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Important nephrology trials

important nephrology trials Randomized trials of catheter-based renal denervation (RDN) as therapy for resistant hypertension showed conflicting results in blood pressure (BP) lowering effect. Quality of life and symptom sub-studies are commonly carried out in clinical trials, as patient reported outcomes are increasingly recognised as important for understanding patients’ experience during treatment and providing support for or against experimental treatments. , F. Novel classes of diabetes therapies present an important opportunity for nephroprotection beyond the blockade of the renin–angiotensin–aldosterone system in this high-risk group. Sodium is a mineral found in salt (sodium chloride), and it is widely used in food preparation. The DISCOVER trial is a multi-year global Phase 3 registrational clinical trial evaluating the safety and efficacy of once-daily Descovy for PrEP compared with Truvada for PrEP ® in men and transgender women who have sex with men and are at risk for sexually acquired HIV infection. Consulting on design of new drugs or devices, clinical trials, the use of specific agents or other research-related activities for the following companies, with honoraria: Bayer, member of event adjudication committee for a clinical trial. A. Find out if clinical trials are right for you. In the clinical science section, we consider clinical trials (RCTs have a priority in our journal), observational studies at large and original work on health economy as applied to nephrology. Click on a condition below to find clinical trials actively recruiting research study volunteers in your area. 1,2 Nevertheless, given the huge prevalence of hypertension in the general population, it still remains the second leading cause of end-stage renal disease (ESRD), with the risk being substantially higher in blacks. Blood pressure control is increasingly important once the renal lesion is present and as renal damage progresses. •Nephrology needs more RCTs to improve care •In the last 12(ish) months we saw advances in treating patients with: •Diabetic kidney disease progressing to dialysis •Glomerulonephritis •Complications of dialysis •Exciting next five years! •More trials •Larger trials •Treatments for problems most important to patients Medtronic, for renal denervation study in patients with treatment-resistant hypertension, receiving honoraria. The renal diet is characterized by the reduction of dietary sodium, potassium, and phosphorus. 22 studies in Kidney Transplant Program (open studies only). The blood protein albumin makes up much of the protein that is lost, though many other important proteins are also lost in nephrotic syndrome. Authors should include the name of the trial register and their clinical trial registration number in the Acknowledgements section of their manuscript. The perceived negative outcome of the trial was that plasma exchange was not really superior to standard of care. Thus far, three large phase III trials of IO combinations compared to sunitinib, including CheckMate-214, 1,2 Keynote-426, 3 and Javelin Renal 101 4 (Table 1), have expanded treatment options for patients. (Nasdaq: EXEL) today announced that COSMIC-313, the phase 3 pivotal trial evaluating the combination of cabozantinib (CABOMETYX ®), nivolumab Dapagliflozin in Patients With Chronic Kidney Disease (DAPA-CKD) Trial 2 Sodium-glucose cotransporter-2 (SGLT-2) inhibitors are known to reduce heart failure hospitalization. Duke Nephrology. Next review due: 24 Feb 2023. Statins do not add benefit in CCF in patients with no other indication and ultrafiltration appears inferior to stepped medical therapy in patients with acute cardio-renal syndrome Surgical revascularisation may be beneficial in some patients ( STITCH ) but the high crossover in this trial makes interpretation very difficult. Clinical trials look at new ways to prevent, detect, or treat disease. Csaba P. News & World Report has ranked nephrology care here among the top 50 programs in the country. A. Renal Denervation in Patients With Uncontrolled Hypertension ; Purpose: The Symplicity HTN-3 study is a, multi-center, prospective, single-blind, randomized, controlled study of the safety and effectiveness of renal denervation in subjects with uncontrolled hypertension. The trial stopped early due to overwhelming benefit. People with kidney failure are demanding better alternatives to dialysis and transplantation. The An analysis of the RADIANCE-HTN SOLO trial, for instance, showed that patients with untreated accessory arteries had less of a BP response to denervation with the Paradise ultrasound system (ReCor Medical). Renal Denervation: This Is Why Device Trials Need Sham Controls — Subtle biases are unavoidable in open-label studies, study suggests by Larry Husten, CardioBrief January 12, 2016 Sternberg CN, Davis ID, Mardiak J, et al. Another important outcome of the trial, which were actually defined as the first secondary outcome, was the renal outcome. Pazopanib in locally advanced or metastatic renal cell carcinoma: results of a randomized phase III trial. placebo, was 43. &#91;1&#93; Nephrology Research Explore our current research projects in the Massachusetts General Hospital Division of Nephrology or search open clinical trials and medical research studies. The resulting build-up of waste products in the body can cause symptoms such as weakness, fatigue, shortness of breath, lethargy, and confusion. More IF Analysis, Trend, Ranking & Prediction. 7 The renal cell trial used a quality of life questionnaire that The opening statements in Chauvin's trial came 10 months after Floyd's death launched a summer of protest, unrest and a societal reckoning with America's criminal justice system. Imaging tests, such as ultrasound, magnetic resonance imaging or a computed tomography (CT) scan, to assess your kidneys' structure and size and look for abnormalities. , Scottsdale/Phoenix, Ariz. When trials unexpectedly demonstrate either no benefit or a detrimental impact of a treatment, especially when that treatment is already used in practice, critics commonly argue that the results were dictated by flawed trial Timing of RRT in Acute Kidney Injury The most effective timing for renal-replacement therapy in critically ill patients is unclear. Most nephrology trials were randomized (72. Do not use salt when cooking food. The most important structural changes in type 1 diabetes occur in the glomeruli, with thickening of the glomerular basement membrane, mesangial expansion, and podocyte injury; in the presence of more advanced DN, however, there are also important changes in the tubules and interstitium with tubular atrophy and interstitial fibrosis and inflammation (). The primary analysis of the study was at Week 48; the Week 96 analysis was a prespecified secondary analysis. Like us on Facebook This is an observational trial designed to characterize the natural decline of renal function markers such as glomerular filtration rate, creatinine, proteinuria and β-2 microglobulin in Alport syndrome patients. Top-line results for the EVOLVE study using cinacalcet (Sensipar) in patients with end-stage renal disease (ESRD) were reported last week. Saver in Rapid Medical’s press release. This organized list can be instrumental to a professional when trying to provide a roadmap of limited options for a dialysis patient prior to, during or after a disaster. This is also because drug trials are more common in this type of research. At the clinical level, U. The most important structural changes in type 1 diabetes occur in the glomeruli, with thickening of the glomerular basement membrane, mesangial expansion, and podocyte injury; in the presence of more advanced DN, however, there are also important changes in the tubules and interstitium with tubular atrophy and interstitial fibrosis and inflammation (). 6 The IDEAL trial concluded that early planned initiation of dialysis in stage V chronic kidney disease was not associated with improvement in survival or clinical outcomes. This randomized, double-blind, placebo-controlled, parallel-group, multicenter clinical trial evaluates the efficacy and safety of canagliflozin versus placebo in preventing clinically important renal and CV outcomes in patients with T2D and established kidney disease. Link to the article here. All patients in the trial had no previous drug treatment for kidney cancer that spread or could not be removed by surgery. Dr. The main secondary hypothesis of HiLo trial is that less stringent phosphate control will reduce risk of all cause mortality, enhance markers of diet and nutrition and improve quality of life. A clinical trial compared patients with advanced renal cell carcinoma who received KEYTRUDA, an immunotherapy, in combination with axitinib, a tyrosine kinase inhibitor (TKI), to those who received sunitinib, another TKI, alone. Seven trials, which were missed in the database search, were identified by hand search of references from important systematic reviews relevant to the topic. The effect of ertugliflozin on exploratory kidney-related outcomes was evaluated using data from the The most important blood pressure medications to treat renal hypertension include: ACE inhibitors(angiotensin converting enzyme inhibitors). Our services are offered in inpatient and outpatient settings at both the Froedtert Hospital (FH) and Clement J. BHAVIN VADODARIYA DNB Surgical Oncology 2nd year Resident, Apollo CBCC Cancer Care, Ahmedabad Date-21/07/2018 Risk Stratification in Renal Cell Carcinoma 2. Early RRT was defined as starting RRT within 8 hours of fulfilling KDIGO stage 2 AKI and delayed RRT defined as starting RRT within 12 hours of the development of KDIGO stage 3 AKI or upon an absolute The relative risk of serious renal damage in patients with uncomplicated essential hypertension is low as compared with other cardiovascular complications. Schwartz Division of Nephrology lead the way in conducting clinical research to define chronic kidney disease and have written the guidelines for its medical management. In this dedicated renal outcome trial, the risk of the primary outcome—doubling of serum creatinine, end-stage kidney disease (ESKD), renal death or CV death—was reduced by 30% by canagliflozin. His team has identified novel therapies that lower intestinal phosphate absorption, and are conducting clinical trials to evaluate the safety and efficacy of these therapies in Metrolina Nephrology Associates is committed to providing the most comprehensive kidney care available. 991. In order to design trials with success potentiality, it is important to define clinically important short-term and long- term targets of therapeutic and non-therapeutic intervention. UP: On the positive side, there were a number of trial characteristics in the nephrology studies that we found to be similar to studies in other subspecialties (for example, rates of randomized versus nonrandomized trials). For over 30 years, the American Kidney Fund Clinical Scientist in Nephrology (CSN) fellowship program has funded researchers whose work is designed to improve diagnosis, treatment and outcomes for patients living with chronic kidney disease (CKD) and has promoted clinical research in nephrology. Moorthi RN, Lam A, Tangri N, Sood MM, Wagner M, Alam A. ” Strong operational and subject matter expertise is a part of our organizational DNA. 0% that included parallel groups, and 9. oup. In CREDENCE, albuminuric chronic kidney disease was an inclusion criterion. This article was originally published on Practical Cardiology’s sister site, EndocrinologyNetwork. The staging of renal cell carcinoma is the most important factor in predicting its prognosis. S. Clinical trial participation for novel therapeutics. Below are current clinical trials. Details of the SPIRiT trial objectives, design and methods have been published previously . , F. This is particu-larly true for patients with pre-existing renal disease and eld- So it’s important to protect the battalion with a team that understands their role in the fight. 15, 2020 (GLOBE NEWSWIRE) — Resverlogix Corp. However, reducing salt/sodium is an important tool in controlling your kidney disease. Bilateral renal denervation will be performed using the Symplicity Kidney Disease Clinical Trials. You need someone to provide care and solutions that help carry this burden. There is also a phase III clinical trial of RenalGuard Therapy to prevent contrast-induced nephropathy. The design of the PROSPER (A Phase 3 Randomized Study Comparing Perioperative Nivolumab vs. Our ultimate goal is to advance health both in our local community and around the globe. 2 Historically Renal Impairment Study. This result is going to be sliced, diced, and analyzed in many different ways for years to come. Landmark Nephrology is an online educational resource that aims to highlight landmark clinical trials which have shaped the way we practice nephrology. S. Typically, this is the difference between the intervention and control groups in a specific variable – and will determine if your intervention is effective or not. 4% that were crossover trials. However, recent data show an increase in quality and quantity of trials in nephrology, including an increase in trials for devices, behavioral interventions, and rare kidney diseases. 00001). Closed trials are not currently enrolling, but may open in All four trials evaluating lipid lowering agents resulted in negative study outcomes, while studies of anti-hypertensive medications (three out of six studies positive) phosphate binding agents (two out of four trials positive) and fish oil or B-vitamins (two out of four trials positive) yielded mixed results. D. Experts don't know what causes fibromuscular dysplasia, but the condition is more common in women and may be something that's present at birth (congenital). The Clinical Nephrology Journal Impact IF 2020-2021 is 0. 7 Lastly, the AKIKI trial found no significant difference with regard to mortality between an early and delayed strategy of RRT and actually saw an appreciable number The National Kidney Foundation participates in research that is helping advance knowledge about chronic kidney disease, treatment and patient outcomes. The purpose is to recognize and treat people with kidney issues as well as help prevent kidney issues from happening. Department of Health and Human Services and the American Society of Nephrology. Rates of acute rejection were reported at 7. com This phase II trial studies whether adding radium-223 dichloride to the usual treatment, cabozantinib, improves outcomes in patients with renal cell cancer that has spread to the bone. Apixaban may be a reasonable treatment option for patients with atrial fibrillation who also have renal disease and are receiving hemodialysis, according to late-breaking clinical trial results from RENAL-AF presented […] Choosing to participate in a study is an important personal decision. The Standardised Outcomes in Nephrology—Polycystic Kidney Disease (SONG-PKD) project aims to establish a consensus-based set of core outcomes for trials in PKD (with an initial focus on ADPKD but inclusive of all stages) that patients and health professionals identify as critically important. UC Davis Health is charged with discovering and sharing knowledge and providing the highest quality care to our community. Yet nearly 1 in 3 individuals with hypertension struggle to control their blood pressure despite being on medication. Our experienced team of pediatric nephrologists and other specialists provides comprehensive, compassionate care to infants, children and adolescents with acute and chronic kidney disorders and When a kidney or urinary tract problem affects your child’s health, it affects your entire life. This work led to several important publications and national leadership on living donor education initiatives, development of an educational toolbox for the American Society of Transplantation and ASN. 2 vs. Several reports suggested that predialysis nephrologist care might have favorable effects on patient outcomes in those stages of CKD upon receiving multidisciplinary treatment [ 19 , 26 ]. This survey, called a Delphi survey, is designed to get everyone’s opinion and to try to reach agreement on the most important outcomes to be included in research in kidney transplantation. About the DISCOVER Trial. 11 Starting doses should be determined individually and based on clinical status (i. “The trial confirmed that the Tigertriever is not only safe and effective but demonstrably improved outcomes over similar trials testing previous technology,” commented Dr. Investigational Agent. R. Surprisingly, however, a large proportion of these trials have had negative or neutral results. Nephrology requires that the clinical trials submitted for its consideration are registered in a publicly accessible database. A clinical trial is the study of new ways to prevent, detect or treat diseases or conditions. , Associate Research Physician in the Lymphoid Malignancies Branch, is leading a study to see how well patients with relapsed refractory metastatic ccRCC respond to a combination Avelumab and interleukin (IL)-15 treatment. e Renal Cell Carcinoma Risk Stratification 1. In addition to helping the body get rid of wastes and toxins, your kidneys work to keep important chemicals and fluids in balance. Devices now specifically designed for critically ill patients with acute kidney injury are widely available and the clinical challenges associated with treating this complex patient population continue to be addressed. 2 per 1,000 patient-years (P-Y) (p = 0. Your kidneys perform many critical functions and play an essential role in your overall health. An important focus of the division is to emphasize translational and multi-disciplinary programs that truly go from bedside to bench to bedside in advancing patient care solutions. Are Important. We’ve forged partnerships and connections with some of the top independent sites and site/LDO networks – both within the United States and abroad. These include ramipril, benazepril, captopril, However, the participants in these dedicated renal outcomes trials all have prevalent nephropathy. Study designs included 24. As is the case with many ailments, early detection leads to the best treatment. Talk with your doctor and family members or friends about deciding to join a study. 9% with a single study group, 64. Fellowship graduates are eligible to be a UNOS-approved medical director of a kidney transplant program. Dr. 1. Clinical trials registries collect basic health information from people who agree to be contacted about participating in future clinical trials or studies. The foundation does this through three major initiatives: the Kidney Early Evaluation Program (KEEP), the Awareness, Detection and Drug Therapy in Type 2 Diabetes Mellitus and Chronic Kidney Disease Study (ADD-CKD) and the Physician can consider HIF‐PHI as alternatives to ESAs in correcting and maintaining haemoglobin (Hb) for renal anaemia both in dialysis‐dependent (DD) and non‐dialysis‐dependent (NDD) CKD patients based on the new data concerning its efficacy and safety from several recent clinical trials. com. , Pitt B. , et al. The trial results were published online in the New England Journal of Medicine and reported simultaneously at the American Heart Association meeting. com. P DUBLIN - April 9, 2018 - Medtronic plc (NYSE: MDT) today announced U. At Joe DiMaggio Children's Hospital, our Pediatric Nephrology and Hypertension Program offers the medical expertise and support your child needs. In one study, patients (n=55) with varying degrees of renal function (ranging from normal through end-stage renal disease requiring dialysis) received a single 60 mg subcutaneous dose of denosumab In a second study, patients (n=32) with severe renal dysfunction (creatinine clearance < 30 mL/min and/or on dialysis) were given two 120 mg remains. Block has served as principal investigator for several Reata trials and been a key advisor mass balance trial suggest that metabolism is an important elimination pathway for olaparib, but the contribution of the renal route cannot be ruled out. With a rapidly growing worldwide readership, the ëAmerican Journal of Nephrologyí is aimed at improving the clinical care of adult and pediatric nephrology patients. Kevin Conlon, M. D . Federal Government. 63, 1. While it is known that early response to treatment is coupled with favourable renal outcomes, early predictors of renal function impairment are lacking. Renal failure, or kidney failure, occurs when the kidneys are no longer able to effectively filter waste products from the blood. Last reviewed: 24 Feb 2020. Connaire completed medical school and adult and pediatric nephrology fellowships at the University of Minnesota Medical School, and served as medical director of the Hennepin County Medical Center Kidney Transplant Program. The patient population and enrichment results are described here. Trials should have a clear primary outcome. The Renal Support Network (RSN) provides a national list of renal resources by state. , tubular, glomerular, interstitial The ongoing Canagliflozin and Renal Endpoints in Diabetes with Established Nephropathy Clinical Evaluation (CREDENCE [NCT02065791]) trial will define whether the albuminuria-associated and creatinine-based effects observed with canagliflozin treatment translate into clinically important renal benefits in individuals with type 2 diabetes and UCSF faculty members have played prominent leadership roles in high-profile, federally-sponsored prospective studies and clinical trials. J. Bhatt D. George Clinical has leveraged the in-depth expertise of our Scientific Leadership Team to design effective studies, select the best sites and accelerate recruitment. ALAMEDA, Calif. Nevertheless, one important aspect which needs to be considered, is that the ATN study and RENAL trial did not measure actual solute removal, and that measured effluent volume normalized for Nephrotic syndrome is diagnosed when large amounts of protein are found in the urine. Food and Drug Administration (FDA) approval to begin an investigational device exemption (IDE) pivotal trial to evaluate the OBJECTIVE To evaluate the impact of once-weekly exenatide (EQW) on microvascular and cardiovascular (CV) outcomes by baseline renal function in the Exenatide Study of Cardiovascular Event Lowering (EXSCEL). This is a phase 3 trial using bardoxolone methyl in patients with autosomal dominant polycystic kidney disease. 73 m2. This important topic will be covered in our clinical trials session, where we will also hear why nephrology needs big trials and hear how to help patients make For more information about the Division of Nephrology and Hypertension at Cincinnati Children's, please call 513-636-4531 or email nephrology@cchmc. 7Patients whose renal function declines on placebo have a much The Renal Association is the professional body for nephrologists and renal scientists based in the UK, and is active in promoting and disseminating research that may ultimately improve outcomes for patients with kidney disease. 81 (0. For more information about RSN, please call (866) 903. “In addition to his participation in most major recent nephrology trials of investigational agents, Dr. ” The UAB Nephrology program features a multi-disciplinary team that provides state-of-the-art clinical care, research, teaching, and disease management for patients with diverse types of kidney disease. S. About Renal Cell Carcinoma Since its inception four decades ago, both the clinical and technologic aspects of continuous renal replacement therapy (CRRT) have evolved substantially. J Clin Oncol. This lead to a The MENTOR study has been published. The ELAIN trial was the only one of the three to show reduced 90-day mortality with early vs delayed initiation of RRT and was the smallest in sample size. DR. 62). Researchers also use clinical trials to look at other aspects of care, such as improving the quality of life for people with chronic illnesses. 04). These trials include parallel groups and a single study group, with a percentage of crossover trials. M. Effects of losartan on renal and cardiovascular outcomes in patients with type 2 diabetes and nephropathy. L. . We must remember that, due to a hierarchy of testing, since only 1 of the 2 co-primary efficacy endpoints was achieved all of these endpoints have to be seen as hypothesis-generating not as final results. Amgen is committed to unlocking the potential of biology for patients suffering from serious illnesses by discovering, developing, manufacturing and delivering innovative human therapeutics. Whether it is the treatment of chronic kidney disease or hypertension, dialysis, vascular access management or transplantation, our patients have the advantage of knowing that their renal needs can be met by their kidney doctor through a variety of services offered by Metrolina Nephrology UCSF offers a one-year Transplant Nephrology Fellowship, accredited by the American Society of Transplantation. Locations and Directions The Division of Nephrology and Hypertension is located on Cincinnati Children's Main (Burnet) Campus , on the sixth floor of Location T. Sacubitril The Onco-Nephrology Clinic at Huntsman Cancer Institute brings together experts in nephrology, multiple myeloma, amyloidosis, and blood and marrow transplant. B. A listing of Kidney Disease medical research trials actively recruiting patient volunteers. Adherence to medication is modest in this patient group and may importantly drive these conflicting results. ) infusions Intrinsic renal causes are also important sources of acute kidney injury and can be categorized by the component of the kidney that is primarily affected (i. Stay current with what is going on in the world of kidney disorders, kidney disease and a wide range of related topics. The larger the accessory renal artery, the more nerves, and the more worthwhile that is for denervation. Aim: The SONAR trial uses an enrichment design based on the individual response to the selective endothelin receptor antagonist atrasentan on efficacy (the degree of the individual response in the urinary albumin-to-creatinine ratio [UACR]) and safety/tolerability (signs of sodium retention and acute increases in serum creatinine) to assess the effects of this agent on major renal outcomes. Racial and ethnic minorities are underrepresented in clinical research. The following medical condtions affect the kidney and urinary tract. S. Since the kidney is closely tied with many systems of the body it is important that it is working properly. Accelerate Nephrology Trials on a Global Scale. Smoking Several lines of evidence have shown that smoking increases the risk and progression of diabetic nephropathy. org - Listing the most important trials in cardiology Renal denervation: Renal denervation: Symplicity HTN-2, Symplicity HTN-3: Thiazides The Center also serves as an important training ground for undergraduate, graduate, and medical students, and postdoctoral fellows and visiting scientists. Kumbhani DJ(1), Bavry AA, Harvey JE, de Souza R, Scarpioni R, Bhatt DL, Kapadia SR. The number of ongoing clinical trials in nephrology continues to increase and these include treatment, prevention, diagnostic and screening. Our group’s research interests are centered on epidemiology and outcomes research, and clinical trials in the fields of nephrology, transplantation medicine and general internal medicine. SGLT2 Inhibitors: Experimental Data. You can find the back-up support your child needs with pediatric nephrology care at the Orlando Health Arnold Palmer Hospital for Children Hewell Kids’ Kidney Center. e. Three Trials, Same Outcome "Renal artery Several challenges and ambiguities that emerge in clinical trials and their possible solutions are provided. The urine sample is collected in a special container in a health care provider’s office or commercial facility and can be tested in the same location or sent to a She has conducted NIH-sponsored research on renal senescence using older deceased donor kidneys and older living donors. The therapy utilizes the RenalGuard System, which measures a person's urine output and infuses an equal volume of normal saline in real-time. Marshal and Karaboyas describe the impact on 1. ERA-EDTA Operative Headquarters Strada dei Mercati 16/A I-43126 Parma – Italy Phone: +39 0521 989078 E-mail: secretariat@era-edta. 345, 861–869 (2001). Aims/hypothesis In previous work, we reported the HR for the risk (95% CI) of the secondary kidney composite endpoint (time to first event of doubling of serum creatinine from baseline, renal dialysis/transplant or renal death) with ertugliflozin compared with placebo as 0. RENAL: This study was conducted in 35 centers in Australia and New Zealand. New Clinical Trials for Nephrology A lot has been learned about the kidney and diseases that can adversely affect it through nephrology clinical studies. Recent trials for advanced CKD patients did not show favorable effects on renal outcome at CKD stages 4 and 5 [23–25]. In the dedicated renal impairment trial, the AUC and Cmax of It has been an exciting time in renal medicine with the publication of several large trials of SGLT-2 inhibitors slowing progression of both diabetic and non diabetic kidney disease. v. Decision Tree. Two phosphAte taRGets in End-stage Renal Disease Trial (TARGET) (TARGET) The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. 5%, with a 12% rate in African American patients. It is an open-label, dual center, randomized controlled trial in which all hemodialysis patients from two large adult renal centers in Manchester (centers 1 and 2) had their electronic medical records screened. (renal failure, CVA) and mortality by reducing blood To facilitate this process and help answer many important questions about the appropriate application of renal revascularization, well-designed and rigorously conducted trials are needed. The objectives of the Association are: to advance, collate and disseminate knowledge of renal structure and function Hypertension, or high blood pressure, affects nearly half of Americans and is the most important risk factor for heart disease and stroke – the two leading causes of death in the world. By contrast, the population of DECLARE–TIMI 58 mainly did not have substantially reduced eGFR at baseline, and 69·1% of the study population had normoalbuminuria. Clinical trials. S. Because kidneys often regulate blood pressure, nephrologists also manage hypertension (high blood pressure) and electrolyte disorders. As one of the largest kidney transplantation centers in the nation, we provide complete renal evaluation services in a compact, efficient time The strength and consistency of these findings makes intervention to improve CKD-MBD an important target in lowering cardiovascular disease event risk in CKD patients. 29th) as judged from a meta-regression of clinical trials Drs. Clinical trials are research studies that evaluate a new medical approach, device, drug, or other treatment. S, Ph. 7%), with very few diagnostic, screening, or health services research studies. Med. Although all parties involved share the same goal of initiating trial enrollment, the contract must reflect their collective, and sometimes differing, needs, which can make the negotiation process complex and time-consuming. Multiple epidemiologic studies have looked at risk factors for hospital mortality in patients with ARF, and in some of these studies Clinical Trials. The primary outcome, end-stage renal disease (ESRD), doubling of serum creatinine, renal or cardiovascular (CV) death, for canagliflozin vs. Predictors of publication of randomized controlled trials in nephrology. Metrics Clinical trials of sodium–glucose cotransporter 2 (SGLT2) inhibitors and glucagon-like peptide 1 (GLP1) receptor agonists have shown beneficial effects of these agents on kidney outcomes in Vidant Health nephrology services provide high-quality, personalized care for your kidney health issues. 1728 or visit www. Hariharan’s scientific contributions cover variety of important renal transplant topics. Penn’s Renal-Electrolyte and Hypertension Division has a 75-year history of excellence in patient care, teaching and research. So we have the challenge of making eligible patients aware of the study and then educating them about clinical research and why it’s important. Besides its main research mission, COCTP provides research training for fellows, residents, graduate and undergraduate students interested in pursuing careers in medicine and/or medical research, and also for Clinical Trial Endpoints. Rose whose text, Clinical Electrolytes and Acid Base Disorders, regaled a generation of learners by harnessing the power of original research to apply it to clinical care. Landmark Nephrology is an online learning tool designed to collect landmark trials in nephrology and distribute content that makes learning nephrology fun and easy. The U. Journal description. Radioactive drugs such as radium-223 dichloride may directly target radiation to cancer cells and minimize harm to normal cells. et al. CREDENCE, the first of a coming wave of dedicated renal outcomes trials for sodium glucose cotransporter 2 (SGLT2) inhibitors, has reported 2 sets of results that suggest there is more news to come The Renal Anhydramnios Fetal Therapy (RAFT) Trial offers eligible pregnant women with a diagnosis of EPRA an experimental therapy of repeated or serial "amnioinfusions" of fluid into the womb. Most nephrology trials were randomized (72. Data on file. Innovation in treatments for kidney failure have stagnated. RESEARCH DESIGN AND METHODS Least squares mean difference (LSMD) in estimated glomerular filtration rate (eGFR) from baseline between the EQW and placebo groups was calculated for 13,844 Purpose: Patient-reported outcomes (PRO) were evaluated in the phase III IMmotion151 trial ([NCT02420821][1]) to inform overall treatment/disease burden of atezolizumab plus bevacizumab versus sunitinib in patients with previously untreated metastatic renal cell carcinoma (mRCC). Likely use in renal impairment Single-use, Inhalation, Or unlikely use in renal Impairment, Mab No study Program session details for Kidney Week 2020. org. rsnhope. BACKGROUND AND AIMS: Changes in clinical practice based on research findings are dependent on the dissemination of information, which is a goal at national meetings. A new analysis of an important trial of the blood pressure-lowering procedure, renal denervation, shows that the main results may have been affected by a number of confounding factors that This will help to ensure that clinical trials in kidney transplantation include outcomes that are important and relevant to as many people as possible. Nephrology trials, compared with 2,264 cardiology trials (5. The Early Versus Late Initiation of Renal Replacement Therapy In Critically Ill Patients With Acute Kidney Injury (ELAIN) trial was a single-centre randomized trial of 231 critically ill patients that tested whether early RRT compared to delayed RRT would reduce all-cause mortality at 90 days . Report in all trials Critically important to some stakeholder groups Report in some trials Important to some or all stakeholder groups Consider for trials SONG-Tx a b Figure 1| Core outcome sets for Standardized Outcomes in Nephrology (SONG). Satellite Dialysis Clinical Investigator Grant of the NKF Project: A Pilot Randomized-Controlled Trial of Integrated Palliative and Nephrology Care versus Standard Nephrology Jennifer Scherer, New York University School of Medicine; New York, NY Patients with advanced kidney disease have many palliative care needs, including symptom control, assistance with treatment decision-making and It has been studied in three double-blind, placebo-controlled trials, which included one 11-month open-label extension and in one separate 12-month open label clinical trial in patients with The journal covers the whole territory of nephrology research including experimental work in animal models and molecular biology studies. 5, 6 These trials show that the efficacy and safety of HIF‐PHI are comparable to ESAs in “The recently published PIVOTAL trial adds important new information that should help nephrologists allay their concerns of IV iron supplementation,” Drs Kshirsagar and Li concluded. In response to this need, the Kidney Health Initiative developed the Technology Roadmap for Innovative Approaches to Renal Replacement Therapy to spur more interest, investment and innovation for this underserved disease area. This huge unmet need is why it was so important for us to initiate the landmark CREDENCE renal outcomes trial over four years ago," said Vlado Perkovic, M. It uses radio frequency Endpoints and outcomes. The HiLo trial is a large, pragmatic , multicenter trial with a cluster randomized design which will test the non-inferiority of liberal phosphate control (target phosphate of 6-7 mg/dl) to currently recommended strict control (target of < 5mg/dl) for all cause hospitalization for dialysis patients. Salt is one of the most commonly used seasonings, and it takes time to get used to reducing the salt in your diet. 0% enrolling # 100 Patient Involvement in Clinical Trials in Nephrology Within nephrology, patient involvement activities can be seen in a few specific areas: the United Kingdom, Australia, Canada, and the United States have structured and supported initiatives in which patients have contributed to the research process. be a measure of something that is not important to the patient (exception: validated surrogate endpoint). The heterogeneity of patient characteristics and reported renal outcomes, which hinders comparisons between trials and drug classes, is highlighted. George Clinical’s scientific expertise is focused on developing new strategies for the prevention of renal and metabolic disease specifically for chronic kidney disease, acute kidney injury and IgA nephropathy. 61. The CRISP studies also lead to the development by the Mayo ADPKD classification tool which is a unique tool (for any type of kidney disease) to estimate the time of inset of ESRD in ADPKD patients with a high level of confidence. This can happen in one or both kidneys. After extensive analysis of data from observational cohorts and interventional trials, the workshop planning committee and attendees recommended a 30 or 40% decline in glomerular filtration rate (GFR) as new surrogate endpoints November 25, 2019 – The exploratory study of patients with atrial fibrillation and on hemodialysis evaluated rates of bleeding when randomized to apixaban versus warfarin. 2010;28(6):1061-1068. Listing a study does not mean it has been evaluated by the U. Our pediatric kidney specialists are nationally-recognized leaders in this important field of health care and research. Open trials refer to studies currently accepting participants. Out of these 85 studies, thirty-six randomized trials which fulfilled the specified inclusion and exclusion criteria were identified for inclusion in the review (for details, please refer Important dates for Kidney Week 2020. with Diabetic Nephropathy trial (CREDENCE, NCT02065791)2,3 involving patients with T2D, macroalbuminuria and eGFR 30 to 90 mL/min/1. We are proud of the compassionate, patient-centered care that our clinical team delivers for the entire spectrum of kidney and hypertension disorders. Kidney cancer is the 6th most common cancer diagnosed in the United States with greater than 73,000 new cases seen each year. Please see Indication and Important Safety Information. New data from a meta-analysis of SGLT2 inhibitor outcome trials is offering an overview of the effects of the class on cardiovascular and kidney outcomes in patients with type 2 diabetes. Clinical Nephrology (old news but important - Apr. This strategy reinforces the lessons learned from Dr. RR includes five major components: such as exercise training, diet &amp; fluid management, medication &amp; medical surveillance, education, psychological &amp; vocational counselling. As a Stanford Health Care patient, you may have access to the latest, advanced clinical trials. Biorasi has a long history of running successful trials in the CKD space, and we’ve used that time to become true experts in nephrology clinical research. See full list on academic. The ISN World Congress of Nephrology, 15/04/2021-19/04/2021 has been accredited by the European Accreditation Council for Continuing Medical Education (EACCME®) with 18 European CME credits (ECMEC®s). Keytruda - Inlyta is the first combination regimen to significantly improve the response to treatment, overall survival, and progression-compared to Sutent. Benefit was seen across all subgroups of advanced renal cell cancer, including favorable, intermediate and poor risk groups, regardless of PD-L1 expression. The presence of albumin in the urine can be detected with a dipstick test performed on a urine sample. Our clinical trial teams have extensive expertise in renal trials that sits atop a foundation of operational excellence that we call “getting the right stuff done. Find out more here. 26,27 In the Appropriate Blood Pressure in Diabetes Trial, 61% of enrollees were smokers. CALGARY, Alberta, Oct. The treatment effect size in the DAPA-CKD trial was large, with an approximate 50% risk reduction of this outcome and proportional risk reduction in primary and secondary prevention patients. Volunteering for a registry does not mean a person has signed up for a clinical trial. Visual Abstract: IDEAL-ICU Trial. | N Engl J Med 2021; 384:129-139 In a trial involving 10,584 patients with diabetes and chronic kidney disease, sotagliflozin resulted in fewer total deaths Clinical Trials in Nephrology. For general information, Learn About Clinical Studies. Data from the Multiple Risk Factor Intervention Trial one of the most important renal risk factors. Zablocki VA Medical Center, as well as through Fresenius and DaVita outpatient dialysis units. The renal artery can narrow so much that the kidney doesn't get an adequate supply of blood and can lead to high blood pressure at a young age. . Jeffrey Connaire, MD, joined DCR in 2015 and oversees scientific and investigator functions across DCR. 0% that included parallel groups, and 9. As these regimens populate clinical practice, we highlight unique aspects to consider, including 1) efficacy and evolving endpoints in clinical In the field of pediatric nephrology in Japan, clinical trials have been conducted on the basis of school urine analysis, and the results have been disseminated to the world. Observation in Patients With Renal Cell Carcinoma Undergoing Nephrectomy) trial (neoadjuvant v adjuvant checkpoint inhibitors) has a unique potential for identifying immune signatures which can be then added to the existing and future models to further improve their predictive accuracy. The Waikar Lab’s overall goal is to improve the lives of our patients suffering from kidney disease through patient-oriented research. FALCON. Target dosages used in the clinical trials that showed reduced morbidity and mortality are listed in Table 2. Burton “Bud” Rose. Dosing trials began in June 2010 in the sixty patient trial. , Szarek M. Brenner, B. The criteria proposed herein may help to standardize the definition of ESRD and reduce the variability in adjudicating the most important renal end point in clinical trials of chronic kidney disease. Chronic kidney disease is assuming epidemic proportions, and an increasing number of clinical trials are testing treatments developed to improve morbidity and mortality. 3 • End-stage renal disease (ESRD): ~500,000 in US alone • Unacceptably high rates of: • Hospitalization: ~2 per patient-year • Mortality: 15–20% • Driven primarily by CVD, but CVD interventions failed in ESRD trials • Focus on ESRD-specific risk factors: Hyperphosphatemia • Ubiquitous complication of ESRD Landmark Nephrology Highlights a Common Clinical Conundrum: Steroids for IgA Nephropathy May 8, 2019 In an ideal world, patients would present to our clinic with straightforward conditions, allowing us to confidently treat the patient with effective medications which will likely have much more benefit than harm. Research + Clinical Trials Physician-researchers in the Tufts Medical Center William B. 26,27 In the Appropriate Blood Pressure in Diabetes Trial, 61% of enrollees were smokers. A Study to Identify Physical Function Trajectories and Biomarkers after Kidney Transplantation. Outcome sets for (a) SONG-Hemodialysis (SONG-HD) and (b) SONG–Kidney Transplantation (SONG-Tx) are shown. Negotiating clinical trial agreements is a routine and important activity for clinical trial sites conducting research. Dr. studies. The RPS promotes excellence in diagnosis, fosters basic, clinical and translational research, encourages training and education in renal disease, sponsors US based and international conferences and symposia, and brings news and updates pertaining to renal pathology to its members around the world. Why Renal Denervation Trials In the U. N. Many of these trials are large, multicenter undertakings with funding from either NIH or the pharmaceutical industry. B. Renal denervation is a technique for treating high blood pressure in patients who are resistant to oral medication. Patients and Methods: Patients were randomized 1:1 to receive atezolizumab 1,200 mg intravenous (i. Blood pressure control is increasingly important once the renal lesion is present and as renal damage progresses. Although there exist many procedural recommendations, some key questions still need to be investigated case-by-case at the Leaders from Luminary Labs, the consultancy that designed and produced the prize, said it represents the ways that the government can promote innovation through public-private partnerships such as KidneyX, which is a collaboration between the U. Importance: One of the difficulties of conducting clinical trials in acute renal failure (ARF) has been that there is no reliable scoring system to stratify patient selection and confirm balanced randomization. We use a highly collaborative and interdisciplinary approach to perform observational studies, biomarker discovery/validation, clinical trials, and implementation research. Engl. N. This is a concern because people of different ages, races, and ethnicities, may react differently to medical products. Article CAS PubMed Google Urine tests, to check the level of the protein albumin in your urine — a high albumin level may indicate kidney disease. When compared to the cardiology studies, there were some with better study characteristics but there is still room for Information on the effects of PTX on hard renal outcomes (doubling of serum creatinine or need for chronic dialysis) were lacking in all the reviewed trials. org ERA-EDTA Registered Office c/o PKF Littlejohn, 15 Westferry Circus, Canary Wharf Division of Nephrology COVID-19 Operational Updates – Protected Link UVA Division of Nephrology and the Center for Immunity, Inflammation and Regenerative Medicine (CIIR), part of the Department of Medicine, is dedicated to the study and treatment of kidney disorders and diseases. Background Early detection and effective management of risk factors can potentially delay progression of chronic kidney disease (CKD) to end-stage kidney disease, and decrease mortality and morbidity from cardiovascular (CV) disease. 3%). Hypertension Clinic Services: Hypertension specialist from nephrology partners with primary care teams to provide comprehensive care for individuals with difficult to control/resistant hypertension, white coat hypertension, masked hypertension, secondary hypertension syndromes, and (PK) studies in renal impaired and hepatic impaired patients and to provide guidance on how to best assess the influ-ence of renal impairment (RI) or hepatic impairment (HI) on the pharmacokinetics of an investigational drug. In the DAPA-CKD trial, treatment with the SGLT2 inhibitor dapagliflozin reduced risk for worsening renal function and death due to CVD or renal disease in patients with chronic kidney disease The results of this trial indicate that apixaban 5 mg BID results in similar rates of bleeding and strokes as warfarin among patients with end-stage renal disease on hemodialysis. We evaluated a specialist nurse-led intervention in the primary care setting to address accepted risk factors in a study sample of adults at ‘high risk of CKD Read about the latest research into kidney cancer and how you can take part in a clinical trial. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. As Jamie Dwyer, Director of Vanderbilt University’s Nephrology Clinical Trials Center, stated to the audience of kidney health professionals, there needs to be a shift in the culture of nephrology to focus on research readiness. We’ve built deep and lasting relationships with respected nephrologists and nephrology key opinion leaders. Outline Prognostic Factors Staging Histopathology MSKCC Criteria HENG Criteria 3. C. They are: Recurrent and De novo Diseases after renal transplantation, Long-term Kidney Transplant Survival, Surrogate Markers for Renal Transplant Outcome and BKV infection after Renal Transplantation. Nephrology Clinical Trials Physicians in the Division undertake clinical trials in patients with chronic kidney disease to yield new information to answer difficult clinical questions. The renal diet is commonly recommended for those with late stages of chronic kidney disease and end-stage kidney disease. CardiologyTrials. Clinical outcomes after percutaneous revascularization versus medical management in patients with significant renal artery stenosis: a meta-analysis of randomized controlled trials. 432 patients received 200 mg of KEYTRUDA intravenously every 3 weeks with 5 mg of axitinib orally twice-a-day, and 429 patients received The results from clinical trials suggest that fears about renal function may be misplaced: in the Studies of Left Ventricular Dysfunction (SOLVD) trial, 16% of patients in the enalapril arm had a rise in serum creatinine >44 μmol/L but so did 12% of patients in the placebo arm. 4%) or prevention (15. This article was originally published on Practical Cardiology’s sister site, EndocrinologyNetwork. Staging can follow the TNM staging system , where the size and extent of the tumour (T), involvement of lymph nodes (N) and metastases (M) are classified separately. The Center is located in 13,000 sq ft of recently renovated space in the Division of Nephrology and the Center for Immunity, Inflammation and Regenerative Medicine (CIIR). ccRCC is the most common subtype of kidney cancer and has been given this name because the malignant cells have a distinctive Upfront immunotherapy (IO) combinations have shifted the landscape of renal cell carcinoma (RCC) therapy with never-before-seen clinical efficacy. PHASE I After results of pre-clinical tests (described in Nature Biotechnology and Science) showed promise, the FDA approved a phase I clinical trial of the bioartificial kidney for treating desperately ill patients already in the ICU and receiving Continuous Venovenous Hemofiltration (CVVH) for acute renal failure along with other life-threatening conditions (such as sepsis A single-center trial of cyclosporine, sirolimus, and prednisone in living, related renal transplant patients demonstrated a reduced rate of acute rejection compared with historical data. 4% that were crossover trials. Most nephrology trials were for treatment (75. Conversely, PTX was effective in reducing proteinuria compared to control, a benefit that was more evident in patients with type-1 diabetes mellitus, higher proteinuria at baseline and A pre-specified exploratory analysis of renal data from the Phase III DECLARE-TIMI 58 trial, the broadest cardiovascular outcomes trial of a sodium-glucose co-transporter 2 (SGLT2) inhibitor, showed that Farxiga (dapagliflozin) reduced the progression of kidney disease or renal death in patients with type-2 diabetes (T2D). Rochester, Minn. Nephrology research does not only deal with finding treatment for glomerular diseases. Common Adverse Events: In a clinical trial of patients with heart failure with reduced ejection fraction, the most commonly observed adverse events with ENTRESTO vs enalapril, occurring at a frequency of at least 5% in either group, were hypotension (18%, 12%), hyperkalemia (12%, 14%), cough (9%, 13%), dizziness (6%, 5%), and renal failure The Division of Nephrology provides primary care and consultative care for patients with various renal diseases. It compared the effects of post-dilution CVVHDF with effluent flow rates of 25 or 40 ml/kg/h on 28 and 90-day mortality rates in 1464 critically ill patients with AKI requiring RRT. These trials must have clearly defined goals and must be sufficiently sized and performed so as to withstand intensive outcomes assessment. However, due to the implementation of the “Clinical Trials Act” and other factors, clinical trials are becoming more and more difficult to conduct. Dedicated hepatic and renal impairment trials are currently ongoing. As opposed to cardiology trials, the number of Nephrology trials is smaller, with less than 100 patients. Also check out the excellent NephJC summary. Filter this list of studies by location, status and more. 5% vs 48. --(BUSINESS WIRE)--Exelixis, Inc. ” The Phase 2 open-label trial is evaluating OMS721 across four different types of complement-associated kidney diseases: IgAN, membranous nephropathy, lupus nephritis, and complement component 3 SGLT2 Inhibitors: Experimental Data. The Medpace Difference for Renal Disease and Nephrology Studies Medpace conducts trials in renally-impaired patients, including patients currently undergoing dialysis, and in patients suffering from other chronic and rare kidney diseases. Sponsors conducting clinical research in nephrology and renal diseases benefit from: Nephrology trials are less invasive because as opposed to cardiology trials, the former is less likely to use procedures. S. Search for closest city to find more detailed information on a research study in your area. We aim at covering the whole spectrum of kidney disease research, from clinical nephrology to hemodialysis and peritoneal dialysis and renal transplantation. In the delayed strategy group, 29% of the patients did not require RRT because they had spontaneous recovery of renal function. ASN's Mission ASN leads the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients. Kovesdy, MD, who is the Fred Hatch Professor of Medicine at UTHSC, heads the group. Smoking Several lines of evidence have shown that smoking increases the risk and progression of diabetic nephropathy. The Division of Nephrology, Hypertension and Kidney Transplantationat UCI School of Medicine provides exemplary care for patients with a variety of renal diseases, fluid, electrolyte and acid-based disorders and hypertension. Study designs included 24. Our scientific I look forward to participating in the Phase 3 clinical trial and to working with Omeros to make this important drug broadly available to patients. ASN leads the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients. With more than 700 patients randomized, this trial was more than 5 times larger than the preceding MEPEX trial (Jayne et al, JASN 2007). Read articles written by Dallas Nephrology doctors, industry professionals and guest specialists to get and stay informed. Clinical trials are part of clinical research and at the heart of all medical advances. 9% with a single study group, 64. Food and Drug Administration (FDA) is now considering new endpoints for clinical trials in chronic kidney disease patients as a result of a special scientific workshop convened by the National Kidney Foundation (NKF) and the FDA on December 3-4 in Baltimore. Chronic & Systemic; 2. The number of trials in ADPKD increased form 1 to more than 20 after this important development. An amnioinfusion involves placing a small needle through the pregnant woman's skin into the womb next to the fetus. Some important features of this trial: The trial was stopped early due to loss of funding (originally powered to enroll 760 patients). (“Resverlogix” or the “Company”) (TSX:RVX) announced today its participation during the following leading scientific conferences: American Society of Nephrology (ASN) Kidney Week Reimagined 2020, 13 th Clinical Trials on Alzheimer’s Disease (CTAD) digital event, and the American Heart Association (AHA) Scientific Renal rehabilitation (RR) is a coordinated, multifaceted intervention designed to optimize a renal patient’s physical, psychological, and social functioning, thus reducing morbidity and mortality. See how OPDIVO® (nivolumab) + YERVOY® (ipilimumab) performed in a clinical trial for kidney cancer (renal cell carcinoma) in certain people when their cancer has spread. S. “Tigertriever is an important advance in stroke treatment devices and a win for patients. Nephrology is a branch of medicine that deals with kidney function and kidney diseases; a nephrologist is a physician who evaluates and treats disorders of the kidneys. Important news from the Nephrology beat. In this randomized trial, patients with acute kidney injury who w Given the cost of trials and widespread recognition of the need to limit unnecessary costs, it is an important issue for the larger nephrology community to consider. An important trial in nephrology investigating Rituximab Vs Cyclosporine for the treatment of membranous nephropathy. SONG E-Newsletter December 2018 Edition Dear Allison, It’s been full steam ahead in 2018 for SONG with the involvement of over 5500 patients, families and health professionals working towards establishing core outcome sets across the spectrum of chronic kidney disease. In this phase 3 placebo-controlled randomized trial of 3,883 patients with secondary hyperparathyroidism, those on active treatment received a titrated dose of cinacalcet starting at 30 mg/day up to 180mg 4 Pandemic-Inspired Considerations to Position Your Nephrology Research Site for Success in the New Normal May 20, 2020 The COVID-19 pandemic is a challenge that is forcing us to reexamine how we do pretty much everything. org. Continuous slow therapy was used as initial modality in 57% of the patients assigned to the early strategy group, and in 55% of those in the delayed group (p = 0. 3%). , Jacksonville, Fla. Current Renal Researchers Christopher Culek- Characterizing the changes in properties of nephritic factors over time Jill Hauer - Defining drivers of C3G including genetic variation in the glycomatrix and autoantibodies to complement proteins and convertases Bertha Martin - Characterizing biomarkers in complement-mediated renal diseases including Dense Deposit Disease and C3 Glomerulonephritis Sacubitril/valsartan was superior to valsartan alone for reduction of renal events in patients with HF and preserved ejection fraction and chronic kidney disease, researchers reported. These include: APOL1 Long-term Kidney Transplantation Outcomes Network (APOLLO), Assess, Serial Evaluation, and Subsequent Sequelae in Acute Kidney Injury (ASSESS-AKI), Acute Renal Failure Trial Network (ATN), CDC Chronic Kidney Disease Surveillance System While many patients believe research is a good thing, only a small number of people with kidney disease are participating in trials. New data from a meta-analysis of SGLT2 inhibitor outcome trials is offering an overview of the effects of the class on cardiovascular and kidney outcomes in patients with type 2 diabetes. Arguably, laboratory-based components of the end point and whether dialysis reflects chronic dialysis could be determined on the basis of prespecified rules. Learn more about the Clinical Scientist in Nephrology (CSN) Program. 5% overall), were more likely to be smaller (64. Neither of these trials found improvements in mortality with higher intensity RRT. important nephrology trials