Effect of bardoxolone methyl on the urine albumin-to-creatinine ratio in patients with type 2 diabetes and stage 4 chronic kidney disease.

Bardoxolone methyl attenuates inflammation by inducing Nrf2 and suppressing NF- κB. The Bardoxolone Methyl Evaluation in Patients With Chronic Kidney Disease and Type 2 Diabetes (BEACON) trial was a phase 3 placebo-controlled, randomized, double-blind, parallel-group, international, multicenter trial in 2185 patients with type 2 diabetes mellitus and stage 4 chronic kidney dis ease. BEACON was terminated because of safety concerns, largely related to a significant increase in early heart failure events in patients randomized to bardoxolone methyl.
Source: Kidney International - Category: Urology & Nephrology Authors: Tags: Clinical Trial Source Type: research

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Abstract While rates of ischemic complications in type 2 diabetes mellitus seem to be declining, some of the most feared and costly complications, namely end-stage kidney disease (ESKD), heart failure, and lower limb amputations, remain on the rise. Herein, we discuss how the results from the Evaluation of the effects of canagliflozin on renal and cardiovascular outcomes in participants with diabetic nephropathy (CREDENCE) trial may change this calculus.1 The development of chronic kidney disease (CKD) in type 2 diabetes mellitus marks the beginning of a sharp increase in cardio-renal complications.2 Indeed, in ty...
Source: Circulation - Category: Cardiology Authors: Tags: Circulation Source Type: research
Crohn’s Disease in Clinical Remission Is Marked by Systemic Oxidative Stress Arno R. Bourgonje1, Julius Z. H. von Martels1, Marian L. C. Bulthuis2, Marco van Londen3, Klaas Nico Faber1, Gerard Dijkstra1† and Harry van Goor2*† 1Department of Gastroenterology and Hepatology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands 2Department of Pathology and Medical Biology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands 3Department of Internal Medicine, Division of Nephrology, University Medical Center Groningen, University of Gro...
Source: Frontiers in Physiology - Category: Physiology Source Type: research
Canagliflozin protects Heart and Kidneys – CREDENCE Trial Canagliflozin is sodium–glucose cotransporter 2 (SGLT2) inhibitor used in the treatment of type 2 diabetes mellitus. CREDENCE Trial [1] has shown that Canagliflozin provides both cardiovascular and renal protection in patients with type 2 diabetes mellitus. CREDENCE (Canagliflozin and Renal Events in Diabetes with Established Nephropathy Clinical Evaluation) trial was a double blind randomized trial comparing Canagliflozin 100 mg daily with placebo in type 2 diabetes with albuminuria and chronic kidney disease. They were also treated with renin–ang...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: Cardiology Source Type: blogs
Conclusion Activation of the Nrf2-dependent antioxidant system plays an important role in cell defense against oxidative stress damage, whereas the insufficiency of the Nrf2 system is associated with multiple aspects of the genesis and progression of metabolic diseases, posing a great risk to the cardiovascular system (Figure 1). The systemic increase of Nrf2 activity by several activators may be beneficial in the treatment of metabolic diseases. In addition, selective upregulation of Nrf2 genes may represent a potential therapy in obesity, diabetes and atherosclerosis. Looking to the future, experimental research that el...
Source: Frontiers in Pharmacology - Category: Drugs & Pharmacology Source Type: research
Conclusion: This study observed an inverse correlation between plasma LDL cholesterol and heart function in individuals with T2DM. Patients with higher levels of plasma LDL cholesterol had worse left ventricular function. Therefore, plasma LDL cholesterol may be a modifiable risk factor of heart failure in diabetes, but prospective studies are necessary to confirm this finding. Introduction Type 2 diabetes mellitus (T2DM) is a metabolic disease that affects a considerable number of patients worldwide (1). Among diabetic individuals, cardiovascular disease (CVD) is the leading cause of morbidity and mortality (2). C...
Source: Frontiers in Endocrinology - Category: Endocrinology 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
Abstract Type 2 diabetes mellitus (T2DM) substantially increases the risk of cardiovascular events, including heart failure (HF), due to complications such as hypertension, obesity and dyslipidemia based on metabolic syndrome, which plays the central pathological role in HF. A reason is that T2DM causes left ventricular (LV) diastolic dysfunction beginning in the early phase of the disease, which in turn increases the risk of development of HF independently of the control of blood glucose levels, blood pressure or the presence of coronary artery diseases. Intracellular metabolic disorders and increased oxidative s...
Source: Clin Med Res - Category: Research Authors: Tags: J Clin Med Res Source Type: research
Authors: Madievsky R Abstract Type 2 diabetes mellitus often goes hand in hand with cardiovascular and renal comorbidities. Stroke, myocardial infarction, heart failure, and chronic kidney disease are high-risk complications of type 2 diabetes that contribute to morbidity and mortality. Recent clinical trials have uncovered evidence that certain antidiabetic agents may confer cardiovascular and/or renal benefits such as reduced cardiovascular and all-cause mortality and reduced need for renal replacement therapy. Two landmark trials in particular, EMPA-REG OUTCOME (Empagliflozin, Cardiovascular Outcomes, and Mortal...
Source: The Permanente journal - Category: General Medicine Tags: Perm J Source Type: research
AbstractIndividuals with diabetes mellitus exhibit an increased propensity to develop cardiovascular disorders such as coronary artery disease, stroke and heart failure. Over recent decades, numerous cardiovascular outcome trials in individuals with type 2 diabetes have been published, with data showing a reduction of cardiovascular morbidity and mortality by sodium –glucose cotransporter 2 (SGLT2) inhibitors. These results not only provide novel therapeutic options for this high-risk population but also advance our current understanding of cardiovascular risk reduction in diabetes. The current overview article summa...
Source: Diabetologia - Category: Endocrinology Source Type: research
ConclusionIn a large US-based outpatient registry, we found that a quarter of adults with T2D had a diagnosis of HF, which was predominantly HFpEF. Although certain T2D medication use in patients with HF appeared consistent with evidence (less use of thiazolidinediones), others appeared contrary to evidence (less use of metformin and SGLT2 inhibitors).
Source: American Heart Journal - Category: Cardiology Source Type: research
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