Novel strategies in nephrology: what to expect from the future?

Çöpür, Sidar; Tanrıöver, Cem; Yavuz, Furkan; Soler, María José; Ortíz, Alberto; Covic, Adrian; Kanbay, Mehmet

doi:10.1093/ckj/sfac212

Cited by 9 publications

(5 citation statements)

References 152 publications

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“…According to the WHO, principles for screening of a disease include the disease being an important public health problem affecting a large group of individuals, availability of a suitable test or examination as well as treatment options [ 97 ]. All those criteria are met with CKD as it is even sometimes described as a global epidemic, eGFR and albuminuria testing is cost effective and treatment options are available [ 98 , 99 , 100 ]. Especially in the last couple of years, with the results from large scale studies showing that SGLT2 inhibitors or nonsteroidal mineralocorticoid receptor antagonists (nsMRA) additional to the already established angiotensin-converting enzyme inhibitors (ACEi) and sartans can reduce mortality and slow progression of CKD, the focus in nephrology has shifted from replacing the kidney via dialysis to actually preventing ESKD [ 99 ].…”

Section: Awareness Of Ckd: the Pivotal Role Of Egfrmentioning

confidence: 99%

Role of Estimated Glomerular Filtration Rate in Clinical Research: The Never-Ending Matter

Abenavoli,

Provenzano,

Ksiazek

et al. 2024

Rev. Cardiovasc. Med.

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Background: Chronic kidney disease (CKD) burden is crucial both on a global scale and at individual patient level, affecting morbidity and mortality directly and through its effect on both cardiovascular damage and CKD progression to end-stage-kidney-disease (ESKD). Unfortunately, the awareness of CKD is poor, with few CKD patients conscious of the severity of their health status. The principal biomarker of kidney function is estimated glomerular filtration rate (eGFR). Methods: We searched the literature and present a review article with the aim of summarizing the role of eGFR in clinical research. In particular, we report the eGFR role as a prognostic, enrichment and endpoint biomarker and its role in the early detection of CKD. Results: eGFR has a major role as a biomarker in clinical research. As a prognostic marker, eGFR reduction is associated with cardiovascular events, ESKD and mortality. As an enrichment biomarker, eGFR values are pivotal for selecting patients to be included in randomized and observational studies; it helps to test a pre-defined drug in early CKD or in more advanced CKD allowing also to avoid screening failures and to shorten the duration of clinical trials. Moreover, eGFR decline (expressed as a percentage of reduction from baseline or continuous slope) can be considered a good endpoint in clinic trials overcoming delays whilst waiting for hard endpoints to develop. Conclusions: eGFR is a strong clinical measure for both observational and intervention studies. It is also helpful in screening the general population for kidney disease and, in particular, to increase awareness of CKD.

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Section: Awareness Of Ckd: the Pivotal Role Of Egfrmentioning

confidence: 99%

Role of Estimated Glomerular Filtration Rate in Clinical Research: The Never-Ending Matter

Abenavoli,

Provenzano,

Ksiazek

et al. 2024

Rev. Cardiovasc. Med.

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“…In the coming years, these high-fidelity prescribing data will also provide an exciting opportunity to assess the real-world implementation and impact of recent, novel evidence-based therapies including sodium–glucose co-transporter-2 inhibitors, glucagon-like peptide 1 receptor agonists, and non-steroidal mineralocorticoid receptor antagonists on temporal trends of cardiovascular disease in patients with kidney failure. 17 In this national, population-based data linkage study, we aimed to investigate temporal trends in the incidence, treatment, and outcomes of myocardial infarction and stroke in patients with kidney failure on dialysis or with a kidney transplant over the last 20 years.…”

Section: Introductionmentioning

confidence: 99%

Kidney replacement therapy: trends in incidence, treatment, and outcomes of myocardial infarction and stroke in a nationwide Scottish study

Gallacher,

Yeung,

Bell

et al. 2024

European Heart Journal

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Background and Aims Patients with kidney failure have a higher risk of cardiovascular disease compared with the general population. Whilst temporal trends of myocardial infarction and stroke are declining in the general population, these have not been evaluated in patients with kidney failure. This study aimed to describe national trends in the incidence, treatment, and outcomes of myocardial infarction and stroke in patients with kidney failure (i.e. on dialysis or with a kidney transplant) over a 20-year period, stratified by age and sex. Methods In this retrospective national data linkage study, all patients with kidney failure in Scotland (UK) receiving kidney replacement therapy between January 1996 and December 2016 were linked to national hospitalization, prescribing, and death records. The primary outcomes were the incidence of myocardial infarction and stroke, and subsequent cardiovascular death. Generalized additive models were constructed to estimate age-standardized, sex-stratified incidence rates and trends in cardiovascular and all-cause death. Results Amongst 16 050 patients with kidney failure [52 (SD 15) years; 41.5% women], there were 1992 [66 (SD 12) years; 34.8% women] and 996 [65 (SD 13) years; 45.1% women] incident myocardial infarctions and strokes, respectively, between January 1996 and December 2016. During this period, the age-standardized incidence of myocardial infarction per 100 000 decreased in men {from 4376 [95% confidence interval (CI) 3998–4785] to 1835 (95% CI 1692–1988)} and women [from 3268 (95% CI 2982–3593) to 1369 (95% CI 1257–1491)]. Similarly, the age-standardized incidence of stroke per 100 000 also decreased in men [from 1978 (95% CI 1795–2175) to 799 (95% CI 729–875)] and women [from 2234 (95% CI 2031–2468) to 903 (95% CI 824–990)]. Compared with the general population, the incidence of myocardial infarction was four- to eight-fold higher in patients with kidney failure, whilst for stroke it was two- to four-fold higher. The use of evidence-based cardioprotective treatment increased over the study period, and the predicted probability of cardiovascular death within 1 year of myocardial infarction for a 66-year-old patient with kidney failure (mean age of the cohort) fell in men (76.6% to 38.6%) and women (76.8% to 38.8%), and also decreased in both sexes following stroke (men, from 63.5% to 41.4%; women, from 67.6% to 45.8%). Conclusions The incidence of myocardial infarction and stroke has halved in patients with kidney failure over the past 20 years but remains significantly higher than in the general population. Despite improvements in treatment and outcomes, the prognosis of these patients following myocardial infarction and stroke remains poor.

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“… 1 It is predicted to be the fifth global cause of death by 2040. 2 In Canadian primary care practices, the prevalence of CKD is 72 per 1000 individuals. 3 Since 2020, important practice changes have been made in medication management for individuals with CKD.…”

Section: Introductionmentioning

confidence: 99%

Review of the top nephrology studies of 2020-2023

Wilson,

Pitman,

Marin

et al. 2024

Can Pharm J

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Novel strategies in nephrology: what to expect from the future?

Cited by 9 publications

References 152 publications

Role of Estimated Glomerular Filtration Rate in Clinical Research: The Never-Ending Matter

Role of Estimated Glomerular Filtration Rate in Clinical Research: The Never-Ending Matter

Kidney replacement therapy: trends in incidence, treatment, and outcomes of myocardial infarction and stroke in a nationwide Scottish study

Review of the top nephrology studies of 2020-2023

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