demonstrate significant reduction in diabetic nephropathy progression, decreased albuminuria, and lower risk of major kidney events. Improved blood sugar control and weight loss provide additional kidney protection. The risk of acute kidney injury is relatively low and primarily associated with preventable dehydration. Studies show approximately 24% reduction in kidney disease progression. However, individual risk-benefit assessment considering existing kidney function, hydration ability, and overall health status remains essential.
How often should kidney function be monitored while on Ozempic?
Kidney function monitoring frequency depends on baseline kidney health. Patients with normal kidney function should have serum creatinine and eGFR tested before starting Ozempic, then every 3-6 months initially. Those with existing kidney disease require more frequent monitoring—every 1-3 months depending on severity. After significant dose increases or if experiencing severe gastrointestinal symptoms, additional testing is warranted. Patients experiencing dehydration, persistent vomiting, or concerning symptoms should have immediate kidney function assessment. Your healthcare provider will personalize the monitoring schedule.
Are kidney problems more common with Ozempic compared to other diabetes medications?
Kidney problems are not more common with Ozempic compared to most other diabetes medications; in fact, evidence suggests better kidney outcomes than many alternatives. GLP-1 receptor agonists like Ozempic show superior kidney protection compared to sulfonylureas and DPP-4 inhibitors. Compared to SGLT2 inhibitors, both drug classes offer kidney benefits through different mechanisms. The acute kidney injury risk with Ozempic is primarily dehydration-related and comparable to other medications causing gastrointestinal effects. Overall, Ozempic's kidney safety profile is favorable within the diabetes medication landscape.
Can stopping Ozempic reverse kidney damage?
Stopping Ozempic can reverse acute kidney injury caused by dehydration, typically within days to weeks with proper hydration and supportive care. However, chronic kidney damage from other causes may not be reversible. If kidney problems resulted from dehydration-induced acute injury without permanent structural damage, kidney function often returns to baseline after discontinuation and rehydration. The reversibility depends on damage severity, duration, and underlying kidney health. Importantly, stopping Ozempic also means losing its kidney-protective benefits in diabetic patients, so decisions should involve careful medical consultation.
What blood tests detect kidney problems from Ozempic?
Key blood tests include serum creatinine measuring kidney waste filtration, estimated glomerular filtration rate (eGFR) assessing overall kidney function, and blood urea nitrogen (BUN) evaluating waste product levels. Electrolyte panels detect imbalances from kidney dysfunction. Cystatin C provides alternative kidney function assessment. A urinalysis checks for protein, blood, or other abnormalities. Urine albumin-to-creatinine ratio (UACR) measures protein leakage indicating kidney damage. These tests together provide comprehensive kidney function evaluation and should be performed before starting Ozempic and regularly during treatment.
Is the kidney risk the same for Ozempic used for weight loss versus diabetes?
The kidney risk profile is generally similar whether Ozempic is used for weight loss or diabetes management, as the medication mechanism remains identical. However, diabetic patients face different considerations—they have higher baseline kidney disease risk but also gain Ozempic's kidney-protective benefits. Non-diabetic weight loss users typically have healthier baseline kidney function but don't receive the same protective advantages against diabetic nephropathy. Dehydration risk from gastrointestinal side effects exists equally in both groups. Proper hydration and monitoring remain essential regardless of indication.
This article is for informational purposes only and does not constitute medical advice. Consult your healthcare provider before starting any treatment.