Search

Your search keyword '"Toto, Robert"' showing total 1,101 results
Start Over Author "Toto, Robert"
1,101 results on '"Toto, Robert"'

206. Predictors of fatal and nonfatal cardiovascular events in patients with type 2 diabetes mellitus, chronic kidney disease, and anemia: An analysis of the Trial to Reduce cardiovascular Events with Aranesp (darbepoetin-alfa) Therapy (TREAT)

Author

McMurray, John J.V., Uno, Hajime, Jarolim, Petr, Desai, Akshay S., de Zeeuw, Dick, Eckardt, Kai-Uwe, Ivanovich, Peter, Levey, Andrew S., Lewis, Eldrin F., McGill, Janet B., Parfrey, Patrick, Parving, Hans-Henrik, Toto, Robert M., Solomon, Scott D., and Pfeffer, Marc A.

Published
2011
Full Text
View/download PDF

209. Effect of Ramipril vs Amlodipine on Renal Outcomes in Hypertensive Nephrosclerosis: A Randomized Controlled Trial

Author

Agodoa, Lawrence Y., Appel, Lawrence, Bakris, George L., Beck, Gerald, Bourgoignie, Jacques, Briggs, Josephine P., Charleston, Jeanne, Cheek, DeAnna, Cleveland, William, Douglas, Janice G., Douglas, Margaret, Dowie, Donna, Faulkner, Marquetta, Gabriel, Avril, Gassman, Jennifer, Greene, Tom, Hall, Yvette, Hebert, Lee, Hiremath, Leena, Jamerson, Kenneth, Johnson, Carolyn J., Kopple, Joel, Kusek, John, Lash, James, Lea, Janice, Lewis, Julia B., Lipkowitz, Michael, Massry, Shaul, Middleton, John, Miller, Edgar R., III, Norris, Keith, O'Connor, Daniel, Ojo, Akinlou, Phillips, Robert A., Pogue, Velvie, Rahman, Mahboob, Randall, Otelio S., Rostand, Stephen, Schulman, Gerald, Smith, Winifred, Thornley-Brown, Denyse, Tisher, C. Craig, Toto, Robert D., Wright, Jackson T., Jr, and Xu, Shichen

Published
2001

212. Sympathetic overactivity in patients with chronic renal failure

Author

Converse, Richard L., Jr., Jacobsen, Tage N., Toto, Robert D., Jost, Charles M.T., Cosentino, Frank, Fouad-Tarazi, Fetnat, and Victor, Ronald G.

Subjects
Chronic kidney failure -- Complications, Hypertension -- Causes of, Nervous system, Sympathetic -- Physiological aspects
Abstract

Overactive sympathetic-nerve discharge may be a factor in the high incidence of high blood pressure seen among patients with chronic renal (kidney) failure. It appears that in patients undergoing hemodialysis for kidney failure there is long-term stimulation of the kidneys' afferent nerves, triggering excessive sympathetic-nerve discharge. The rate of discharge in the peroneal nerve was compared among 18 hemodialysis patients, 5 hemodialysis patients who had undergone the removal of both kidneys and 11 normal subjects. The discharge rate among patients receiving hemodialysis who still had their kidneys was significantly higher than among those who had them removed and was two and one-half times higher than that of normal subjects. Furthermore, 14 of the 18 patients with kidneys had high blood pressure but only one of the five patients without kidneys had high blood pressure. Kidney removal seems to lower sympathetic discharge and the risk for high blood pressure among patients with chronic kidney failure.

Published
1992

216. Effect of Intensive Blood Pressure Control on Aortic Stiffness in the SPRINT-HEART.

Author

Upadhya, Bharathi, Pajewski, Nicholas M., Rocco, Michael V., Hundley, W. Gregory, Aurigemma, Gerard, Hamilton, Craig A., Bates, Jeffrey T., He, Jiang, Chen, Jing, Chonchol, Michel, Glasser, Steve P., Hung, Adriana M., Pisoni, Roberto, Punzi, Henry, Supiano, Mark A., Toto, Robert, Taylor, Addison, Kitzman, Dalane W., and SPRINT Research Group

Abstract

[Figure: see text]. [ABSTRACT FROM AUTHOR]

Published
2021
Full Text
View/download PDF

218. MOESM1 of Rationale, design, and baseline characteristics of the CArdiovascular safety and Renal Microvascular outcomE study with LINAgliptin (CARMELINAÂŽ): a randomized, double-blind, placebo-controlled clinical trial in patients with type 2 diabetes and high cardio-renal risk

Author

Rosenstock, Julio, Perkovic, Vlado, Alexander, John, Cooper, Mark, Marx, Nikolaus, Pencina, Michael, Toto, Robert, Wanner, Christoph, Zinman, Bernard, Baanstra, David, Pfarr, Egon, Mattheus, Michaela, Broedl, Uli, Hans-Juergen Woerle, Jyothis George, Eynatten, Maximilian, and McGuire, Darren

Abstract

Additional file 1. Full inclusion and exclusion criteria for CARMELINAÂŽ.

Published
2018
Full Text
View/download PDF

224. 388-P: Interrelationship between Hypoglycemia and CV and Mortality Outcomes in Type 2 Diabetes in the CARMELINA Trial

Author

ROSENSTOCK, JULIO, primary, KAHN, STEVEN E., additional, JOHANSEN, ODD ERIK, additional, COOPER, MARK E., additional, MARX, NIKOLAUS, additional, ALEXANDER, JOHN H., additional, TOTO, ROBERT D., additional, WANNER, CHRISTOPH, additional, PFARR, EGON, additional, SCHNAIDT, SVEN, additional, GEORGE, JYOTHIS, additional, EYNATTEN, MAXIMILIAN VON, additional, MCGUIRE, DARREN K., additional, PERKOVIC, VLADO, additional, and ZINMAN, BERNARD, additional

Published
2019
Full Text
View/download PDF

225. 432-P: Analyses of First plus Recurrent Cardiovascular and Hospitalization Events in the Cardiovascular and Renal Microvascular Outcome Study with Linagliptin (CARMELINA) in Patients with Type 2 Diabetes and Cardiorenal Disease

Author

MARX, NIKOLAUS, primary, MCGUIRE, DARREN K., additional, JOHANSEN, ODD ERIK, additional, ROSENSTOCK, JULIO, additional, KAHN, STEVEN E., additional, COOPER, MARK E., additional, TOTO, ROBERT D., additional, WANNER, CHRISTOPH, additional, PFARR, EGON, additional, SCHNAIDT, SVEN, additional, GEORGE, JYOTHIS, additional, EYNATTEN, MAXIMILIAN VON, additional, PERKOVIC, VLADO, additional, ZINMAN, BERNARD, additional, and ALEXANDER, JOHN H., additional

Published
2019
Full Text
View/download PDF

227. Count me in: using a patient portal to minimize implicit bias in clinical research recruitment

Author

Kannan, Vaishnavi, primary, Wilkinson, Kathleen E, additional, Varghese, Mereeja, additional, Lynch-Medick, Sarah, additional, Willett, Duwayne L, additional, Bosler, Teresa A, additional, Chu, Ling, additional, Gates, Samantha I, additional, Holbein, M E Blair, additional, Willett, Mallory M, additional, Reimold, Sharon C, additional, and Toto, Robert D, additional

Published
2019
Full Text
View/download PDF

228. Blood pressure in chronic kidney disease: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference

Author

Cheung, Alfred K., primary, Chang, Tara I., additional, Cushman, William C., additional, Furth, Susan L., additional, Ix, Joachim H., additional, Pecoits-Filho, Roberto, additional, Perkovic, Vlado, additional, Sarnak, Mark J., additional, Tobe, Sheldon W., additional, Tomson, Charles R.V., additional, Cheung, Michael, additional, Wheeler, David C., additional, Winkelmayer, Wolfgang C., additional, Mann, Johannes F.E., additional, Bakris, George L., additional, Damasceno, Albertino, additional, Dwyer, Jamie P., additional, Fried, Linda F., additional, Haynes, Richard, additional, Hirawa, Nobuhito, additional, Holdaas, Hallvard, additional, Ibrahim, Hassan N., additional, Ingelfinger, Julie R., additional, Iseki, Kunitoshi, additional, Khwaja, Arif, additional, Kimmel, Paul L., additional, Kovesdy, Csaba P., additional, Ku, Elaine, additional, Lerma, Edgar V., additional, Luft, Friedrich C., additional, Lv, Jicheng, additional, McFadden, Christopher B., additional, Muntner, Paul, additional, Myers, Martin G., additional, Navaneethan, Sankar D., additional, Parati, Gianfranco, additional, Peixoto, Aldo J., additional, Prasad, Ramesh, additional, Rahman, Mahboob, additional, Rocco, Michael V., additional, Rodrigues, Cibele Isaac Saad, additional, Roger, Simon D., additional, Stergiou, George S., additional, Tomlinson, Laurie A., additional, Tonelli, Marcello, additional, Toto, Robert D., additional, Tsukamoto, Yusuke, additional, Walker, Robert, additional, Wang, Angela Yee-Moon, additional, Wang, Jiguang, additional, Warady, Bradley A., additional, Whelton, Paul K., additional, and Williamson, Jeff D., additional

Published
2019
Full Text
View/download PDF

230. SUN-LB015 Baseline Characteristics and Effects on CV and Kidney Outcomes with Linagliptin Versus Placebo, Across GFR Categories in CARMELINA

Author

Kahn, Steven, primary, Perkovic, Vlado, additional, Johansen, Odd Erik, additional, Rosenstock, Julio, additional, McGuire, Darren, additional, Toto, Robert, additional, Nikolaus, Marx, additional, Alexander, John, additional, Zinman, Bernard, additional, Pfarr, Egon, additional, Schnaidt, Sven, additional, Meinicke, Thomas, additional, George, Jyothis, additional, von Eynatten, Max, additional, Cooper, Mark, additional, and Wanner, Christoph, additional

Published
2019
Full Text
View/download PDF

231. Treatment of Anemia With Darbepoetin Prior to Dialysis Initiation and Clinical Outcomes: Analyses From the Trial to Reduce Cardiovascular Events With Aranesp Therapy (TREAT)

Author

Mc Causland, Finnian R., primary, Claggett, Brian, additional, Burdmann, Emmanuel A., additional, Chertow, Glenn M., additional, Cooper, Mark E., additional, Eckardt, Kai-Uwe, additional, Ivanovich, Peter, additional, Levey, Andrew S., additional, Lewis, Eldrin F., additional, McGill, Janet B., additional, McMurray, John J.V., additional, Parfrey, Patrick, additional, Parving, Hans-Henrik, additional, Remuzzi, Giuseppe, additional, Singh, Ajay K., additional, Solomon, Scott D., additional, Toto, Robert D., additional, and Pfeffer, Marc A., additional

Published
2019
Full Text
View/download PDF

232. Change in albuminuria as a surrogate endpoint for progression of kidney disease: a meta-analysis of treatment effects in randomised clinical trials

Author

Heerspink, Hiddo J L, primary, Greene, Tom, additional, Tighiouart, Hocine, additional, Gansevoort, Ron T, additional, Coresh, Josef, additional, Simon, Andrew L, additional, Chan, Tak Mao, additional, Hou, Fan Fan, additional, Lewis, Julia B, additional, Locatelli, Francesco, additional, Praga, Manuel, additional, Schena, Francesco Paolo, additional, Levey, Andrew S, additional, Inker, Lesley A, additional, Sevillano, Angel, additional, Kamper, Anne-Lise, additional, van Zuilen, Arjan D., additional, Brenner, Barry M., additional, Maes, Bart, additional, Ihle, Benno U., additional, Barret, Brendan, additional, Leung, CB, additional, Szeto, CC, additional, Fitzner, Christina, additional, Wanner, Christoph, additional, Pozzi, Claudio, additional, Montagnino, Claudio Ponticelli, additional, Xie, Di, additional, de Zeeuw, Dick, additional, Lewis, Edmund, additional, Verde, Eduardo, additional, Gutierrez, Eduardo, additional, Imai, Enyu, additional, Caravaca, Fernando, additional, Fervenza, Fernando C., additional, Kobayashi, Fumiaki, additional, Moroni, Gabriella, additional, Becker, Gavin J., additional, Beck, Gerald J., additional, Appel, Gerald B., additional, Frisch, Gershon, additional, van Essen, GG, additional, Maschio, Giuseppe, additional, Remuzzi, Giuseppe, additional, Montogrino, Giuseppe, additional, Parving, Hans-Henrik, additional, Heerspink, Hiddo J.L., additional, Makino, Hirofumi, additional, Jehan, Imitiaz, additional, Wetzels, Jack F.M., additional, Donadio, James, additional, Dwyer, Jamie, additional, van den Brand, Jan, additional, Kusek, John, additional, Lachin, John M., additional, Luño, Jose, additional, Lewis, Julia B., additional, Floege, Jürgen, additional, Abebe, Kaleab Z., additional, Chow, KM, additional, Hunsicker, Lawrence G., additional, del Vecchio, Lucia, additional, Carlo, Manno, additional, Goicoechea, Marian, additional, von Eynatten, Maximilian, additional, Poulter, Neil, additional, Chaturvedi, Nish, additional, Passerini, Patrizia, additional, de Jong, Paul E., additional, Blankestijn, Peter J., additional, Li, Philip, additional, Ruggenenti, Piero, additional, Zucchelli, Pietro, additional, Kincaid-Smith, Priscilla S., additional, Hilgers, Ralf-Dieter, additional, Estacio, Raymond O., additional, Rohde, Richard D., additional, Katafuchi, Ritsuko, additional, Toto, Robert D., additional, Schrier, Robert W., additional, Rodby, Roger A., additional, Perrone, Ronald D., additional, Ito, Sadayoshi, additional, Klahr, Saulo, additional, Andrulli, Simeone, additional, Strandgaard, Svend, additional, Hannedouche, Thierry P., additional, Rauen, Thomas, additional, Verdalles, Ursula, additional, Perkovic, Vlado, additional, and Keane, William, additional

Published
2019
Full Text
View/download PDF

234. 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

Abstract

Chronic kidney disease and heart failure are insulin resistant states associated with a high incidence of diabetes. We assessed the effect of dapagliflozin on new-onset type 2 diabetes in a pooled analysis of patient-level data from the DAPA-CKD and DAPA-HF trials.

Published
2022
Full Text
View/download PDF

236. Associations of High-Sensitivity Troponin and Natriuretic Peptide Levels With Outcomes After Intensive Blood Pressure Lowering: Findings From the SPRINT Randomized Clinical Trial

Author

Berry, Jarett D., Nambi, Vijay, Ambrosius, Walter T., Chen, Haiying, Killeen, Anthony A., Taylor, Addison, Toto, Robert D., Soliman, Elsayed Z., McEvoy, John W., Pandey, Ambarish, Joshi, Parag H., Blankenberg, Stefan, Kitzman, Dalane W., Ballantyne, Christie M., and de Lemos, James A.

Abstract

IMPORTANCE: Elevated high-sensitivity cardiac troponin T (hscTnT) and N-terminal pro–B-type natriuretic peptide (NTproBNP) levels are associated with risk of heart failure (HF) and mortality among individuals in the general population. However, it is unknown if this risk is modifiable. OBJECTIVE: To test the hypothesis that elevated hscTnT and NTproBNP levels would identify individuals with the greatest risk for mortality and HF and the largest benefit associated with intensive systolic blood pressure (SBP) lowering. DESIGN, SETTING, AND PARTICIPANTS: This is a nonprespecified post hoc analysis of the multicenter, prospective, randomized clinical Systolic Blood Pressure Intervention Trial (SPRINT), conducted from October 20, 2010, to August 20, 2015. A total of 9361 patients without diabetes with increased risk for cardiovascular disease were randomized to receive intensive vs standard SBP lowering. Statistical analysis was performed on an intention-to-treat basis from September 30, 2019, to July 29, 2021. INTERVENTIONS: Participants were randomized to undergo intensive (<120 mm Hg) or standard (<140 mm Hg) SBP lowering. High-sensitivity cardiac troponin T and NTproBNP levels were measured from stored specimens collected at enrollment, with elevated levels defined as 14 ng/L or more for hscTnT (to convert to micrograms per liter, multiply by 0.001) and 125 pg/mL or more for NTproBNP (to convert to nanograms per liter, multiply by 1.0). MAIN OUTCOMES AND MEASURES: The primary outcome of this ancillary study was HF and mortality. RESULTS: Of the 9361 participants enrolled in SPRINT, 8828 (5578 men [63.2%]; mean [SD] age, 68.0 [9.5] years) had measured hscTnT levels and 8836 (5585 men [63.2%]; mean [SD] age, 68.0 [9.5] years) had measured NTproBNP levels; 2262 of 8828 patients (25.6%) had elevated hscTnT levels, 3371 of 8836 patients (38.2%) had elevated NTproBNP, and 1411 of 8828 patients (16.0%) had both levels elevated. Randomization to the intensive SBP group led to a 4.9% (95% CI, 1.7%-7.5%) absolute risk reduction (ARR) over 4 years in death and HF (421 events) for those with elevated hscTnT and a 1.7% (95% CI, 0.7%-2.5%) ARR for those without elevated levels. Similarly, for those with elevated NTproBNP, the ARR for death and HF over 4 years was 4.6% (95% CI, 2.3%-6.5%) vs 1.8% (95% CI, 0.9%-2.5%) in those without elevated levels. For those with elevated levels of both biomarkers, the ARR for death and HF over 4 years was 7.8% (95% CI, 3.3%-11.3%) vs 1.7% (95% CI, 0.8%-2.3%) in those with neither biomarker elevated. No significant treatment group by biomarker category interactions were detected. CONCLUSIONS AND RELEVANCE: Intensive SBP control led to large absolute differences in death and HF among patients with abnormal hscTnT and NTproBNP levels. These findings demonstrate that risk associated with elevation of these biomarkers is modifiable with intensive BP control. A prospective, randomized clinical trial is needed to evaluate whether these biomarkers may help guide selection of patients for intensive SBP lowering. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01206062

Published
2021
Full Text
View/download PDF

237. Effects of Dapagliflozin in Patients With Kidney Disease, With and Without Heart Failure

Author

McMurray, John J.V., Wheeler, David C., Stefánsson, Bergur V., Jongs, Niels, Postmus, Douwe, Correa-Rotter, Ricardo, Chertow, Glenn M., Hou, Fan Fan, Rossing, Peter, Sjöström, C. David, Solomon, Scott D., Toto, Robert D., Langkilde, Anna Maria, and Heerspink, Hiddo J.L.

Abstract

The purpose of this paper was to investigate the effects of dapagliflozin in chronic kidney disease (CKD) patients, with and without heart failure (HF).

Published
2021
Full Text
View/download PDF

238. Effect of dapagliflozin on urinary albumin excretion in patients with chronic kidney disease with and without type 2 diabetes: a prespecified analysis from the DAPA-CKD trial

Author

Jongs, Niels, Greene, Tom, Chertow, Glenn M, McMurray, John J V, Langkilde, Anna Maria, Correa-Rotter, Ricardo, Rossing, Peter, Sjöström, C David, Stefansson, Bergur V, Toto, Robert D, Wheeler, David C, and Heerspink, Hiddo J L

Abstract

Reductions in albuminuria are associated with a subsequent lower risk of kidney failure in patients with chronic kidney disease. The SGLT2 inhibitor dapagliflozin significantly reduced albuminuria in patients with type 2 diabetes and normal or near-normal kidney function. Whether this effect persists in patients with chronic kidney disease with and without type 2 diabetes is unknown. We assessed the effects of dapagliflozin on albuminuria in patients with chronic kidney disease with and without type 2 diabetes in the dapagliflozin and prevention of adverse outcomes in chronic kidney disease (DAPA-CKD) trial.

Published
2021
Full Text
View/download PDF

239. Effect of dapagliflozin on the rate of decline in kidney function in patients with chronic kidney disease with and without type 2 diabetes: a prespecified analysis from the DAPA-CKD trial

Author

Heerspink, Hiddo J L, Jongs, Niels, Chertow, Glenn M, Langkilde, Anna Maria, McMurray, John J V, Correa-Rotter, Ricardo, Rossing, Peter, Sjöström, C David, Stefansson, Bergur V, Toto, Robert D, Wheeler, David C, and Greene, Tom

Abstract

Dapagliflozin reduced the risk of kidney failure in patients with chronic kidney disease with and without type 2 diabetes in the DAPA-CKD trial. In this pre-specified analysis, we assessed the effect of dapagliflozin on the rate of change in estimated glomerular filtration rate (eGFR)—ie, the eGFR slope.

Published
2021
Full Text
View/download PDF

243. Accrual to Clinical Trials (ACT): A Clinical and Translational Science Award Consortium Network.

Author

Visweswaran, Shyam, Visweswaran, Shyam, Becich, Michael J, D'Itri, Vincent S, Sendro, Elaina R, MacFadden, Douglas, Anderson, Nicholas R, Allen, Karen A, Ranganathan, Dipti, Murphy, Shawn N, Morrato, Elaine H, Pincus, Harold A, Toto, Robert, Firestein, Gary S, Nadler, Lee M, Reis, Steven E, Visweswaran, Shyam, Visweswaran, Shyam, Becich, Michael J, D'Itri, Vincent S, Sendro, Elaina R, MacFadden, Douglas, Anderson, Nicholas R, Allen, Karen A, Ranganathan, Dipti, Murphy, Shawn N, Morrato, Elaine H, Pincus, Harold A, Toto, Robert, Firestein, Gary S, Nadler, Lee M, and Reis, Steven E

Abstract

The Accrual to Clinical Trials (ACT) network is a federated network of sites from the National Clinical and Translational Science Award (CTSA) Consortium that has been created to significantly increase participant accrual to multi-site clinical trials. The ACT network represents an unprecedented collaboration among diverse CTSA sites. The network has created governance and regulatory frameworks and a common data model to harmonize electronic health record (EHR) data, and deployed a set of Informatics for Integrating Biology and the Bedside (i2b2) data repositories that are linked by the Shared Health Research Information Network (SHRINE) platform. It provides investigators the ability to query the network in real time and to obtain aggregate counts of patients who meet clinical trial inclusion and exclusion criteria from sites across the United States. The ACT network infrastructure provides a basis for cohort discovery and for developing new informatics tools to identify and recruit participants for multi-site clinical trials.

Published
2018

244. Effect of linagliptin versus placebo on cardiovascular and kidney outcomes in nephrotic-range proteinuria and type 2 diabetes: the CARMELINA randomized controlled trial.

Author

Wanner, Christoph, Cooper, Mark E, Johansen, Odd Erik, Toto, Robert, Rosenstock, Julio, McGuire, Darren K, Kahn, Steven E, Pfarr, Egon, Schnaidt, Sven, Eynatten, Maximilian von, George, Jyothis T, Gollop, Nicholas D, Marx, Nikolaus, Alexander, John H, Zinman, Bernard, Perkovic, Vlado, and investigators, the CARMELINA

Subjects
TYPE 2 diabetes, PROTEINURIA, CHRONIC kidney failure, KIDNEYS, KIDNEY diseases, PLASMAPHERESIS, LINAGLIPTIN
Abstract

Background Nephrotic-range proteinuria (NRP) is associated with rapid kidney function loss and increased cardiovascular (CV) disease risk. We assessed the effects of linagliptin (LINA) on CV and kidney outcomes in people with Type 2 diabetes (T2D) with or without NRP. Methods Cardiovascular and renal microvascular outcome study with LINA randomized participants with T2D and CV disease and/or kidney disease to LINA 5 mg or placebo (PBO). The primary endpoint [time to first occurrence of 3-point major adverse cardiac events (3P-MACE)], and kidney outcomes, were evaluated by NRP status [urinary albumin:creatinine ratio (UACR) ≥2200 mg/g] at baseline (BL) in participants treated with one or more dose of study medication. Results NRP was present in 646/6979 [9.3% (LINA/PBO n  = 317/ n  = 329); median UACR 3486 (Q1: 2746/Q3: 4941) mg/g] participants, who compared with no-NRP were younger (62.3/66.1 years) and had lower estimated glomerular filtration rate (eGFR) (39.9/56.1 mL/min/1.73 m2). Over a median of 2.2 years, 3P-MACE occurred with a 2.0-fold higher rate in NRP versus no-NRP (PBO group), with a neutral LINA effect, regardless of NRP. The composite of time to renal death, end-stage kidney disease (ESKD) or decrease of ≥40 or ≥50% in eGFR, occurred with 12.3- and 13.6-fold higher rate with NRP (PBO group); evidence of heterogeneity of effects with LINA was observed for the former [NRP yes/no: hazard ratio 0.80 (0.63–1.01)/1.25 (1.02–1.54); P-interaction 0.005], but not the latter [0.83 (0.64–1.09)/1.17 (0.91–1.51), P-interaction 0.07]. No heterogeneity was observed for renal death or ESKD [0.88 (0.64–1.21)/0.94 (0.67–1.31), P-interaction 0.79]. Glycated haemoglobin A1c (HbA1c) was significantly reduced regardless of NRP, without increasing hypoglycaemia risk. Regression to normoalbuminuria [1.20 (1.07–1.34)] and reduction of UACR ≥50% [1.15 (1.07–1.25)] from BL, occurred more frequently with LINA, regardless of NRP status (P-interactions >0.05). Conclusions Individuals with T2D and NRP have a high disease burden. LINA reduces their albuminuria burden and HbA1c, without affecting CV or kidney risk. [ABSTRACT FROM AUTHOR]

Published
2021
Full Text
View/download PDF

245. The effects of atrasentan on urinary metabolites in patients with type 2 diabetes and nephropathy

Author

Pena, Michelle J, de Zeeuw, Dick, Andress, Dennis, Brennan, John J, Correa-Rotter, Ricardo, Coll, Blai, Kohan, Donald E, Makino, Hirofumi, Perkovic, Vlado, Remuzzi, Giuseppe, Tobe, Sheldon W, Toto, Robert, Parving, Hans-Henrik, Sharma, Shoba, Corringham, Tom, Sharma, Kumar, Lambers Heerspink, Hiddo J. L., Groningen Kidney Center (GKC), Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), and Methods in Medicines evaluation & Outcomes research (M2O)

Subjects
MITOCHONDRIAL-FUNCTION, ALBUMINURIA, ANTAGONISTS, ENDOTHELIN, eGFR decline, KIDNEY-DISEASE, metabolomics, diabetic kidney disease, DYSFUNCTION
Abstract

We assessed the effect of atrasentan therapy on a pre-specified panel of 13 urinary metabolites known to reflect mitochondrial function in patients with diabetic kidney disease. This post-hoc analysis was performed using urine samples collected during the RADAR study which was a randomized, double-blind, placebo-controlled trial that tested the effects of atrasentan on albuminuria reduction in patients with type 2 diabetes and nephropathy. At baseline, four of the 13 metabolites, quantified by gas-chromatography mass spectrometry, were below detectable levels, and six were reduced in patients with eGFR

Published
2017

249. 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.

Abstract

Immunoglobulin A (IgA) nephropathy is a common form of glomerulonephritis, which despite use of renin-angiotensin-aldosterone-system blockers and immunosuppressants, often progresses to kidney failure. In the Dapagliflozin and Prevention of Adverse Outcomes in Chronic Kidney Disease trial, dapagliflozin reduced the risk of kidney failure and prolonged survival in participants with chronic kidney disease with and without type 2 diabetes, including those with IgA nephropathy. Participants with estimated glomerular filtration rate (eGFR) 25-75 mL/min/1.73m2and urinary albumin-to-creatinine ratio 200-5000 mg/g (22.6-565 mg/mol) were randomized to dapagliflozin 10mg or placebo, as adjunct to standard care. The primary composite endpoint was a sustained decline in eGFR of 50% or more, end-stage kidney disease, or death from a kidney disease-related or cardiovascular cause. Of 270 participants with IgA nephropathy (254 [94%] confirmed by previous biopsy), 137 were randomized to dapagliflozin and 133 to placebo, and followed for median 2.1 years. Overall, mean age was 51.2 years; mean eGFR, 43.8 mL/min/1.73m2; and median urinary albumin-to-creatinine ratio, 900 mg/g. The primary outcome occurred in six (4%) participants on dapagliflozin and 20 (15%) on placebo (hazard ratio, 0.29; 95% confidence interval, 0.12, 0.73). Mean rates of eGFR decline with dapagliflozin and placebo were −3.5 and −4.7 mL/min/1.73m2/year, respectively. Dapagliflozin reduced the urinary albumin-to-creatinine ratio by 26% relative to placebo. Adverse events leading to study drug discontinuation were similar with dapagliflozin and placebo. There were fewer serious adverse events with dapagliflozin, and no new safety findings in this population. Thus, in participants with IgA nephropathy, dapagliflozin reduced the risk of chronic kidney disease progression with a favorable safety profile.

Published
2021
Full Text
View/download PDF

250. Effects of Linagliptin on Cardiovascular and Kidney Outcomes in People With Normal and Reduced Kidney Function: Secondary Analysis of the CARMELINA Randomized Trial.

Author

Perkovic, Vlado, Toto, Robert, Cooper, Mark E., Mann, Johannes F.E., Rosenstock, Julio, McGuire, Darren K., Kahn, Steven E., Marx, Nikolaus, Alexander, John H., Zinman, Bernard, Pfarr, Egon, Schnaidt, Sven, Meinicke, Thomas, von Eynatten, Maximillian, George, Jyothis T., Johansen, Odd Erik, Wanner, Christoph, and CARMELINA investigators

Subjects
*THERAPEUTIC use of protease inhibitors, *CARDIOVASCULAR disease prevention, *CHRONIC kidney failure, *GLOMERULAR filtration rate, *KIDNEYS, *PROTEASE inhibitors, *MORTALITY, *CARDIOVASCULAR diseases, *HYPOGLYCEMIC agents, *RETROSPECTIVE studies, *PROGNOSIS, *DISEASE incidence, *CARDIOVASCULAR system, *TYPE 2 diabetes, *TREATMENT effectiveness, *DIABETIC nephropathies, *PHARMACODYNAMICS, *DISEASE complications, CHRONIC kidney failure complications
Abstract

Objective: Type 2 diabetes is a leading cause of kidney failure, but few outcome trials proactively enrolled individuals with chronic kidney disease (CKD). We performed secondary analyses of cardiovascular (CV) and kidney outcomes across baseline estimated glomerular filtration rate (eGFR) categories (≥60, 45 to <60, 30 to <45, and <30 mL/min/1.73 m2) in Cardiovascular and Renal Microvascular Outcome Study With Linagliptin (CARMELINA), a cardiorenal placebo-controlled outcome trial of the dipeptidyl peptidase 4 inhibitor linagliptin (NCT01897532).Research Design and Methods: Participants with CV disease and/or CKD were included. The primary outcome was time to first occurrence of CV death, nonfatal myocardial infarction, or nonfatal stroke (three-point major adverse CV event [3P-MACE]), with a secondary outcome of renal death, end-stage kidney disease, or sustained ≥40% decrease in eGFR from baseline. Other end points included progression of albuminuria, change in HbA1c, and adverse events (AEs) including hypoglycemia.Results: A total of 6,979 subjects (mean age 65.9 years; eGFR 54.6 mL/min/1.73 m2; 80.1% albuminuria) were followed for 2.2 years. Across eGFR categories, linagliptin as compared with placebo did not affect the risk for 3P-MACE (hazard ratio 1.02 [95% CI 0.89, 1.17]) or the secondary kidney outcome (1.04 [0.89, 1.22]) (interaction P values >0.05). Regardless of eGFR, albuminuria progression was reduced with linagliptin, as was HbA1c, without increasing risk for hypoglycemia. AEs were balanced among groups overall and across eGFR categories.Conclusions: Across all GFR categories, in participants with type 2 diabetes and CKD and/or CV disease, there was no difference in risk for linagliptin versus placebo on CV and kidney events. Significant reductions in risk for albuminuria progression and HbA1c and no difference in AEs were observed. [ABSTRACT FROM AUTHOR]

Published
2020
Full Text
View/download PDF

Catalog

Books, media, physical & digital resources
See catalog results