Publications
Stay up to date with our literature reviews which are curated by experts to feature the most important publications released each month. Explore our publications for access to concise summary slides for your own use.
Including Measures of Chronic Kidney Disease to Improve Cardiovascular Risk Prediction by SCORE2 and SCORE2-OP
Eur J Prev Cardiol. 2023;30:8–16 DOI: 10.1093/eurjpc/zwac176
The 2021 ESC guideline on CVD prevention categorises moderate and severe CKD as high and very-high CVD risk status regardless of other factors like age and does not include eGFR and albuminuria in its SCORE2 and SCORE2-OP algorithms to predict CVD risk. Here, three CKD ‘Add-ons' to SCORE2 and SCORE2-OP were developed and validated: eGFR only, eGFR + urinary albumin-to-creatinine ratio (the primary Add-on), and eGFR + dipstick proteinuria.
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Efficacy of Dapagliflozin by Baseline Diabetes Medications: A Prespecified Analysis From the DAPA-CKD Study
Diabetes Care. 2023; online ahead of print DOI: 10.2337/dc22-1514
Achieving optimal glucose control can be challenging in patients with T2D and CKD because impaired kidney function hampers the use of several oral or injectable glucose-lowering therapies (GLTs) and increases the likelihood of hypoglycaemia. This prespecified analysis from the DAPA-CKD trial evaluated whether the benefits of dapagliflozin in patients with T2D and CKD varied by background GLT number or class.
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Effect of Finerenone on Ambulatory Blood Pressure in Chronic Kidney Disease in Type 2 Diabetes
J Hypertens. 2023;41:295–302 DOI: 10.1097/HJH.0000000000003330
It has been postulated that the effects of finerenone on cardiorenal outcomes may be mediated primarily via non-haemodynamic pathways, but office BP measurements are insufficient to fully assess haemodynamic effects. A substudy of the ARTS-DN phase IIb trial was conducted to obtain further insights into the mechanism of action of finerenone by analysing 24-h ambulatory BP in patients with CKD and T2D.
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Empagliflozin in Patients with Chronic Kidney Disease
N Engl J Med. 2022; online ahead of print
Among a wide range of at-risk patients with CKD, empagliflozin reduced progression of kidney disease or death from CV causes compared with placebo in the EMPA-KIDNEY trial.
Previous large trials involving patients with diabetic kidney disease and albuminuria have shown that SGLT2i reduce the risk of progression to kidney failure; however, most patients with CKD have low levels of albuminuria (UACR <300 mg/g) and do not have diabetes.
Cost-Effectiveness of Dapagliflozin as a Treatment for Chronic Kidney Disease: A Health-Economic Analysis of DAPA-CKD
Clin J Am Soc Nephrol. 2022; online ahead of print DOI: 10.2215/CJN.03790322
Dapagliflozin has been shown to reduce CKD progression and KRT requirement when added to standard therapy in patients with CKD in the DAPA-CKD trial. This analysis was designed to estimate the cost-effectiveness of dapagliflozin for the treatment of CKD from payer perspectives in the UK, Germany and Spain.
Finerenone efficacy in patients with chronic kidney disease, type 2 diabetes and atherosclerotic cardiovascular disease
Eur Heart J Cardiovasc Pharmacother. 2022; online ahead of print DOI: 10.1093/ehjcvp/pvac054
Finerenone reduced the risk of CV and kidney outcomes consistently across the spectrum of CKD in patients with T2D, irrespective of prevalent ASCVD.
Finerenone in Patients With Chronic Kidney Disease and Type 2 Diabetes by Sodium–Glucose Cotransporter 2 Inhibitor Treatment: The FIDELITY Analysis
Diabetes Care 2022; online ahead of print doi: 10.2337/dc22-0294
In the FIDELITY analysis, finerenone reduced the risk of cardiovascular and kidney outcomes compared with placebo. Concomitant treatment with a sodium-glucose cotransporter-2 inhibitor (SGLT2i) did not modify the observed benefits.
FIDELITY pooled populations from the FIDELIO-DKD and FIGARO-DKD studies in order to examine the effect of finerenone and interaction with SGLT2i use on prespecified outcomes in patients with chronic kidney disease (CKD) and type 2 diabetes (T2D). In both trial, use of SGLT2i was permitted at baseline, as was initiation of SGLT2i at any time during the trial.
Effect of Canagliflozin on Total Cardiovascular Burden in Patients With Diabetes and Chronic Kidney Disease: A Post Hoc Analysis From the CREDENCE Trial
J Am Heart Assoc 2022;11:e025045 DOI: 10.1161/JAHA.121.025045
Cardiovascular disease is highly prevalent, and represents a major burden in patients with both T2D and CKD. In the CREDENCE trial, canagliflozin reduced the risk of first composite cardiovascular events; this post hoc analysis evaluated the effect on total (first and recurrent) events. During the trial, a total of 883 cardiovascular events occurred in 634 patients; 72% were first and 28% were subsequent events. Analysis showed canagliflozin reduced first and total cardiovascular events by 26% and 29%, respectively, with consistent results across patient subgroups and by baseline cardiovascular history.
These findings provide further support for the benefit of continuing canagliflozin therapy after an initial event to prevent recurrent CV events.
Semaglutide in Type 2 Diabetes With Chronic Kidney Disease at High Risk of Progression: Real-World Clinical Practice
Clin Kidney J 2022;15(8);1593-600 doi: 10.1093/ckj/sfac096
In this real-world study, patients with type 2 diabetes (T2D) and chronic kidney disease (CKD) treated with semaglutide significantly improved glycaemic control and decreased weight.
Empagliflozin and Incidence of Events Consistent With Acute Kidney Injury: Pooled Safety Analysis in More Than 15,000 Individuals
Diabetes Obes Metab 2022;24:1390-3 doi: 10.1111/dom.14694
In this pooled analysis of patients from the global empagliflozin trial programme, the risk of acute kidney injury (AKI) and acute kidney disease (AKD) with empagliflozin was comparable with placebo. This comprehensive analysis indicates that empagliflozin is not associated with an increased risk of acute kidney failure compared with placebo treatment.