Common diabetes drug found safe for most diabetics with kidney disease

(Johns Hopkins Medicine) Results of a large-scale study suggest that the oral diabetes drug metformin is safe for most diabetics who also have chronic kidney disease (CKD). The study of more than 150,000 adults by Johns Hopkins Medicine investigators found that metformin's association with the development of a life-threatening condition called lactic acidosis was seen only among patients with severely decreased kidney function.
Source: EurekAlert! - Medicine and Health - Category: International Medicine & Public Health Source Type: news

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AbstractBackgroundFructose intake may lead to hyperuricaemia, which is associated with increased risk and progression of kidney disease. We aimed to explore the acute effects of fructose loading from different sources, with and without a pizza, on levels of serum uric acid in patients with chronic kidney disease (CKD), type 2 diabetes (T2D) without CKD, and in healthy subjects (HS).MethodsThe study included six HS, and three CKD stage 4 ‐5 and seven T2D patients. Drinks consumed were blueberry drink (17.5 g fructose), Coca‐Cola (18 g fructose) and fructose drink (35 g fructose). The drinks were also comb...
Source: European Journal of Clinical Investigation - Category: General Medicine Authors: Tags: ORIGINAL ARTICLE Source Type: research
Authors: Klug E, Raal FJ, Marais AD, Smuts CM, Schamroth C, Jankelow D, Blom DJ, Webb DA Abstract South Africa (SA) is home to a heterogeneous population with a wide range of cardiovascular risk factors. Cholesterol reduction in combination with aggressive management of modifiable risk factors, including nutrition, physical activity, blood pressure and smoking, can help to reduce and prevent morbidity and mortality in individuals who are at increased risk of cardiovascular events. This updated consensus guide to management of dyslipidaemia in SA is based on the updated European Society of Cardiology and European At...
Source: South African Medical Journal - Category: African Health Tags: S Afr Med J Source Type: research
We examined 717 patients with severe AS and HF undergoing TAVI. NT-proBNP nonresponders were defined as patients whose NT-proBNP levels decreased by  ≤ 30%. Mean NT-proBNP levels decreased from 7698 ± 7853 pg/mL (baseline) to 4523 ±  5173 pg/mL (post-TAVI); 269 patients (38%) were nonresponders. Female gender and prevalence of diabetes mellitus (DM), chronic kidney disease (CKD), atrial fibrillation (AF), and history of coronary artery revascularization were more common for NT-proBNP nonresponders. Permanent pacemaker implantation rate was higher for N...
Source: Heart and Vessels - Category: Cardiology Source Type: research
The impact of glycemic control in diabetic patients with chronic kidney disease (CKD) who may or may not transition to dialysis remains uncertain, given recent interest in the conservative management of advanced CKD without dialysis therapy, which may benefit from alternative glycemic control strategies.
Source: Journal of Renal Nutrition - Category: Urology & Nephrology Authors: Tags: Original Research Source Type: research
This study sought to fill this knowledge gap.
Source: Journal of the Neurological Sciences - Category: Neurology Authors: Tags: Clinical short communication Source Type: research
Authors: Cucchiari D, Torregrosa JV Abstract Calciphylaxis, also known as calcific uraemic arteriolopathy, is a rare syndrome that typically causes skin necrosis and usually affects dialysis patients. Its pathogenesis is multifactorial and is the consequence of many factors causing ectopic calcifications in patients with chronic kidney disease, such as calcium-phosphate metabolism disorders, hyper- or hypo-parathyroidism, diabetes, obesity, systemic inflammation and the use of vitamin K antagonists, among others. From a clinical point of view, calciphylaxis may progress from painful purpura to extensive areas of sk...
Source: Nefrologia : publicacion oficial de la Sociedad Espanola Nefrologia - Category: Urology & Nephrology Tags: Nefrologia Source Type: research
Conclusion Evidence of clinical benefit of most available apps is very limited. Design features that enhance usability and maximise efficacy were identified. A provisional 'first-pass' evaluation framework is proposed that can help decide which apps should be endorsed by government agencies following more detailed technical assessments and which could then be recommended with confidence by clinicians to their patients.What is known about the topic? Smartphone health apps have attracted considerable interest from patients and health managers as a means of promoting more effective self-management of chronic diseases, which l...
Source: Australian Health Review - Category: Hospital Management Authors: Tags: Aust Health Rev Source Type: research
ConclusionPatiromer decreased serum K+ through 52 weeks in patients with hyperkalemia, chronic kidney disease, and heart failure with EF>40%, all of whom were taking RAAS inhibitors. These post-hoc results require prospective evaluation, but suggest that patiromer allows control of hyperkalemia in heart failure patients with EF>40% on RAAS inhibitors.ResultOverall, 55 out of 306 randomized patients had heart failure with EF>40% (100% Caucasian, 75% male, 69% ≥65 years of age). Mean (SD) EF was 48 (7)% and mean (SD) eGFR was 41 (13) mL/min/1.73 m² at baseline. All patients had hypertension (mean BP 155/83 m...
Source: Heart and Lung: The Journal of Acute and Critical Care - Category: Respiratory Medicine Source Type: research
This study developed an amino acid-based metabolic panel and sought to see whether this panel could add diagnostic and prognostic value to currently used B-type natriuretic peptide (BNP) measurements. Mass spectrometry and ultra-performance liquid chromatography were performed on 1288 participants, including 129 normal controls and 712 patients at HF stages A to D in the initial cohort and 447 stage C patients in the validation cohort. Patients were followed up for composite events (death/HF-related rehospitalization). Histidine, ornithine, and phenylalanine were 3 metabolites found strongly significant to identify patient...
Source: Disease Markers - Category: Laboratory Medicine Tags: Dis Markers Source Type: research
ConclusionsIn Asian patients from EMPA ‐REG OUTCOME®, empagliflozin improved kidney outcomes, slowed eGFR decline and lowered albuminuria versus placebo, consistent with the overall trial population findings.This article is protected by copyright. All rights reserved.
Source: Journal of Diabetes Investigation - Category: Endocrinology Authors: Tags: Original Article Source Type: research
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