No dose adjustment of Victoza is recommended for patients with renal impairment. In the Victoza arm of the LEADER trial, no overall differences in safety or efficiency were seen in patients with mild, moderate, or severe renal function compared to those with normal renal function. There is limited experience with Victoza in patients with end-stage renal disease. There have been postmarketing reports if acute renal failure and worsening of chronic renal failure, which may sometimes require hemodialysis. Use caution when initiating or escalating doses of Victoza in patients with renal impairment.