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Defining end-stage renal disease in clinical trials: a framework for adjudication
Unlike definition of stroke and myocardial infarction, there is no uniformly agreed upon definition to adjudicate end-stage renal disease (ESRD). ESRD remains the most unambiguous and clinically relevant end point for clinical trialists, regulators, payers and patients with chronic kidney disease. The prescription of dialysis to patients with advanced chronic kidney disease is subjective and great variations exist among physicians and countries. Given the difficulties in diagnosing ESRD, the presence of estimated GFR <15 mL/min/1.7 3m2 itself has been suggested as an end point. However, this definition is still a surrog...
Source: Nephrology Dialysis Transplantation - May 22, 2016 Category: Urology & Nephrology Authors: Agarwal, R. Tags: IDEAS, CONJECTURES AND REFUTATIONS Source Type: research

Interventions for lowering plasma homocysteine levels in dialysis patients.
CONCLUSIONS: Homocysteine-lowering therapies were not found to reduce mortality (cardiovascular and all-cause) or cardiovascular events among people with ESKD. PMID: 27243372 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - May 30, 2016 Category: Journals (General) Authors: Nigwekar SU, Kang A, Zoungas S, Cass A, Gallagher MP, Kulshrestha S, Navaneethan SD, Perkovic V, Strippoli GF, Jardine MJ Tags: Cochrane Database Syst Rev Source Type: research

ANGPTL2 is associated with an increased risk of cardiovascular events and death in diabetic patients
Conclusions/interpretationIn patients with type 2 diabetes, serum ANGPTL2 concentrations were independently associated with death and MACE. Therefore, ANGPTL2 is a promising candidate biomarker for improving risk stratification in type 2 diabetes patients, and may prove to be a valuable therapeutic target.
Source: Diabetologia - September 30, 2016 Category: Endocrinology Source Type: research

Preoperative Cardiac Evaluation in Kidney Transplant Patients: Is Coronary Angiography Superior? A Focused Review.
Authors: Katta N, Balla S, Velagapudi P, Mittal M, Agrawal H, Kumar A, Aggarwal K Abstract Cardiovascular disease is the major cause of morbidity and mortality in chronic kidney disease patients. Because of a higher occurrence of asymptomatic coronary artery disease and increased perioperative cardiovascular mortality in kidney transplant patients, screening for coronary artery disease before transplant surgery is essential. Various studies have shown that cardiac stress testing is an unreliable screening method in these patients because of significant variability in sensitivity and negative predictive value. We su...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - October 13, 2017 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

Add-On Antihypertensive Medications to Angiotensin-Aldosterone System Blockers in Diabetes: A Comparative Effectiveness Study.
CONCLUSIONS: Compared with thiazide diuretics, calcium channel blockers were associated with a lower risk of significant kidney events and a similar risk of cardiovascular events. PODCAST: This article contains a podcast at https://www.asn-online.org/media/podcast/CJASN/2018_03_23_CJASNPodcast_18_5_S.mp3. PMID: 29572286 [PubMed - as supplied by publisher]
Source: Clinical Journal of the American Society of Nephrology : CJASN - March 23, 2018 Category: Urology & Nephrology Authors: Schroeder EB, Chonchol M, Shetterly SM, Powers JD, Adams JL, Schmittdiel JA, Nichols GA, O'Connor PJ, Steiner JF Tags: Clin J Am Soc Nephrol Source Type: research

Design and baseline characteristics of the eValuation of ERTugliflozin effIcacy and safety CardioVascular outcomes trial (VERTIS-CV)
ConclusionThe results from the VERTIS-CV trial will define the CV and renal safety and efficacy of ertugliflozin in patients with T2DM and ASCVD.ClinicalTrials.gov identifier: NCT01986881
Source: American Heart Journal - September 6, 2018 Category: Cardiology Source Type: research

Long-Term Single Centre Outcomes of Patients with Chronic Renal Dialysis Undergoing Cardiac Surgery
CONCLUSIONSCardiac surgery in DD-CRF patients is associated with high morbidity and mortality. Interestingly, overall mortality was mainly none cardiac-related, where elderly patients or those presented with CHF had the worst life expectancy. However, subsequent kidney transplantation positively impact long-term survival in such patients.
Source: The Annals of Thoracic Surgery - September 27, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Long-Term Single Centre Outcomes of Patients with Chronic Renal Dialysis Undergoing Cardiac Surgery.
CONCLUSIONS: Cardiac surgery in DD-CRF patients is associated with high morbidity and mortality. Interestingly, overall mortality was mainly none cardiac-related, where elderly patients or those presented with CHF had the worst life expectancy. However, subsequent kidney transplantation positively impact long-term survival in such patients. PMID: 31563486 [PubMed - as supplied by publisher]
Source: The Annals of Thoracic Surgery - September 25, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Mourad F, Cleve N, Nowak J, Wendt D, Sander A, Demircioglu E, El Gabry M, Jakob H, Shehada SE Tags: Ann Thorac Surg Source Type: research

Myeloperoxidase and the Risk of CKD Progression, Cardiovascular Disease, and Death in the Chronic Renal Insufficiency Cohort (CRIC) Study
ConclusionsHigher MPO level was associated with increased risk for CKD progression, but not with CVD and death in patients with CKD from CRIC. Whether therapies aimed at reducing MPO activity can result in improved clinical outcomes is yet to be determined.
Source: American Journal of Kidney Diseases - December 20, 2019 Category: Urology & Nephrology Source Type: research

Peripheral arterial disease diagnosed by ankle-brachial index: Predictor for early renal replacement therapy in chronic kidney disease.
Abstract Our study aimed to investigate the relationship between ankle-brachial index (ABI) and need for early renal replacement therapy (RRT) in predialysis patients with chronic kidney disease (CKD). A total of 112 patients (62% men) with pre-dialysis CKD, seen in the outpatient clinic, were included, and ABI was obtained as per standard protocol. Peripheral arterial disease (PAD) was defined as ABI <0.9 or >1.3 in either leg. The clinical data were analyzed, and the risk factors for early RRT were determined by multivariate logistic regression analysis. The prevalence of PAD was 44% in predialysis CKD pat...
Source: Saudi Journal of Kidney Diseases and Transplantation - December 31, 2019 Category: Urology & Nephrology Authors: Ozgur Y, Akin S, Parmaksiz E, Meşe M, Bahcebasi ZB, Keskin O Tags: Saudi J Kidney Dis Transpl Source Type: research

Potassium binders for chronic hyperkalaemia in people with chronic kidney disease.
CONCLUSIONS: Evidence supporting clinical decision-making for different potassium binders to treat chronic hyperkalaemia in adults with CKD is of low certainty; no studies were identified in children. Available studies have not been designed to measure treatment effects on clinical outcomes such as cardiac arrhythmias or major GI symptoms. This review suggests the need for a large, adequately powered study of potassium binders versus placebo that assesses clinical outcomes of relevance to patients, clinicians and policy-makers. This data could be used to assess cost-effectiveness, given the lack of definitive studies and t...
Source: Cochrane Database of Systematic Reviews - June 25, 2020 Category: General Medicine Authors: Natale P, Palmer SC, Ruospo M, Saglimbene VM, Strippoli GF Tags: Cochrane Database Syst Rev Source Type: research

Development and Internal Validation of a Discrete Event Simulation Model of Diabetic Kidney Disease Using CREDENCE Trial Data
ConclusionCREDEM-DKD is an important new tool in the evaluation of treatment interventions in the DKD population.Trial RegistrationClinicalTrials.gov identifier, NCT02065791.
Source: Diabetes Therapy - September 14, 2020 Category: Endocrinology Source Type: research

Cost-Effectiveness of Canagliflozin Added to Standard of Care for Treating Diabetic Kidney Disease (DKD) in Patients with Type  2 Diabetes Mellitus (T2DM) in England: Estimates Using the CREDEM-DKD Model
ConclusionModel results suggest that adding canagliflozin 100  mg to SoC can improve patient outcomes while reducing overall net costs from the NHS perspective in England.Trial RegistrationClinicalTrials.gov identifier, NCT02065791.
Source: Diabetes Therapy - December 2, 2020 Category: Endocrinology Source Type: research

Clinical Outcomes and Healthcare Resource Utilization in a Real-World Population Reflecting the DAPA-CKD Trial Participants
ConclusionThe significant adverse renal and cardiovascular outcomes observed, particularly in the DAPA-CKD-like cohort, represent a substantial burden resulting in increased mortality, HCRU and costs, demonstrating the need for additional treatment options.
Source: Advances in Therapy - January 20, 2021 Category: Drugs & Pharmacology Source Type: research

CZecking heart failure in patients with advanced chronic kidney disease (Czech HF-CKD): Study protocol
DISCUSSION: This trial will differ from others by: (1) detailed repeated hemodynamic assessment including arteriovenous access flow and (2) by careful assessment of adequate hydration to avoid confusion between HF and water overload.PMID:35676802 | DOI:10.1177/11297298221099843
Source: The Journal of Vascular Access - June 9, 2022 Category: Surgery Authors: Jan Malik Anna Valerianova Satu Sinikka Pesickova Zdenka Hruskova Vladimira Bednarova Pavel Michalek Vladimir Polakovic Vladimir Tesar Source Type: research

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