OBJECTIVE
Finerenone significantly improved cardiorenal outcomes in patients with chronic kidney disease (CKD) and type 2 diabetes (T2D) in the Finerenone in Reducing Kidney Failure and Disease Progression in Diabetic Kidney Disease trial. We explored whether baseline HbA1c level and insulin treatment influenced outcomes.
RESEARCH DESIGN AND METHODS
Patients with T2D, urine albumin-to-creatinine ratio (UACR) of 30–5,000 mg/g, estimated glomerular filtration rate (eGFR) of 25 to <75 mL/min/1.73 m2, and treated with optimized renin–angiotensin system blockade were randomly assigned to receive finerenone or placebo. Efficacy outcomes included kidney (kidney failure, sustained decrease ≥40% in eGFR from baseline, or renal death) and cardiovascular (cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure) composite endpoints. Patients were analyzed by baseline insulin use and by baseline HbA1c <7.5% (58 mmol/mol) or ≥7.5%.
RESULTS
Of 5,674 patients, 3,637 (64.1%) received insulin at baseline. Overall, 5,663 patients were included in the analysis for HbA1c; 2,794 (49.3%) had baseline HbA1c <7.5% (58 mmol/mol). Finerenone significantly reduced risk of the kidney composite outcome independent of baseline HbA1c level and insulin use (Pinteraction = 0.41 and 0.56, respectively). Cardiovascular composite outcome incidence was reduced with finerenone irrespective of baseline HbA1c level and insulin use (Pinteraction = 0.70 and 0.33, respectively). Although baseline HbA1c level did not affect kidney event risk, cardiovascular risk increased with higher HbA1c level. UACR reduction was consistent across subgroups. Adverse events were similar between groups regardless of baseline HbA1c level and insulin use; few finerenone-treated patients discontinued treatment because of hyperkalemia.
CONCLUSIONS
Finerenone reduces kidney and cardiovascular outcome risk in patients with CKD and T2D, and risks appear consistent irrespective of HbA1c levels or insulin use.
Volume 4(2): 2-2 5. Pittas AG, Westcott GP, Balk EM (2015) Efficacy, safety, and patient acceptability of Technosphere inhaled insulin for people with diabetes; a systematic review and metaanalysis.
Linked Hypophosphatemia (XLH) is a genetic disorder that affects the bones and teeth, primarily characterized by low levels of phosphate in the blood. XLH is a rare disorder but is considered the most common inherited form of rickets. The clinical presentation of XLH varies widely with the most common symptoms of XLH being short stature, bowing of the legs, and dental defects. Diagnosis of XLH is typically made through clinical evaluation and genetic testing. Treatment options include monoclonal antibody therapy, oral phosphates, and bisphosphonates. This article will discuss the general clinical presentation of XLH, including the common symptoms and signs, the age of onset, diagnosis and treatment options, and the importance of primary care physician screening.
X-linked hypophosphatemia (XLH) is a hereditary condition characterized by reduced
phosphate levels in the bloodstream, leading to skeletal abnormalities. Extensive
research has been conducted on XLH, leading to the publication of numerous
scientific papers and disease state reviews. With the advancement of artificial
intelligence (AI) language models, such as ChatGPT, evaluating their proficiency
in medical academic writing becomes crucial. In this study, we aimed to assess the
capabilities of ChatGPT by comparing its AI-generated research paper on XLH
with a human-generated review of the disease state we authored. We employed a
comparative analysis approach to examine the AI- and human-generated articles’
content, structure, accuracy, and overall quality. Our evaluation considered factors
such as accuracy of the information, writing style and clarity, evidence-based
documentation quantity, and content depth and breadth. The findings of this
study have important implications for integrating AI language models into medical
research and academic writing. Understanding the strengths and limitations of AI-
generated articles can help researchers and healthcare professionals make informed
decisions regarding their utilization in scientific publications and clinical practice.
This article gives a brief account of the origins and evolution of coffee and its important
role in human society for the last 1200 years. Fast forward to today, and 66% of Americans
consume coffee daily. In the last few decades, a multitude of studies has researched the
claims that coffee drinking offers cardiovascular, neurologic, metabolic, carcinogenic, and
reproductive protections. This review evaluates and summarizes these findings, including the latest discoveries on the impact of caffeine on human health and the protection of human body systems.
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