A Rare Case of Semaglutide-Associated Small Bowel Obstruction Complicated by Acute Kidney Injury Requiring Dialysis

Glucagon-like peptide-1 (GLP-1) receptor agonists are widely used in the treatment of diabetes mellitus and obesity. They have proven to be cardioprotective, neuroprotective, and renoprotective, and are now also being considered for drug addiction. There has been increasing demand for these medications over the last several years, with the most common side effects being nausea, vomiting, and constipation. Nausea and vomiting are known to improve over a period of time due to tachyphylaxis. We present the case of a 59-year-old Hispanic obese female on semaglutide for weight loss. Her medication dose was recently increased from 0.25 mg to 0. 5mg under her physician's supervision. She presented with nausea, vomiting, and abdominal pain, which was later diagnosed as small bowel obstruction (SBO) from severe ileus, and developed acute kidney injury (AKI) requiring hemodialysis for several weeks. This case was also complicated because of the past medical history of autoimmune disorder and granulomatosis polyangiitis, which required additional testing to rule out a possible autoimmune etiology of the current presentation. To our knowledge, this is a rare case of semaglutide-associated SBO and concomitant AKI requiring temporary dialysis, highlighting the adverse effects of GLP-1 receptor agonists and the need for further studies to help formulate best practice guidelines.