Background: Intravenous (IV) hydration is considered a protective factor in reducing the incidence of acyclovir-induced nephrotoxicity. A systemsbased review of cases of acyclovir-associated acute kidney injury can be used to examine institution-, care provider-, and task-related factors involved in administering the drug and can serve as a basis for developing a quality improvement intervention to achieve safer administration of acyclovir.
Purpose of the review: Sodium-glucose cotransporter-2 inhibitors (SGLT2is) are recommended for eligible patients with type 2 diabetes for the secondary prevention of adverse cardiovascular and kidney disease outcomes. Patients with type 2 diabetes and albuminuric chronic kidney disease, a history of atherosclerotic cardiovascular disease, and/or heart failure with reduced ejection fraction should be assessed for the use of these therapies. Sources of information: The sources include published clinical trials with SGLT2is, with a focus on cardiovascular safety studies and kidney protection trials. Methods: Information was gathered via a review of relevant literature and clinical practice guidelines, incorporated with real-life clinical experience. Key findings: Clinicians prescribing these agents must be familiar with the benefits of SGLT2is on cardiovascular and renal endpoints, and with adverse effects of SGLT2is, including mycotic genital infections and diabetic ketoacidosis. Primary care physicians and specialists should know how to adjust antihypertensive, antiglycemic, and diuretic agents. With the results of completed cardiovascular outcome trials and the Canagliflozin and Renal Outcomes in Type 2 Diabetes and Nephropathy trial, nephrologists specifically have a unique opportunity to impact the safe, effective, and equitable implementation of SGLT2is into clinical practice. Limitations: Further work is needed in specific patient subgroups, including patients with chronic kidney disease stages IV and V, patients with kidney disease but lower levels of albuminuria, and in patients without diabetes.
The purpose of the Zero to Five study was to compare automated office blood pressure (AOBP) readings obtained after either 0 or 5 minutes of antecedent rest in relation to the awake ambulatory blood pressure. AOBP is recommended in different jurisdictions following either a 0- or 5-minute rest. This was a prospective, randomized, 2 arm, trial with blinded outcomes, recruiting adult patients referred for ambulatory blood pressure monitoring (ABPM). Participants had an AOBP measurement performed according to clinical practice guidelines with an OMRON HEM-907XL set to measure after 0 or 5 minutes of rest. The primary outcome was the difference between the mean AOBP and mean awake ABPM in the 0-minute wait group versus that in the 5-minute wait group. The study enrolled 618 participants, mean age 57.1 years, 52% women. For the 0-minute rest group, the mean AOBP was 141.2/83.1 (17.1/12.1 mm Hg) and the awake ABPM was 141.3/83.8 (16.1/10.2 mm Hg), with difference −0.02/0.52 (17.4/11.4 mm Hg). For the 5-minute rest group, the mean AOBP was 138.2/81.7 (16.9/12.4 mm Hg) and the awake ABPM was 143.4/83.6 (17.3/10.3 mm Hg), with difference −5.16/−0.8 (18.6/11.6 mm Hg). The difference of differences in systolic blood pressure (AOBP-awake ABPM) for the 0 versus the 5-minute wait group was 5.1 mm Hg (95% CI, 2.3–8.0, P =0.005) with the 0-minute AOBP measurement closest to the awake ABPM. The Zero to Five study demonstrated that a wait time of 0 minute before an AOBP measurement was closer to the daytime ABPM result than a 5-minute wait before the AOBP. REGISTRATION: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT03732924.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.