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2. First interim results from FINE-REAL: a prospective, non-interventional, phase 4 study providing insights into the use and safety of finerenone in a routine clinical setting

Author

Nicholas, Susanne B., Correa-Rotter, Ricardo, Desai, Nihar R., Guo, Lixin, Navaneethan, Sankar D., Pantalone, Kevin M., Wanner, Christoph, Hamacher, Stefanie, Fatoba, Samuel T., Horvat-Broecker, Andrea, Garreta-Rufas, Antonio, Gay, Alain, Merz, Martin, and Wheeler, David C.

Published
2024
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3. Mind the gap in kidney care: translating what we know into what we do

Author

Luyckx, Valerie A., Tuttle, Katherine R., Abdellatif, Dina, Correa-Rotter, Ricardo, Fung, Winston W. S., Haris, Agnès, Hsiao, Li-Li, Khalife, Makram, Kumaraswami, Latha A., Loud, Fiona, Raghavan, Vasundhara, Roumeliotis, Stefanos, Sierra, Marianella, Ulasi, Ifeoma, Wang, Bill, Lui, Siu-Fai, Liakopoulos, Vassilios, and Balducci, Alessandro

Published
2024
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6. Long-term effects of hypercalcemia in kidney transplant recipients with persistent hyperparathyroidism

Author

Ramirez-Sandoval, Juan Carlos, Marino, Lluvia, Cojuc-Konigsberg, Gabriel, Reul-Linares, Estefania, Pichardo-Cabrera, Nathalie Desire, Cruz, Cristino, Hernández-Paredes, Elisa Naomi, Berman-Parks, Nathan, Vidal-Ruíz, Vanessa, Estrada-Linares, Jonathan Mauricio, Reza-Albarrán, Alfredo Adolfo, Correa-Rotter, Ricardo, and Morales-Buenrostro, Luis Eduardo

Published
2023
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14. Effect of SGLT2 Inhibitors on Discontinuation of Renin–angiotensin System Blockade: A Joint Analysis of the CREDENCE and DAPA-CKD Trials

Author

Fletcher, Robert A., Jongs, Niels, Chertow, Glenn M., McMurray, John J.V., Arnott, Clare, Jardine, Meg J., Mahaffey, Kenneth W., Perkovic, Vlado, Rockenschaub, Patrick, Rossing, Peter, Correa-Rotter, Ricardo, Toto, Robert D., Vaduganathan, Muthiah, Wheeler, David C., Heerspink, Hiddo J.L., and Neuen, Brendon L.

Published
2023
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17. Mind the Gap in Kidney Care: Translating What We Know into What We Do

Author

Luyckx, Valerie A., primary, Tuttle, Katherine R., additional, Abdellatif, Dina, additional, Correa-Rotter, Ricardo, additional, Fung, Winston W.S., additional, Haris, Agnès, additional, Hsiao, Li-Li, additional, Khalife, Makram, additional, Kumaraswami, Latha A., additional, Loud, Fiona, additional, Raghavan, Vasundhara, additional, Roumeliotis, Stefanos, additional, Sierra, Marianella, additional, Ulasi, Ifeoma, additional, Wang, Bill, additional, Lui, Siu-Fai, additional, Liakopoulos, Vassilios, additional, Balducci, Alessandro, additional, Kumaraswami, Latha, additional, Lui, Siu Fai, additional, and Haris, Ágnes, additional

Published
2024
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18. The long-term effects of dapagliflozin in chronic kidney disease: a time-to-event analysis

Author

McEwan, Phil, primary, Gabb, Peter D, additional, Davis, Jason A, additional, Sanchez, Juan Jose Garcia, additional, Sjöström, C David, additional, Barone, Salvatore, additional, Kashioulis, Pavlos, additional, Ouwens, Mario, additional, Cassimaty, Syd, additional, Correa-Rotter, Ricardo, additional, Rossing, Peter, additional, Wheeler, David C, additional, and Heerspink, Hiddo J L, additional

Published
2024
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19. #294 Pragmatic literature reviews to populate a patient-level model to project the future clinical burden of CKD in low-and middle-income countries

Author

Correa-Rotter, Ricardo, primary, Ngigi, John, additional, Holt, Steve, additional, Cong, Luong Nguyen, additional, Sanchez, Juan Jose Garcia, additional, Solorzano, Jaime, additional, Goncalves, Susana, additional, Guzek, John, additional, Mitchyn, Markiyan, additional, Webber, Laura, additional, and Retat, Lise, additional

Published
2024
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20. #255 PaCE CKD: the impact of caregiving on health states and work productivity in chronic kidney disease: results from an international survey

Author

Sanchez, Juan Jose Garcia, primary, Wu, Mai-Szu, additional, Chadban, Steven, additional, Correa-Rotter, Ricardo, additional, Reichel, Helmut, additional, Elsayed, Hesham, additional, Rangaswami, Janani, additional, Esposito, Ciro, additional, Hull, Richard, additional, Pentakota, Surendra, additional, West, Bronwyn, additional, Kularatne, Thames, additional, and Fifer, Simon, additional

Published
2024
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21. #254 PaCE CKD: examining health status and financial burden in patients with chronic kidney disease: assessing the non-clinical burden of disease

Author

Sanchez, Juan Jose Garcia, primary, Reichel, Helmut, additional, Rangaswami, Janani, additional, Esposito, Ciro, additional, Elsayed, Hesham, additional, Wu, Mai-Szu, additional, Hull, Richard, additional, Chadban, Steven, additional, Correa-Rotter, Ricardo, additional, Pentakota, Surendra, additional, West, Bronwyn, additional, Kularatne, Thames, additional, and Fifer, Simon, additional

Published
2024
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26. Mind the Gap in Kidney Care: Translating What We Know Into What We Do.

Author

Luyckx, Valerie A, Tuttle, Katherine R, Abdellatif, Dina, Correa-Rotter, Ricardo, Fung, Winston W S, Haris, Agnès, Hsiao, Li-Li, Khalife, Makram, Kumaraswami, Latha A, Loud, Fiona, Raghavan, Vasundhara, Roumeliotis, Stefanos, Sierra, Marianella, Ulasi, Ifeoma, Wang, Bill, Lui, Siu-Fai, Liakopoulos, Vassilios, and Balducci;, Alessandro

Subjects
HEART failure, NON-communicable diseases, RENAL osteodystrophy, NEPHROLOGISTS, MEDICAL personnel, MANAGEMENT of electronic health records
Abstract

The article discusses the global burden of kidney disease and the gaps in kidney care, particularly in low- and middle-income countries. It highlights the high death rates and economic burden associated with chronic kidney disease (CKD) and the disparities in prevention, early detection, diagnosis, and treatment. The text emphasizes the importance of integrating kidney care into national non-communicable disease strategies and strengthening health systems. It also discusses the challenges in managing CKD, including the need for regulation and monitoring of drug manufacturing, the importance of real-world data, and strategies to improve CKD management. The article addresses the cost and availability of medication for individuals with kidney disease, highlighting the paradoxical situation in high-income countries and the catastrophic health expenditure in low- and middle-income countries. It calls for pharmaceutical companies to ensure diverse participation in research studies and fair pricing of effective drugs. The article also emphasizes the need to focus on children with kidney diseases and suggests strategies to improve kidney disease care, including the use of polypills and digital technologies. It concludes with a call to action to address barriers and disparities in access to diagnosis and treatment and to ensure equitable kidney care worldwide. [Extracted from the article]

Published
2024
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27. Dapagliflozin and new-onset type 2 diabetes in patients with chronic kidney disease or heart failure: pooled analysis of the DAPA-CKD and DAPA-HF trials

Author

Rossing, Peter, Inzucchi, Silvio E, Vart, Priya, Jongs, Niels, Docherty, Kieran F, Jhund, Pardeep S, Køber, Lars, Kosiborod, Mikhail N, Martinez, Felipe A, Ponikowski, Piotr, Sabatine, Marc S, Solomon, Scott D, DeMets, David L, Bengtsson, Olof, Lindberg, Magnus, Langkilde, Anna Maria, Sjöstrand, Mikaela, Stefansson, Bergur V, Karlsson, Cecilia, Chertow, Glenn M, Hou, Fan Fan, Correa-Rotter, Ricardo, Toto, Robert D, Wheeler, David C, McMurray, John J V, and Heerspink, Hiddo J L

Published
2022
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28. A pre-specified analysis of the Dapagliflozin and Prevention of Adverse Outcomes in Chronic Kidney Disease (DAPA-CKD) randomized controlled trial on the incidence of abrupt declines in kidney function

Author

Heerspink, Hiddo J.L., Wheeler, David C., Chertow, Glenn, Correa-Rotter, Ricardo, Greene, Tom, Hou, Fan Fan, McMurray, John, Rossing, Peter, Toto, Robert, Stefansson, Bergur, Langkilde, Anna Maria, Maffei, L.E., Raffaele, P., Solis, S.E., Arias, C.A., Aizenberg, D., Luquez, C., Zaidman, C., Cluigt, N., Mayer, M., Alvarisqueta, A., Wassermann, A., Maldonado, R., Bittar, J., Maurich, M., Gaite, L.E., Garcia, N., Sivak, L., Ramallo, P.O., Santos, J.C., Garcia Duran, R., Oddino, J.A., Maranon, A., Maia, L.N., Avila, D.D., Barros, E.J.G., Vidotti, M.H., Panarotto, D., Noronha, I.D.L., Turatti, L.A.A., Deboni, L., Canziani, M.E., Riella, M.C., Bacci, M.R., Paschoalin, R.P., Franco, R.J., Goldani, J.C., St-Amour, E., Steele, A.W., Goldenberg, R., Pandeya, S., Bajaj, H., Cherney, D., Kaiser, S.M., Conway, J.R., Chow, S.S., Bailey, G., Lafrance, J., Winterstein, J., Cournoyer, S., Gaudet, D., Madore, F., Houlden, R.L., Dowell, A., Langlois, M., Muirhead, N., Khandwala, H., Levin, A., Hou, F., Xue, Y., Zuo, L., Hao, C., Ni, Z., Xing, C., Chen, N., Dong, Y., Zhou, R., Xiao, X., Zou, Y., Wang, C., Liu, B., Chen, Q., Lin, M., Luo, Q., Zhang, D., Wang, J., Chen, M., Wang, X., Zhong, A., Dong, J., Zhu, C., Yan, T., Luo, P., Ren, Y., Pai, P., Li, D., Zhang, R., Zhang, J., Xu, M., Zhuang, Y., Kong, Y., Yao, X., Peng, X., Persson, F.I., Hansen, T.K., Borg, R., Pedersen Bjergaard, U., Hansen, D., Hornum, M., Haller, H., Klausmann, G., Tschope, D., Kruger, T., Gross, P., Hugo, C., Obermuller, N., Rose, L., Mertens, P., Zeller-Stefan, H., Fritsche, A., Renders, L., Muller, J., Budde, K., Schroppel, B., Wittmann, I., Voros, P., Dudas, M., Tabak, G.A., Kirschner, R., Letoha, A., Balku, I., Hermanyi, Z., Zakar, G., Mezei, I., Nagy, G.G., Lippai, J., Nemeth, A., Khullar, D., Gowdaiah, P.K., Fernando Mervin, E., Rao, V.A., Dewan, D., Goplani, K., Maddi, V.S.K., Vyawahare, M.S., Pulichikkat, R.K., Pandey, R., Sonkar, S.K., Gupta, V.K., Agarwal, S., Asirvatham, A.J., Ignatius, A., Chaubey, S., Melemadathil, S., Alva, H., Kadam, Y., Shimizu, H., Sueyoshi, A., Takeoka, H., Abe, Y., Imai, T., Onishi, Y., Fujita, Y., Tokita, Y., Oura, M., Makita, Y., Idogaki, A., Koyama, R., Kikuchi, H., Kashihara, N., Hayashi, T., Ando, Y., Tanaka, T., Shimizu, M., Hidaka, S., Gohda, T., Tamura, K., Abe, M., Kamijo, Y., Imasawa, T., Takahashi, Y., Nakayama, M., Tomita, M., Hirano, F., Fukushima, Y., Kiyosue, A., Kurioka, S., Imai, E., Kitagawa, K., Waki, M., Wada, J., Uehara, K., Iwatani, H., Ota, K., Shibazaki, S., Katayama, K., Narita, I., Iinuma, M., Matsueda, S., Sasaki, S., Yokochi, A., Tsukamoto, T., Yoshimura, T., Kang, S., Lee, S., Lim, C.S., Chin, H., Joo, K.W., Han, S.Y., Chang, T.I., Park, S., Park, H., Park, C.W., Han, B.G., Cha, D.R., Yoon, S.A., Kim, W., Kim, S.W., Ryu, D., Correa Rotter, R., Irizar Santana, S.S., Hernandez Llamas, G., Valdez Ortiz, R., Secchi Nicolas, N.C., Gonzalez Galvez, G., Lazcano Soto, J.R., Bochicchio Riccardelli, T., Bayram Llamas, E.A., Ramos Ibarra, D.R., Melo, M.G.S., Gonzalez Gonzalez, J.G., Sanchez Mijangos, J.H., Madero Robalo, M., Garcia Castillo, A., Manrique, H.A., Farfan, J.C., Vargas, R., Valdivia, A., Dextre, A., Escudero, E., Calderon Ticona, J.R., Gonzales, L., Villena, J., Leon, L., Molina, G., Saavedra, A., Garrido, E., Arbanil, H., Vargas Marquez, S., Rodriguez, J., Isidto, R., Villaflor, A.J., Gumba, M.A., Tirador, L., Comia, R.S., Sy, R.A., Guanzon, M.L.V.V., Aquitania, G., De Asis, N.C., Silva, A.A., Romero, C.M., Lim, M.E., Danguilan, R.A., Nowicki, M., Rudzki, H., Landa, K., Kucharczyk-Bauman, I., Gogola-Migdal, B., Golski, M., Olech-Cudzik, A., Stompor, T., Szczepanik, T., Miklaszewicz, B., Sciborski, R., Kuzniewski, M., Ciechanowski, K., Wronska, D., Klatko, W., Mazur, S., Popenda, G., Myslicki, M., Bolieva, L.Z., Berns, S., Galyavich, A., Abissova, T., Karpova, I., Platonov, D., Koziolova, N., Kvitkova, L., Nilk, R., Medina, T., Rebrov, A., Rossovskaya, M., Sinitsina, I., Vishneva, E., Zagidullin, N., Novikova, T., Krasnopeeva, N., Magnitskaya, O., Antropenko, N., Batiushin, M., Escudero Quesada, V., Barrios Barrea, C., Espinel Garauz, E., Cruzado Garrit, J.M., Morales Portillo, C., Gorriz Teruel, J.L., Cigarran Guldris, S., Praga Terente, M., Robles Perez-Monteoliva, N.R., Tinahones Madueno, F.J., Soto Gonzalez, A., Diaz Rodriguez, C., Furuland, H., Saeed, A., Dreja, K., Spaak, J., Bruchfeld, A., Kolesnyk, M., Levchenko, O., Pyvovarova, N., Stus, V., Doretskyy, V., Korobova, N., Horoshko, O., Katerenchuk, I., Mostovoy, Y.M., Orynchak, M., Legun, O., Dudar, I., Bilchenko, O., Andreychyn, S., Levchenko, A., Zub, L., Tereshchenko, N., Topchii, I., Ostapenko, T., Bezuglova, S., Kopytsya, M., Turenko, O., Mark, P., Barratt, J., Bhandari, S., Fraser, D., Kalra, P., Kon, S.P., Mccafferty, K., Mikhail, A., Alvarado, O.P., Anderson, R., Andrawis, N.S., Arif, A., Benjamin, S.A., Bueso, G., Busch, R.S., Carr, K.W., Crawford, P., Daboul, N., De La Calle, G.M., Delgado, B., Earl, J., El-Shahawy, M.A., Graf, R.J., Greenwood, G., Guevara, A., Wendland, E.M., Mayfield, R.K., Montero, M., Morin, D.J., Narayan, P., Numrungroad, V., Reddy, A.C., Reddy, R., Samson, M.B., Trejo, R., Butcher, M.B., Wise, J.K., Zemel, L.R., Raikhel, M., Weinstein, D., Hernandez, P., Wynne, A., Khan, B.V., Sterba, G.A., Jamal, A., Ross, D., Rovner, S.F., Tan, A., Ovalle, F., Patel, R.J., Talano, J., Patel, D.R., Burgner, A., Aslam, N., Elliott, M., Goral, S., Jovanovich, A., Manley, J.A., Umanath, K., Waguespack, D., Weiner, D., Yu, M., Schneider, L., Jalal, D., Le, T., Nguyen, N., Nguyen, H., Nguyen, D., Nguyen, V., Do, T., Chu, P., Ta, D., Tran, N., Pham, B., Pfeffer, Marc A., Pocock, Stuart, Swedberg, Karl, Rouleau, Jean L., Chaturvedi, Nishi, Ivanovich, Peter, Levey, Andrew S., Christ-Schmidt, Heidi, Held, Claes, Christersson, Christina, Mann, Johannes, Varenhorst, Christoph, Cherney, David, Postmus, Douwe, Stefánsson, Bergur V., Chertow, Glenn M., Dwyer, Jamie P., Kosiborod, Mikhail, McMurray, John J.V., Sjöström, C. David, and Toto, Robert D.

Published
2022
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29. WCN24-1766 EFFECTS OF DAPAGLIFLOZIN IN PATIENTS WITH MEMBRANOUS NEPHROPATHY

Author

Heerspink, Hiddo J.L., primary, Wheeler, David C., additional, Correa-Rotter, Ricardo, additional, Dwyer, Jamie P., additional, Langkilde, Anna Maria, additional, Mark, Patrick B., additional, Nowicki, Michal, additional, Rossing, Peter, additional, Toto, Robert D., additional, Chertow, Glenn M., additional, and Jongs, Niels, additional

Published
2024
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30. WCN24-1464 MEASUREMENT OF CEREBRAL BLOOD FLOW USING TRANSCRANIAL DOPPLER ULTRASOUND: COMPARISON OF TWO POPULATIONS OF PATIENTS IN CHRONIC HEMODIALYSIS

Author

Rodríguez, Omar Fueyo, primary, Cruz Mendoza, Néstor H., additional, Félix Bauer, Karina C., additional, Geraldo Murillo, José Adrián, additional, Argaiz, Eduardo Ríos, additional, López-Ruelas, María José, additional, ArdavínItuarte, Juan Manuel, additional, Gómez Ruiz, Ismael Antonio, additional, Silva, Fernando Flores, additional, Correa-Rotter, Ricardo, additional, Vega-Vega, Olynka, additional, and Toro-Cisneros, Noemi del, additional

Published
2024
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31. WCN24-890 INSIDE CKD - PRAGMATIC LITERATURE REVIEWS TO POPULATE A PATIENT-LEVEL MODEL TO PROJECT THE FUTURE CLINICAL BURDEN OF CKD IN FOUR LOW- AND MIDDLE INCOME COUNTRIES

Author

Cong, Luong Nguyen, primary, Correa-Rotter, Ricardo, additional, Ngigi, John, additional, Goncalves, Susana, additional, Sanchez, Juan Garcia, additional, Solorzano, Jaime, additional, Mitchyn, Markiyan, additional, Coker, Timothy, additional, Webber, Laura, additional, and Retat, Lise, additional

Published
2024
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32. WCN24-1229 EFFECTS OF TREATMENT AND CLINICAL EVENTS ON QUALITY OF LIFE IN PATIENTS WITH CHRONIC KIDNEY DISEASE: A PRESPECIFIED ANALYSIS OF THE DAPA-CKD TRIAL

Author

Heerspink, Hiddo J.L., primary, Jongs, Niels, additional, Correa-Rotter, Ricardo, additional, Rossing, Peter, additional, Toto, Robert D., additional, Wheeler, David C., additional, McMurray, John J.V., additional, Langkilde, Anna Maria, additional, Vart, Priya, additional, and Chertow, Glenn M., additional

Published
2024
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37. A pre-specified analysis of the DAPA-CKD trial demonstrates the effects of dapagliflozin on major adverse kidney events in patients with IgA nephropathy

Author

Wheeler, David C., Toto, Robert D., Stefánsson, Bergur V., Jongs, Niels, Chertow, Glenn M., Greene, Tom, Hou, Fan Fan, McMurray, John J.V., Pecoits-Filho, Roberto, Correa-Rotter, Ricardo, Rossing, Peter, Sjöström, C. David, Umanath, Kausik, Langkilde, Anna Maria, and Heerspink, Hiddo J.L.

Published
2021
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39. Ambient heat exposure and kidney function in patients with chronic kidney disease:a post-hoc analysis of the DAPA-CKD trial

Author

Zhang, Zhiyan, Heerspink, Hiddo J.L., Chertow, Glenn M., Correa-Rotter, Ricardo, Gasparrini, Antonio, Jongs, Niels, Langkilde, Anna Maria, McMurray, John J.V., Mistry, Malcolm N., Rossing, Peter, Toto, Robert D., Vart, Priya, Nitsch, Dorothea, Wheeler, David C., Caplin, Ben, Zhang, Zhiyan, Heerspink, Hiddo J.L., Chertow, Glenn M., Correa-Rotter, Ricardo, Gasparrini, Antonio, Jongs, Niels, Langkilde, Anna Maria, McMurray, John J.V., Mistry, Malcolm N., Rossing, Peter, Toto, Robert D., Vart, Priya, Nitsch, Dorothea, Wheeler, David C., and Caplin, Ben

Abstract

Background Higher temperatures are associated with higher rates of hospital admissions for nephrolithiasis and acute kidney injury. Occupational heat stress is also a risk factor for kidney dysfunction in resource-poor settings. It is unclear whether ambient heat exposure is associated with loss of kidney function in patients with established chronic kidney disease. We assessed the association between heat index and change in estimated glomerular filtration rate (eGFR) in participants from the DAPA-CKD trial in a post-hoc analysis. Methods DAPA-CKD was a randomised controlled trial of oral dapagliflozin 10 mg once daily or placebo that enrolled participants aged 18 years or older, with or without type 2 diabetes, with a urinary albumin-to-creatinine ratio of 200–5000 mg/g, and an eGFR of 25–75 mL/min per 1·73 m2. In this post-hoc analysis, we explored the association between time-varying daily centre-level heat index (ERA5 dataset) and individual-level change in eGFR in trial participants using linear mixed effect models and case-time series. The DAPA-CKD trial is registered with ClinicalTrials.gov, NCT03036150. Findings Climate and eGFR data were available for 4017 (93·3%) of 4304 participants in 21 countries (mean age: 61·9 years; mean eGFR: 43·3 mL per 1·73 m2; median 28 months follow-up). Across centres, a heat index of more than 30°C occurred on a median of 0·6% of days. In adjusted linear mixed effect models, within each 120-day window, each 30 days’ heat index of more than 30°C was associated with a –0·6% (95% CI –0·9% to –0·3%) change in eGFR. Similar estimates were obtained using case-time series. Additional analyses over longer time-windows showed associations consistent with haemodynamic or seasonal variability, or both, but overall estimates corresponded to an additional 3·7 mL per 1·73 m2 (95% CI 0·1 to 7·0) loss of eGFR per year in a patient with an eGFR of 45 mL per 1·73 m2 located in a very hot versus a temperate environ, Background: Higher temperatures are associated with higher rates of hospital admissions for nephrolithiasis and acute kidney injury. Occupational heat stress is also a risk factor for kidney dysfunction in resource-poor settings. It is unclear whether ambient heat exposure is associated with loss of kidney function in patients with established chronic kidney disease. We assessed the association between heat index and change in estimated glomerular filtration rate (eGFR) in participants from the DAPA-CKD trial in a post-hoc analysis. Methods: DAPA-CKD was a randomised controlled trial of oral dapagliflozin 10 mg once daily or placebo that enrolled participants aged 18 years or older, with or without type 2 diabetes, with a urinary albumin-to-creatinine ratio of 200–5000 mg/g, and an eGFR of 25–75 mL/min per 1·73 m2. In this post-hoc analysis, we explored the association between time-varying daily centre-level heat index (ERA5 dataset) and individual-level change in eGFR in trial participants using linear mixed effect models and case-time series. The DAPA-CKD trial is registered with ClinicalTrials.gov, NCT03036150. Findings: Climate and eGFR data were available for 4017 (93·3%) of 4304 participants in 21 countries (mean age: 61·9 years; mean eGFR: 43·3 mL per 1·73 m2; median 28 months follow-up). Across centres, a heat index of more than 30°C occurred on a median of 0·6% of days. In adjusted linear mixed effect models, within each 120-day window, each 30 days’ heat index of more than 30°C was associated with a –0·6% (95% CI –0·9% to –0·3%) change in eGFR. Similar estimates were obtained using case-time series. Additional analyses over longer time-windows showed associations consistent with haemodynamic or seasonal variability, or both, but overall estimates corresponded to an additional 3·7 mL per 1·73 m2 (95% CI 0·1 to 7·0) loss of eGFR per year in a patient with an eGFR of 45 mL per 1·73 m2 located in a very hot versus

Published
2024

40. Dapagliflozin in chronic kidney disease:cost-effectiveness beyond the DAPA-CKD trial

Author

McEwan, Phil, Davis, Jason A., Gabb, Peter D., Wheeler, David C., Rossing, Peter, Chertow, Glenn M., Correa-Rotter, Ricardo, Tamura, Kouichi, Barone, Salvatore, Sanchez, Juan Jose Garcia, McEwan, Phil, Davis, Jason A., Gabb, Peter D., Wheeler, David C., Rossing, Peter, Chertow, Glenn M., Correa-Rotter, Ricardo, Tamura, Kouichi, Barone, Salvatore, and Sanchez, Juan Jose Garcia

Abstract

BACKGROUND: The Dapagliflozin and Prevention of Adverse Outcomes in CKD (DAPA-CKD) trial enrolled patients with estimated glomerular filtration rate 25-75 mL/min/1.73 m2 and urine albumin-to-creatinine ratio >200 mg/g. The Dapagliflozin Effect on CardiovascuLAR Events-Thrombolysis in Myocardial Infarction 58 (DECLARE-TIMI 58) trial enrolled patients with type 2 diabetes, a higher range of kidney function and no albuminuria criterion. The study objective was to estimate the cost-effectiveness of dapagliflozin in a broad chronic kidney disease population based on these two trials in the UK, Spain, Italy and Japan.METHODS: We adapted a published Markov model based on the DAPA-CKD trial but to a broader population, irrespective of urine albumin-to-creatinine ratio, using patient-level data from the DAPA-CKD and DECLARE-TIMI 58 trials. We sourced cost and utility inputs from literature and the DAPA-CKD trial. The analysis considered healthcare system perspectives over a lifetime horizon.RESULTS: Treatment with dapagliflozin was predicted to attenuate disease progression and extend projected life expectancy by 0.64 years (12.5 versus 11.9 years, undiscounted) in the UK, with similar estimates in other settings. Clinical benefits translated to mean quality-adjusted life year (QALY; discounted) gains between 0.45 and 0.68 years across countries. Incremental cost-effectiveness ratios in the UK, Spain, Italy and Japan ($10 676/QALY, $14 479/QALY, $7771/QALY and $13 723/QALY, respectively) were cost-effective at country-specific willingness-to-pay thresholds. Subgroup analyses suggest dapagliflozin is cost-effective irrespective of urinary albumin-to-creatine ratio and type 2 diabetes status.CONCLUSION: Treatment with dapagliflozin may be cost-effective for patients across a wider spectrum of estimated glomerular filtration rates and albuminuria than previously demonstrated, with or without type 2 diabetes, in the UK, Spanish, Italian and Japanese he

Published
2024

41. Dapagliflozin and Blood Pressure in Patients with Chronic Kidney Disease and Albuminuria

Author

Heerspink, Hiddo J. L., Provenzano, Michele, Vart, Priya, Jongs, Niels, Correa-Rotter, Ricardo, Rossing, Peter, Mark, Patrick B., Pecoits-Filho, Roberto, McMurray, John J. V., Langkilde, Anna Maria, Wheeler, David C., Toto, Robert B., Chertow, Glenn M., Heerspink, Hiddo J. L., Provenzano, Michele, Vart, Priya, Jongs, Niels, Correa-Rotter, Ricardo, Rossing, Peter, Mark, Patrick B., Pecoits-Filho, Roberto, McMurray, John J. V., Langkilde, Anna Maria, Wheeler, David C., Toto, Robert B., and Chertow, Glenn M.

Abstract

BACKGROUND AND AIMS: Sodium-glucose cotransporter 2 inhibitors decrease blood pressure in patients with type 2 diabetes, but the consistency and magnitude of blood pressure lowering with dapagliflozin in patients with chronic kidney disease (CKD) is unknown. We conducted a prespecified analysis of the DAPA-CKD trial to investigate the effect of dapagliflozin on systolic blood pressure (SBP) in patients with CKD, with and without type 2 diabetes.METHODS: A total of 4304 adults with baseline estimated glomerular filtration rate (eGFR) 25-75 mL/min/1.73m 2 and urinary albumin-to-creatinine ratio (UACR) 200-5000 mg/g were randomized to either dapagliflozin 10 mg or placebo once daily; median follow-up was 2.4 years. The primary endpoint was a composite of sustained ≥50% eGFR decline, end-stage kidney disease, or death from a kidney or cardiovascular cause. Change in SBP was a prespecified outcome. RESULTS: Baseline mean (SD) SBP was 137.1 mmHg (17.4). By Week 2, dapagliflozin compared to placebo reduced SBP by 3.6 mmHg (95% CI 2.8-4.4 mmHg), an effect maintained over the duration of the trial (2.9 mmHg, 2.3-3.6 mmHg). Time-averaged reductions in SBP were 3.2 mmHg (2.5-4.0 mmHg) in patients with diabetes and 2.3 mmHg (1.2-3.4 mmHg) in patients without diabetes. The time-averaged effect of dapagliflozin on diastolic blood pressure (DBP) was 1.0 mmHg (0.6-1.4 mmHg); 0.8 mmHg (0.4-1.3 mmHg) in patients with diabetes and 1.4 mmHg (0.7-2.1 mmHg) in patients without diabetes. Benefits of dapagliflozin on the primary composite and secondary endpoints were evident across the spectrum of baseline SBP and DBP.CONCLUSION: In patients with CKD and albuminuria, randomization to dapagliflozin was associated with modest reductions in systolic and diastolic BP.

Published
2024

42. Efficacy and Safety of Dapagliflozin in Patients with Chronic Kidney Disease across the Spectrum of Frailty

Author

Vart, Priya, Butt, Jawad H, Jongs, Niels, Schechter, Meir, Chertow, Glenn M, Wheeler, David C, Pecoits-Filho, Roberto, Langkilde, Anna Maria, Correa-Rotter, Ricardo, Rossing, Peter, McMurray, John J V, Heerspink, Hiddo J L, Vart, Priya, Butt, Jawad H, Jongs, Niels, Schechter, Meir, Chertow, Glenn M, Wheeler, David C, Pecoits-Filho, Roberto, Langkilde, Anna Maria, Correa-Rotter, Ricardo, Rossing, Peter, McMurray, John J V, and Heerspink, Hiddo J L

Abstract

Background: A sizeable proportion of patients with chronic kidney disease (CKD) are reported to be frail. Here we examined the safety andefficacy of dapagliflozin in patients with CKD by frailty level.Methods: Adults with CKD, with/without type 2 diabetes, with an estimated glomerular filtration rate (eGFR) of 25–75 mL/min/1.73 m2 , andurinary albumin-to-creatinine ratio 200–5 000 mg/g were randomized to dapagliflozin (10 mg/day) or placebo. The primary endpoint was a com-posite of sustained ≥50% eGFR decline, end-stage kidney disease (ESKD), or death from kidney or cardiovascular (CV) causes.Results: Frailty index (FI), assessed by Rockwood cumulative deficit approach, was calculable in 4 303/4 304 (99.9%) patients: 1 162 (27.0%)in not-to-mildly frail (FI ≤0.210), 1 642 (38.2%) in moderately frail (FI 0.211–0.310), and 1 499 (34.8%) in severely frail categories (FI >0.311).Dapagliflozin reduced the risk of the primary composite endpoint across all FI categories (hazard ratios [95% confidence interval {CI}]: 0.50[0.33–0.76], 0.62 [0.45–0.85], and 0.64 [0.49–-0.83], respectively; p-interaction = 0.67). Results were similar for secondary outcomes includ-ing kidney composite outcome (sustained ≥50% eGFR decline, ESKD or death from kidney cause; p-interaction = 0.44), CV endpoint (heartfailure hospitalization or CV death; p-interaction = 0.63), and all-cause mortality (p-interaction p = .42). Results were consistent when usingFI as a continuous variable. Occurrence of serious adverse events was numerically lower in patients receiving dapagliflozin versus placeboin all FI categories (16.9% vs 20.1%, 26.3% vs 30.7%, and 42.9% vs 47.8%, in not-to-mildly, moderately, and severely frail categories,respectively).Conclusions: The relative benefit of dapagliflozin for all outcomes was consistent across all frailty categories, with no difference in associatedsafety., BACKGROUND: A sizeable proportion of patients with chronic kidney disease (CKD) are reported to be frail. Here we examined the safety and efficacy of dapagliflozin in patients with CKD by frailty level.METHODS: Adults with CKD, with/without type 2 diabetes, with estimated glomerular filtration rate (eGFR) 25-75 mL/min/1.73m 2 and urinary albumin-to-creatinine ratio 200-5000 mg/g were randomized to dapagliflozin (10 mg/day) or placebo. The primary endpoint was composite of sustained ≥50% eGFR decline, end-stage kidney disease (ESKD) or death from kidney or cardiovascular (CV) causes.RESULTS: Frailty index (FI), assessed by Rockwood cumulative deficit approach, was calculable in 4303/4304 (99.9%) patients: 1162 (27.0%) in not-to-mildly frail(FI≤0.210), 1642 (38.2%) in moderately frail(FI 0.211-0.310), and 1499 (34.8%) in severely frail categories (FI>0.311). Dapagliflozin reduced the risk of the primary composite endpoint across all FI categories (hazard ratios [95% CI]: 0.50 [0.33-0.76], 0.62 [0.45-0.85], and 0.64 [0.49-0.83], respectively (P-interaction =0.67). Results were similar for secondary outcomes including kidney composite outcome (sustained ≥50% eGFR decline, ESKD or death from kidney cause; P-interaction=0.44), CV endpoint (heart failure hospitalization or CV death; P-interaction=0.63), and all-cause mortality (P-interaction p=0.42). Results were consistent when using FI as a continuous variable. Occurrence of serious adverse events was numerically lower in patients receiving dapagliflozin vs. placebo in all FI categories (16.9% vs. 20.1%, 26.3% vs. 30.7%, and 42.9% vs 47.8%, in not-to-mildly, moderately and severely frail categories, respectively).CONCLUSIONS: The relative benefit of dapagliflozin for all outcomes was consistent across all frailty categories, with no difference in associated safety.

Published
2024

43. 423.9: The First 52 Global Kidney Exchange Transplants: Overcoming Multiple Barriers to Transplantation

Author

Rees, Michael, Roth, Alvin E., Marino, Ignazio, Krawiak, Kimberly, Rees, Susan, Sweeeney, Krista, Dunn, Ty, Punch, Jeff, Zimmerman, Michael, Aziz, Feroz, Al Obaidli, Ali Abdul Kareem, Ashlagi, Itai, Whittaker, Vaughn, Rege, Aparna, Forbes, Rachel, Kuhr, Christian, Correa-Rotter, Ricardo, Franco, Citterio, Okwenna, Obi, Paloyo, Siegfredo, Sung, Randall, Leventhall, Joseph, Mor, Eytan, Rogers, Jeffery, Tan, Miguel, Basagoitia, Laura, Ellis, Matthew, Anwar, Siddiq, and Romagnoli, Jacopo

Published
2022
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47. Global Disparities in Chronic Kidney Disease Clinical Trials: A Systematic Review

Author

Cojuc-Konigsberg, Gabriel, primary, Güijosa, Alberto, additional, Moscona-Nissan, Alberto, additional, Nordmann-Gomes, Alberto, additional, Canaviri-Flores, Vianca Anabel, additional, Braverman-Poyastro, Alan, additional, de la Fuente-Ramírez, Regina, additional, Tinajero-Sánchez, Denisse, additional, de las Fuentes Cepeda, Alejandra, additional, Noyola-Pérez, Andrés, additional, Lozano, Rafael, additional, Correa-Rotter, Ricardo, additional, and Ramírez-Sandoval, Juan C., additional

Published
2024
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49. Effects of Dapagliflozin in Chronic Kidney Disease Across the Spectrum of Age and by Sex

Author

Yu, Margaret K., primary, Vart, Priya, additional, Jongs, Niels, additional, Correa-Rotter, Ricardo, additional, Rossing, Peter, additional, McMurray, John J.V., additional, Hou, Fan-Fan, additional, Douthat, Walter, additional, Khullar, Dinesh, additional, Langkilde, Anna Maria, additional, Wheeler, David C., additional, Heerspink, Hiddo J. L., additional, and Chertow, Glenn M., additional

Published
2023
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