The FLOW trial (Perkovic et al., NEJM 2024) established that once-weekly semaglutide significantly reduces the risk of clinically important kidney outcomes and cardiovascular death in adults with type 2 diabetes and chronic kidney disease (CKD) - the first GLP-1 receptor agonist to demonstrate dedicated renal-protection benefit at this scale. The trial was stopped early for efficacy because the benefit crossed pre-specified thresholds. The results have driven updates to kidney-disease treatment guidelines and expanded the cardiometabolic case for GLP-1 peptide therapy well beyond weight and glycemic control.