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By Venkatesh Ariyamuthu Transplant Nephrologist at UT Southwestern Medical Center
https://www.readbyqxmd.com/read/30418475/effect-of-linagliptin-vs-placebo-on-major-cardiovascular-events-in-adults-with-type-2-diabetes-and-high-cardiovascular-and-renal-risk-the-carmelina-randomized-clinical-trial
#1
Julio Rosenstock, Vlado Perkovic, Odd Erik Johansen, Mark E Cooper, Steven E Kahn, Nikolaus Marx, John H Alexander, Michael Pencina, Robert D Toto, Christoph Wanner, Bernard Zinman, Hans Juergen Woerle, David Baanstra, Egon Pfarr, Sven Schnaidt, Thomas Meinicke, Jyothis T George, Maximillian von Eynatten, Darren K McGuire
Importance: Type 2 diabetes is associated with increased cardiovascular (CV) risk. Prior trials have demonstrated CV safety of 3 dipeptidyl peptidase 4 (DPP-4) inhibitors but have included limited numbers of patients with high CV risk and chronic kidney disease. Objective: To evaluate the effect of linagliptin, a selective DPP-4 inhibitor, on CV outcomes and kidney outcomes in patients with type 2 diabetes at high risk of CV and kidney events. Design, Setting, and Participants: Randomized, placebo-controlled, multicenter noninferiority trial conducted from August 2013 to August 2016 at 605 clinic sites in 27 countries among adults with type 2 diabetes, hemoglobin A1c of 6...
November 9, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/30413250/update-on-chronic-kidney-disease-mineral-and-bone-disorder-in-cardiovascular-disease
#2
REVIEW
Joseph Lunyera, Julia J Scialla
Chronic kidney disease mineral and bone disorder (MBD) encompasses changes in mineral ion and vitamin D metabolism that are widespread in the setting of chronic kidney disease and end-stage renal disease. MBD components associate with cardiovascular disease in many epidemiologic studies. Through impacts on hypertension, activation of the renin-angiotensin-aldosterone system, vascular calcification, endothelial function, and cardiac remodeling and conduction, MBD may be a direct and targetable cause of cardiovascular disease...
November 2018: Seminars in Nephrology
https://www.readbyqxmd.com/read/27188921/diabetic-kidney-disease
#3
REVIEW
Merlin C Thomas, Michael Brownlee, Katalin Susztak, Kumar Sharma, Karin A M Jandeleit-Dahm, Sophia Zoungas, Peter Rossing, Per-Henrik Groop, Mark E Cooper
The kidney is arguably the most important target of microvascular damage in diabetes. A substantial proportion of individuals with diabetes will develop kidney disease owing to their disease and/or other co-morbidity, including hypertension and ageing-related nephron loss. The presence and severity of chronic kidney disease (CKD) identify individuals who are at increased risk of adverse health outcomes and premature mortality. Consequently, preventing and managing CKD in patients with diabetes is now a key aim of their overall management...
July 30, 2015: Nature Reviews. Disease Primers
https://www.readbyqxmd.com/read/29216336/managing-diabetic-kidney-disease
#4
Sagen Zac-Varghese, Peter Winocour
Introduction: Diabetes mellitus (DM) is the leading cause of chronic kidney disease (CKD). This review covers the pillars of care essential for the management of diabetic kidney disease (DKD) including (1) early diagnosis, (2) improved glycaemic control, (3) treatment of hypertension, (4) identification and treatment of associated metabolic bone disease and (5) identification and effective management of dyslipidaemia and additional cardiovascular risk factors. Sources of data: We searched PubMed for articles using search terms: diabetic nephropathy, diabetic kidney disease, diabetes and chronic kidney disease...
March 1, 2018: British Medical Bulletin
https://www.readbyqxmd.com/read/29798887/intensive-blood-pressure-targets-and-kidney-disease
#5
Tara I Chang, Mark J Sarnak
No abstract text is available yet for this article.
October 8, 2018: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29798889/incidence-and-progression-of-chronic-kidney-disease-in-black-and-white-individuals-with-type-2-diabetes
#6
Claire Gerber, Xuan Cai, Jungwha Lee, Timothy Craven, Julia Scialla, Nao Souma, Anand Srivastava, Rupal Mehta, Amanda Paluch, Alexander Hodakowski, Rebecca Frazier, Mercedes R Carnethon, Myles Selig Wolf, Tamara Isakova
BACKGROUND AND OBJECTIVES: Type 2 diabetes and associated CKD disproportionately affect blacks. It is uncertain if racial disparities in type 2 diabetes-associated CKD are driven by biologic factors that influence propensity to CKD or by differences in type 2 diabetes care. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We conducted a post hoc analysis of 1937 black and 6372 white participants of the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial to examine associations of black race with change in eGFR and risks of developing microalbuminuria, macroalbuminuria, incident CKD (eGFR<60 ml/min per 1...
June 7, 2018: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29792268/toward-individual-glomerular-phenotyping-advent-of-precision-medicine-in-kidney-biopsies
#7
COMMENT
Kumar Sharma, Ljiljana Paša-Tolić
The road to precision medicine for nephrology is approaching quickly. In the present volume, the glomerular proteome has now been characterized at a single glomerulus level in mouse and human kidneys. Using the Single-Pot Solid-Phase-enhanced Sample Preparation (SP3) approach the authors demonstrated that LAMP1 is a key lysosomal protein that is increased in glomerular diseases and may play a pathogenic role.
June 2018: Kidney International
https://www.readbyqxmd.com/read/29792269/pcsk9-inhibition-ready-for-prime-time-in-ckd
#8
COMMENT
Marion Mafham, Richard Haynes
Lowering LDL cholesterol reduces the risk of atherosclerotic vascular disease in a wide range of patients with chronic kidney disease, with no evidence of a threshold below which further reductions no longer reduce risk. Statins safely lower LDL cholesterol, but novel inhibitors of proprotein convertase subtilisin kexin 9 (PCSK9) provide additional reductions which may reduce atherosclerotic vascular disease yet further in this high risk population.
June 2018: Kidney International
https://www.readbyqxmd.com/read/29784612/risk-of-progression-of-nonalbuminuric-ckd-to-end-stage-kidney-disease-in-people-with-diabetes-the-cric-chronic-renal-insufficiency-cohort-study
#9
Digsu N Koye, Dianna J Magliano, Christopher M Reid, Christopher Jepson, Harold I Feldman, William H Herman, Jonathan E Shaw
BACKGROUND: Reduced glomerular filtration rate (GFR) in the absence of albuminuria is a common manifestation of chronic kidney disease (CKD) in diabetes. However, the frequency with which it progresses to end-stage kidney disease (ESKD) is unknown. STUDY DESIGN: Multicenter prospective cohort study. SETTING & PARTICIPANTS: We included 1,908 participants with diabetes and reduced GFR enrolled in the Chronic Renal Insufficiency Cohort (CRIC) Study in the United States...
May 18, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29762739/ckd-staging-with-cystatin-c-or-creatinine-based-formulas-flipping-the-coin
#10
Sergio Luis-Lima, Beatriz Escamilla-Cabrera, Natalia Negrín-Mena, Sara Estupiñán, Patricia Delgado-Mallén, Domingo Marrero-Miranda, Ana González-Rinne, Rosa Miquel-Rodríguez, María Ángeles Cobo-Caso, Manuel Hernández-Guerra, Juana Oramas, Norberto Batista, Ana Aldea-Perona, Pablo Jorge-Pérez, Carlos González-Alayón, Miguel Moreno-Sanfiel, Juan Antonio González-Rodríguez, Laura Henríquez, Raquel Alonso-Pescoso, Laura Díaz-Martín, Federico González-Rinne, Bernardo Alio Lavín-Gómez, Judith Galindo-Hernández, Macarena Sánchez-Gallego, Alejandra González-Delgado, Alejandro Jiménez-Sosa, Armando Torres, Esteban Porrini
Background: Chronic kidney disease (CKD) affects 10-13% of the population worldwide. CKD classification stratifies patients in five stages of risk for progressive renal disease based on estimated glomerular filtration rate (eGFR) by formulas and albuminuria. However, the reliability of formulas to reflect real renal function is a matter of debate. The effect of the error of formulas in the CKD classification is unclear, particularly for cystatin C-based equations. Methods: We evaluated the reliability of a large number of cystatin C and/or creatinine-based formulas in the definition of the stages of CKD in 882 subjects with different clinical situations over a wide range of glomerular filtration rates (GFRs) (4...
May 11, 2018: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29735306/renoprotective-effects-of-sodium-glucose-cotransporter-2-inhibitors
#11
REVIEW
Hiddo J L Heerspink, Mikhail Kosiborod, Silvio E Inzucchi, David Z I Cherney
Over the past two years, our understanding of anti-hyperglycemic medications used to treat patients with type 2 diabetes (T2D) has fundamentally changed. Before the EMPA-REG OUTCOME trial, agents used to lower blood glucose were felt to prevent or delay the development of microvascular complications, but were not known to definitively reduce cardiovascular risk or mortality. Previous studies with then novel sodium-glucose cotransport-2 (SGLT2) inhibitors demonstrated improvements in several cardiovascular and renal risk factors, including HbA1c, blood pressure, weight, renal hyperfiltration, and albuminuria...
July 2018: Kidney International
https://www.readbyqxmd.com/read/29735308/grazoprevir-plus-elbasvir-in-hcv-genotype-1-or-4-infected-patients-with-stage-4-5-severe-chronic-kidney-disease-is-safe-and-effective
#12
Laurent Alric, Isabelle Ollivier-Hourmand, Emilie Bérard, Sophie Hillaire, Maeva Guillaume, Anais Vallet-Pichard, Brigitte Bernard-Chabert, Veronique Loustaud-Ratti, Marc Bourlière, Victor de Ledinghen, Isabelle Fouchard-Hubert, Valerie Canva, Anne Minello, Eric Nguyen-Khac, Vincent Leroy, David Saadoun, Dominique Trias, Stanislas Pol, Nassim Kamar
Patients with advanced chronic kidney disease who receive direct-acting antiviral drugs require special consideration regarding comorbid conditions. Here we assessed the efficacy and safety of grazoprevir plus elbasvir in 93 patients infected with HCV genotype 1 or 4 and with advanced chronic kidney disease in a non-randomized, multicenter, nationwide observational survey. Twenty patients with HCV genotype 1a, 51 patients with 1b, four unclassified genotype 1, 17 with genotype 4 and one with genotype 6 received grazoprevir plus elbasvir (100/50 mg) once daily...
July 2018: Kidney International
https://www.readbyqxmd.com/read/29527974/cardiovascular-safety-of-febuxostat-or-allopurinol-in-patients-with-gout
#13
RANDOMIZED CONTROLLED TRIAL
William B White, Kenneth G Saag, Michael A Becker, Jeffrey S Borer, Philip B Gorelick, Andrew Whelton, Barbara Hunt, Majin Castillo, Lhanoo Gunawardhana
BACKGROUND: Cardiovascular risk is increased in patients with gout. We compared cardiovascular outcomes associated with febuxostat, a nonpurine xanthine oxidase inhibitor, with those associated with allopurinol, a purine base analogue xanthine oxidase inhibitor, in patients with gout and cardiovascular disease. METHODS: We conducted a multicenter, double-blind, noninferiority trial involving patients with gout and cardiovascular disease; patients were randomly assigned to receive febuxostat or allopurinol and were stratified according to kidney function...
March 29, 2018: New England Journal of Medicine
https://www.readbyqxmd.com/read/29486908/update-of-pathophysiology-and-management-of-diabetic-kidney-disease
#14
REVIEW
Yi-Chih Lin, Yu-Hsing Chang, Shao-Yu Yang, Kwan-Dun Wu, Tzong-Shinn Chu
Diabetic kidney disease (DKD) is a major cause of morbidity and mortality in patients with diabetes mellitus and the leading cause of end-stage renal disease in the world. The most characteristic marker of DKD is albuminuria, which is associated with renal disease progression and cardiovascular events. Renal hemodynamics changes, oxidative stress, inflammation, hypoxia and overactive renin-angiotensin-aldosterone system (RAAS) are involved in the pathogenesis of DKD, and renal fibrosis plays the key role. Intensified multifactorial interventions, including RAAS blockades, blood pressure and glucose control, and quitting smoking, help to prevent DKD development and progression...
August 2018: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/29478869/management-of-traditional-cardiovascular-risk-factors-in-ckd-what-are-the-data
#15
REVIEW
L Parker Gregg, S Susan Hedayati
Patients with non-dialysis-dependent chronic kidney disease (NDD-CKD) are 10 times more likely to die of cardiovascular (CV) diseases than the general population, and dialysis-dependent patients are at even higher risk. Although traditional CV risk factors are highly prevalent in individuals with CKD, these patients were often excluded from studies targeting modification of these risks. Although treatment of hypertension is beneficial in CKD, the best target blood pressure has not been established. Trial data showed that renin-angiotensin-aldosterone blockade may prevent CV events in patients with CKD...
November 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29487093/management-of-osteoporosis-in-ckd
#16
REVIEW
Pascale Khairallah, Thomas L Nickolas
CKD mineral and bone disease is a common complication of kidney disease, and it affects the majority of patients with moderate to severe CKD. Recently, prospective studies have shown that measurement of bone mineral density by dual energy x-ray absorptiometry predicts incident fracture, providing nephrologists the ability to risk classify patients for skeletal fragility and targeted antifracture strategies for the first time. Furthermore, an expanding body of literature and anecdotal evidence suggest that pharmacologic agents used to treat osteoporosis in the general population can be safely used in patients with CKD...
June 7, 2018: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29478868/management-of-heart-failure-in-advancing-ckd-core-curriculum-2018
#17
Andrew A House
Heart failure and chronic kidney disease have increasing incidence and prevalence owing in part to the aging population and increasing rates of hypertension, diabetes, and other cardiovascular and kidney disease risk factors. The presence of one condition also has a strong influence on the other, leading to greater risks for hospitalization, morbidity, and death, as well as very high health care costs. Despite the frequent coexistence of heart failure and chronic kidney disease, many of the pivotal randomized trials that guide the management of heart failure have excluded patients with more advanced stages of chronic kidney disease...
August 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29406201/proton-pump-inhibitors-review-of-emerging-concerns
#18
REVIEW
Avinash K Nehra, Jeffrey A Alexander, Conor G Loftus, Vandana Nehra
First introduced in 1989, proton pump inhibitors (PPIs) are among the most widely utilized medications worldwide, both in the ambulatory and inpatient clinical settings. The PPIs are currently approved by the US Food and Drug Administration for the management of a variety of gastrointestinal disorders including symptomatic peptic ulcer disease, gastroesophageal reflux disease, and nonulcer dyspepsia as well as for prevention of gastrointestinal bleeding in patients receiving antiplatelet therapy. PPIs inhibit gastric acid secretion, and the most commonly associated adverse effects include abdominal pain, diarrhea, and headache...
February 2018: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/29459980/diagnosis-evaluation-prevention-and-treatment-of-chronic-kidney-disease-mineral-and-bone-disorder-synopsis-of-the-kidney-disease-improving-global-outcomes-2017-clinical-practice-guideline-update
#19
Markus Ketteler, Geoffrey A Block, Pieter Evenepoel, Masafumi Fukagawa, Charles A Herzog, Linda McCann, Sharon M Moe, Rukshana Shroff, Marcello A Tonelli, Nigel D Toussaint, Marc G Vervloet, Mary B Leonard
Description: The Kidney Disease: Improving Global Outcomes (KDIGO) 2017 Clinical Practice Guideline Update for the Diagnosis, Evaluation, Prevention, and Treatment of Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD) is a selective update of the prior CKD-MBD guideline published in 2009. The guideline update and the original publication are intended to assist practitioners caring for adults with CKD and those receiving long-term dialysis. Methods: Development of the guideline update followed an explicit process of evidence review and appraisal...
March 20, 2018: Annals of Internal Medicine
https://www.readbyqxmd.com/read/29222373/2-classification-and-diagnosis-of-diabetes-standards-of-medical-care-in-diabetes-2018
#20
REVIEW
(no author information available yet)
The American Diabetes Association (ADA) "Standards of Medical Care in Diabetes" includes ADA's current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, a multidisciplinary expert committee, are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA's clinical practice recommendations, please refer to the Standards of Care Introduction Readers who wish to comment on the Standards of Care are invited to do so at professional...
January 2018: Diabetes Care
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