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Trial, esrd, gfr and diabetes

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https://www.readbyqxmd.com/read/28599901/esrd-after-heart-failure-myocardial-infarction-or-stroke-in-type%C3%A2-2-diabetic-patients-with-ckd
#1
David M Charytan, Scott D Solomon, Peter Ivanovich, Giuseppe Remuzzi, Mark E Cooper, Janet B McGill, Hans-Henrik Parving, Patrick Parfrey, Ajay K Singh, Emmanuel A Burdmann, Andrew S Levey, Dick de Zeeuw, Kai-Uwe Eckardt, John J V McMurray, Brian Claggett, Eldrin F Lewis, Marc A Pfeffer
BACKGROUND: How cardiovascular (CV) events affect progression to end-stage renal disease (ESRD), particularly in the setting of type 2 diabetes, remains uncertain. STUDY DESIGN: Observational study. SETTING & PARTICIPANTS: 4,022 patients with type 2 diabetes, anemia, and chronic kidney disease from the Trial to Reduce Cardiovascular Events With Aranesp Therapy (TREAT). PREDICTOR: Postrandomization CV events. OUTCOMES: ESRD (defined as initiation of dialysis for >30 days, kidney transplantation, or refusal or nonavailability of renal replacement therapy) and post-ESRD mortality within 30 days and during overall follow-up after an intercurrent CV event...
June 6, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28577742/dual-renin-angiotensin-system-blockade-for-nephroprotection
#2
Piero Ruggenenti
In experimental diabetic and nondiabetic chronic kidney disease, angiotensin-converting enzyme (ACE) inhibitor and angiotensin receptor blockers (ARB) combination therapy reduce proteinuria and prevent structural lesions more effectively than either drug alone. Consistently, in humans, a multidrug individually tailored antiproteinuric treatment based on combination therapy with maximum tolerated doses of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers ("Remission Clinic") reduced proteinuria and prevented end-stage renal disease more effectively than angiotensin-converting enzyme/angiotensin receptor blockers monotherapy, in particular in subjects with nondiabetic chronic kidney disease...
April 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/28522654/diabetic-kidney-disease-challenges-progress-and-possibilities
#3
Radica Z Alicic, Michele T Rooney, Katherine R Tuttle
Diabetic kidney disease develops in approximately 40% of patients who are diabetic and is the leading cause of CKD worldwide. Although ESRD may be the most recognizable consequence of diabetic kidney disease, the majority of patients actually die from cardiovascular diseases and infections before needing kidney replacement therapy. The natural history of diabetic kidney disease includes glomerular hyperfiltration, progressive albuminuria, declining GFR, and ultimately, ESRD. Metabolic changes associated with diabetes lead to glomerular hypertrophy, glomerulosclerosis, and tubulointerstitial inflammation and fibrosis...
May 18, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28449320/a-randomised-double-blind-trial-of-the-safety-and-efficacy-of-omarigliptin-a-once-weekly-dpp-4-inhibitor-in-subjects-with-type-2-diabetes-and-renal-impairment
#4
Antonio Chacra, Ira Gantz, Geraldine Mendizabal, Lucila Durlach, Edward A O'Neill, Zachary Zimmer, Shailaja Suryawanshi, Samuel S Engel, Eseng Lai
AIMS: To assess the safety and efficacy of omarigliptin in subjects with type 2 diabetes mellitus (T2DM) and chronic renal impairment (RI). METHODS: Patients with T2DM with moderate RI (estimated glomerular filtration rate [eGFR] ≥30 to <60 mL/min/1.73 m(2) ) (N=114), severe RI (eGFR <30 mL/min/1.73 m(2) ) (N=55) or end-stage renal disease on dialysis (N=44), who were either not on an antihyperglycaemic agent therapy for at least 12 weeks at screening, washed-off of oral antihyperglycaemic agent monotherapy or low-dose dual combination therapy, or on insulin monotherapy, with baseline glycated haemoglobin (HbA1c) of 6...
April 27, 2017: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/28396115/improved-clinical-trial-enrollment-criterion-to%C3%A2-identify-patients-with-diabetes-at-risk-of-end-stage-renal-disease
#5
Masayuki Yamanouchi, Jan Skupien, Monika A Niewczas, Adam M Smiles, Alessandro Doria, Robert C Stanton, Andrzej T Galecki, Kevin L Duffin, Nick Pullen, Matthew D Breyer, Joseph V Bonventre, James H Warram, Andrzej S Krolewski
Design of Phase III trials for diabetic nephropathy currently requires patients at a high risk of progression defined as within three years of a hard end point (end-stage renal disease, 40% loss of estimated glomerular filtration rate, or death). To improve the design of these trials, we used natural history data from the Joslin Kidney Studies of chronic kidney disease in patients with diabetes to develop an improved criterion to identify such patients. This included a training cohort of 279 patients with type 1 diabetes and 134 end points within three years, and a validation cohort of 221 patients with type 2 diabetes and 88 end points...
July 2017: Kidney International
https://www.readbyqxmd.com/read/28288249/association-of-intensive-blood-pressure-control-and-kidney-disease-progression-in-nondiabetic-patients-with-chronic-kidney-disease-a-systematic-review-and-meta-analysis
#6
Wan-Chuan Tsai, Hon-Yen Wu, Yu-Sen Peng, Ju-Yeh Yang, Hung-Yuan Chen, Yen-Ling Chiu, Shih-Ping Hsu, Mei-Ju Ko, Mei-Fen Pai, Yu-Kang Tu, Kuan-Yu Hung, Kuo-Liong Chien
Importance: The optimal blood pressure (BP) target remains debated in nondiabetic patients with chronic kidney disease (CKD). Objective: To compare intensive BP control (<130/80 mm Hg) with standard BP control (<140/90 mm Hg) on major renal outcomes in patients with CKD without diabetes. Data Sources: Searches of PubMed, MEDLINE, Embase, and Cochrane Library for publications up to March 24, 2016. Study Selection: Randomized clinical trials that compared an intensive vs a standard BP target in nondiabetic adults with CKD, reporting changes in glomerular filtration rate (GFR), doubling of serum creatinine level, 50% reduction in GFR, end-stage renal disease (ESRD), or all-cause mortality...
June 1, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28202222/early-initiation-of-immunosuppressive-treatment-in-membranous-nephropathy-patients
#7
Chieh Kai Chan, Tai Shuan Lai, Ping Min Chen, Yu Hsiang Chou, Ching Fang Wu, Yen Ling Chiu, Wen Chih Chiang, Yung Ming Chen, Tzong-Shinn Chu, Kwan Dun Wu
BACKGROUND: Suggestion for the management of idiopathic membranous nephropathy (IMN) includes 6 months of observation, followed with steroid plus alkylating agent. However, delayed immunosuppression exposes the kidneys to persistent damage. This study aimed to examine the benefit of early immunosuppression in IMN patients. METHOD: A retrospective study was performed. From 1993 to 2013, 161 IMN patients were enrolled. Patients receiving immunosuppression within 6 months after diagnosis were classified as initial-treatment group, whereas other patients as initial-no-treatment group...
February 12, 2017: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/28120497/rationale-design-and-baseline-characteristics-of-the-canagliflozin-cardiovascular-assessment-study-renal-canvas-r-a-randomized-placebo-controlled-trial
#8
Bruce Neal, Vlado Perkovic, David R Matthews, Kenneth W Mahaffey, Greg Fulcher, Gary Meininger, Ngozi Erondu, Mehul Desai, Wayne Shaw, Frank Vercruysse, Jacqueline Yee, Hsiaowei Deng, Dick de Zeeuw
AIMS: The primary aim of the CANagliflozin cardioVascular Assessment Study-Renal (CANVAS-R) is to determine whether the favourable effects of inhibition of the sodium glucose co-transporter 2 (SGLT2) on blood glucose, blood pressure and body weight are accompanied by protection against adverse renal outcomes. MATERIALS AND METHODS: CANVAS-R is a prospective, randomized, double-blind, placebo-controlled trial in patients with type 2 diabetes with a history or high risk of cardiovascular events...
March 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28093841/effect-of-valsartan-on-kidney-outcomes-in-people-with-impaired-glucose-tolerance
#9
Gemma Currie, M Angelyn Bethel, Björn Holzhauer, Steven M Haffner, Rury R Holman, John J V McMurray
AIMS: To examine the effect of valsartan on kidney outcomes in patients with impaired glucose tolerance (IGT). METHODS: In a double-blind randomized trial, 9306 patients with IGT were assigned to valsartan (160 mg daily) or placebo. The co-primary endpoints were the development of diabetes and two composite cardiovascular outcomes. Prespecified renal endpoints included: the composite of renal death, end-stage renal disease (ESRD) or doubling of serum creatinine; estimated glomerular filtration rate (eGFR) ≤30 mL/min/1...
June 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/27753805/ssa-02-4-disparities-in-hypertension-management-of-ckd-in-south-asia
#10
Tazeen Jafar
Chronic kidney disease (CKD) defined as reduced estimated glomerular filtration rate (eGFR) or presence of albuminuria, progresses to end stage renal disease (ESRD), needing dialysis or kidney transplant to sustain life, and is associated with increased risks of premature cardiovascular disease (CVD) and mortality. CKD ranked 18 leading (and most rapidly rising cause of mortality by the Global Burden of Disease Study 2010. The social and economic consequences of CKD are far worse in low and middle income countries (LMICs) including India, Pakistan, Bangladesh, and Sri Lanka...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27642932/ssa-02-4-disparities-in-hypertension-management-of-ckd-in-south-asia
#11
Tazeen Jafar
Chronic kidney disease (CKD) defined as reduced estimated glomerular filtration rate (eGFR) or presence of albuminuria, progresses to end stage renal disease (ESRD), needing dialysis or kidney transplant to sustain life, and is associated with increased risks of premature cardiovascular disease (CVD) and mortality. CKD ranked 18 leading (and most rapidly rising cause of mortality by the Global Burden of Disease Study 2010. The social and economic consequences of CKD are far worse in low and middle income countries (LMICs) including India, Pakistan, Bangladesh, and Sri Lanka...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27532796/multidisciplinary-management-of-diabetic-kidney-disease-a-systematic-review-and-meta-analysis
#12
Nancy Helou, Andrew Dwyer, Maya Shaha, Anne Zanchi
BACKGROUND: The increasing prevalence of diabetes poses significant challenges to healthcare systems around the world. Diabetes is the leading cause of end-stage renal disease. Diabetic kidney disease (DKD) is becoming a global health concern because it is a progressive disease associated with major health complications and increased health costs. The treatment goals for DKD are to slow the progression of the renal disease and prevent cardiovascular events. Accordingly, patients are expected to adhere to prescribed treatments and manage a wide range of daily self-care activities...
July 2016: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/27528374/safety-and-efficacy-of-incretin-based-therapies-in-patients-with%C3%A2-type-2-diabetes-mellitus-and-ckd-a-systematic-review%C3%A2-and-meta-analysis
#13
REVIEW
Patricia M Howse, Lyudmila N Chibrikova, Laurie K Twells, Brendan J Barrett, John-Michael Gamble
BACKGROUND: The pharmacokinetics and pharmacodynamics of antidiabetic therapies for patients with type 2 diabetes are often altered in the context of chronic kidney disease (CKD). STUDY DESIGN: Systematic review and meta-analysis. SETTING & POPULATION: Patients with type 2 diabetes and CKD. SELECTION CRITERIA FOR STUDIES: 2 reviewers independently screened studies identified through bibliographic databases (Cochrane Library, PubMed, Embase, International Pharmaceutical Abstracts), clinical trial registries, and references from pertinent articles and clinical practice guidelines...
November 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/27492324/modulation-of-endogenous-antioxidant-defense-and-the-progression-of-kidney-disease-in-multi-heritage-groups-of-patients-with-type-2-diabetes-prospective-evaluation-of-early-nephropathy-and-its-treatment-prevent
#14
Kenneth A Earle, Karima Zitouni, John Pepe, Maria Karaflou, James Godbold
BACKGROUND: Diabetes is the western world's leading cause of end-stage renal disease. Glucose-dependent, oxidative stress is linked to the development of renal inflammation and sclerosis, which, in animal models of diabetes, can be prevented by anti-oxidative treatment. Patients of non-Caucasian heritage have low activity of the selenoprotein, antioxidant enzyme, glutathione peroxidase (GPx) and its co-factor vitamin E, which may be linked to their increased propensity to developing end-stage renal disease...
2016: Journal of Translational Medicine
https://www.readbyqxmd.com/read/27440829/sglt2-inhibitors-and-the-diabetic-kidney
#15
Paola Fioretto, Alberto Zambon, Marco Rossato, Luca Busetto, Roberto Vettor
Diabetic nephropathy (DN) is the most common cause of end-stage renal disease worldwide. Blood glucose and blood pressure control reduce the risk of developing this complication; however, once DN is established, it is only possible to slow progression. Sodium-glucose cotransporter 2 (SGLT2) inhibitors, the most recent glucose-lowering oral agents, may have the potential to exert nephroprotection not only through improving glycemic control but also through glucose-independent effects, such as blood pressure-lowering and direct renal effects...
August 2016: Diabetes Care
https://www.readbyqxmd.com/read/27423055/effect-of-moderately-intense-perioperative-glucose-control-on-renal-allograft-function-a-pilot-randomized-controlled-trial-in-renal-transplantation
#16
Justin Parekh, Garrett R Roll, Steven Wisel, Robert J Rushakoff, Ryutaro Hirose
Recipient diabetes accounts for ~34% of end stage renal disease in patients awaiting renal transplantation and has been linked to poor graft function. We conducted a single center, open label, randomized controlled trial to determine if moderately intense glucose control during allograft reperfusion would reduce the incidence of poor graft function. Adult diabetics undergoing deceased donor renal transplant were randomized to moderately intense glucose control (n=30) or standard control (n=30). The primary outcome was poor graft function (dialysis within seven days of transplant or failure of serum creatinine to fall by 10% for three consecutive days)...
July 16, 2016: Clinical Transplantation
https://www.readbyqxmd.com/read/27421689/impact-of-bariatric-surgery-on-renal-functions-in-patients-with-type-2-diabetes-systematic-review-of-randomized-trials-and-observational-studies
#17
Xu Zhou, Ling Li, Joey S W Kwong, Jiajie Yu, Youping Li, Xin Sun
BACKGROUND: The impact of bariatric surgery on renal functions in patients with type 2 diabetes (T2D) remains uncertain. OBJECTIVES: To assess the impact of bariatric surgery on renal functions in patients with T2D. SETTING: Systemic review and meta-analysis of randomized trials and observational studies. METHODS: We searched PubMed, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL) from inception to April 3, 2016...
December 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/27337598/individualized-prediction-of-the-effect-of-angiotensin-receptor-blockade-on-renal-and-cardiovascular-outcomes-in-patients-with-diabetic-nephropathy
#18
N G C van der Sande, J A N Dorresteijn, F L J Visseren, J P Dwyer, P J Blankestijn, Y van der Graaf, H L J Heerspink
AIMS: To predict individualized treatment effects of angiotensin receptor blockers (ARBs) on cardiovascular and renal complications in order to help clinicians and patients assess the benefit of treatment (or adherence) and estimate remaining disease risk. MATERIALS AND METHODS: In patients with diabetic nephropathy, the 3-year treatment effect of ARBs was predicted in terms of absolute risk reduction (ARR) for end-stage renal disease (ESRD) and cardiovascular disease (CVD; i...
June 23, 2016: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/27216240/chinese-herbal-medicine-tangshen-formula-treatment-of-patients-with-type-2-diabetic-kidney-disease-with-macroalbuminuria-study-protocol-for-a-randomized-controlled-trial
#19
Meihua Yan, Yumin Wen, Liping Yang, Xi'ai Wu, Xiaoguang Lu, Bingxuan Zhang, Weiping Huang, Ping Li
BACKGROUND: Diabetic kidney disease (DKD) is one of the most common microvascular complications of diabetes mellitus and the main cause of end-stage renal disease. Present medications for DKD are not entirely satisfactory. Preliminary studies indicate that the Chinese herbal formula Tangshen Formula (TSF) appears to decrease the proteinuria and improve the estimated glomerular filtration rate (eGFR) in DKD patients. METHODS/DESIGN: This trial is a five-center, randomized, double-blind, placebo-controlled study...
2016: Trials
https://www.readbyqxmd.com/read/27108247/coronary-artery-disease-is-a-predictor-of-progression-to-dialysis-in-patients-with-chronic-kidney-disease-type-2-diabetes-mellitus-and-anemia-%C3%A2-an-analysis-of-the-trial-to-reduce-cardiovascular-events-with-aranesp-therapy-treat
#20
Marwa A Sabe, Brian Claggett, Emmanuel A Burdmann, Akshay S Desai, Peter Ivanovich, Reshma Kewalramani, Eldrin F Lewis, John J V McMurray, Kurt A Olson, Patrick Parfrey, Scott D Solomon, Marc A Pfeffer
BACKGROUND: Although clear evidence shows that chronic kidney disease is a predictor of cardiovascular events, death, and accelerated coronary artery disease (CAD) progression, it remains unknown whether CAD is a predictor of progression of chronic kidney disease to end-stage renal disease. We sought to assess whether CAD adds prognostic information to established predictors of progression to dialysis in patients with chronic kidney disease, diabetes, and anemia. METHODS AND RESULTS: Using the previously described Trial to Reduce Cardiovascular Events With Aranesp Therapy (TREAT) population, we compared baseline characteristics of patients with and without CAD...
April 23, 2016: Journal of the American Heart Association
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