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Effects of empagliflozin on first and recurrent clinical events in patients with type 2 diabetes and atherosclerotic cardiovascular disease: a secondary analysis of the EMPA-REG OUTCOME trial.

Darren K McGuire, Bernard Zinman, Silvio E Inzucchi, Christoph Wanner, David Fitchett, Stefan D Anker, Stuart Pocock, Stefan Kaspers, Jyothis T George, Maximilian von Eynatten, Odd Erik Johansen, Waheed Jamal, Michaela Mattheus, Ulrich Elsasser, Stefan Hantel, Søren S Lund,

BACKGROUND:Patients with type 2 diabetes and atherosclerotic cardiovascular disease are at high clinical risk. We assessed the effect of the sodium-glucose co-transporter-2 inhibitor, empagliflozin, on total cardiovascular events and admissions to hospital in the EMPA-REG OUTCOME trial. METHODS:The EMPA-REG OUTCOME trial was a randomised, double-blind, non-inferiority trial of patients (aged ... Read more >>

Lancet Diabetes Endocrinol (The lancet. Diabetes & endocrinology)
[2020, 8(12):949-959]

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Metabolic syndrome in patients with type 2 diabetes and atherosclerotic cardiovascular disease: a post hoc analyses of the EMPA-REG OUTCOME trial.

João Pedro Ferreira, Subodh Verma, David Fitchett, Anne Pernille Ofstad, Sabine Lauer, Isabella Zwiener, Jyothis George, Christoph Wanner, Bernard Zinman, Silvio E Inzucchi,

BACKGROUND:Patients with type 2 diabetes (T2D) and metabolic syndrome (MetS) are at greater cardiovascular risk than those with T2D without MetS. In the current report we aim to study the characteristics, cardio-renal outcomes and the effect of empagliflozin in patients with MetS enrolled in the EMPA-REG OUTCOME trial. METHODS:A total ... Read more >>

Cardiovasc Diabetol (Cardiovascular diabetology)
[2020, 19(1):200]

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Metabolic Syndrome in patients with type 2 diabetes and atherosclerotic cardiovascular disease: A post hoc analyses of the EMPA-REG OUTCOME trial

João Pedro Ferreira, Subodh Verma, David Fitchett, Anne Pernille Ofstad, Sabine Lauer, Isabella Zwiener, Jyothis George, Christoph Wanner, Bernard Zinman, Silvio Inzucchi,

Abstract Background : Patients with type 2 diabetes (T2D) and metabolic syndrome (MetS) are at greater cardiovascular risk than those with T2D without MetS. In the current report we aim to study the characteristics, cardio-renal outcomes and the effect of empagliflozin in patients with MetS enrolled in the EMPA-REG OUTCOME ... Read more >>

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Diabetes Management in Chronic Kidney Disease: Synopsis of the 2020 KDIGO Clinical Practice Guideline.

Sankar D Navaneethan, Sophia Zoungas, M Luiza Caramori, Juliana C N Chan, Hiddo J L Heerspink, Clint Hurst, Adrian Liew, Erin D Michos, Wasiu A Olowu, Tami Sadusky, Nikhil Tandon, Katherine R Tuttle, Christoph Wanner, Katy G Wilkens, Lyubov Lytvyn, Jonathan C Craig, David J Tunnicliffe, Martin Howell, Marcello Tonelli, Michael Cheung, Amy Earley, Peter Rossing, Ian H de Boer, Kamlesh Khunti,

DESCRIPTION:The Kidney Disease: Improving Global Outcomes (KDIGO) organization developed a clinical practice guideline in 2020 for the management of patients with diabetes and chronic kidney disease (CKD). METHODS:The KDIGO Work Group (WG) was tasked with developing the guideline for diabetes management in CKD. It defined the scope of the guideline, ... Read more >>

Ann Intern Med (Annals of internal medicine)
[2020, :]

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Characterization and implications of the initial estimated glomerular filtration rate 'dip' upon sodium-glucose co-transporter-2 inhibition with empagliflozin in the EMPA-REG OUTCOME trial.

Bettina J Kraus, Matthew R Weir, George L Bakris, Michaela Mattheus, David Z I Cherney, Naveed Sattar, Hiddo J L Heerspink, Ivana Ritter, Maximilian von Eynatten, Bernard Zinman, Silvio E Inzucchi, Christoph Wanner, Audrey Koitka-Weber,

Treatment with sodium-glucose co-transporter-2 inhibitors induces an initial 3-5 ml/min/1.73 m2 decline in estimated glomerular filtration rate (eGFR). Although considered to be of hemodynamic origin and largely reversible, this 'eGFR dip' may cause concern in clinical practice, which highlights the need to better understand its incidence and clinical implications. In ... Read more >>

Kidney Int (Kidney international)
[2020, :]

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Meta-analysis uncovers genome-wide significant variants for rapid kidney function decline.

Mathias Gorski, Bettina Jung, Yong Li, Pamela R Matias-Garcia, Matthias Wuttke, Stefan Coassin, Chris H L Thio, Marcus E Kleber, Thomas W Winkler, Veronika Wanner, Jin-Fang Chai, Audrey Y Chu, Massimiliano Cocca, Mary F Feitosa, Sahar Ghasemi, Anselm Hoppmann, Katrin Horn, Man Li, Teresa Nutile, Markus Scholz, Karsten B Sieber, Alexander Teumer, Adrienne Tin, Judy Wang, Bamidele O Tayo, Tarunveer S Ahluwalia, Peter Almgren, Stephan J L Bakker, Bernhard Banas, Nisha Bansal, Mary L Biggs, Eric Boerwinkle, Erwin P Bottinger, Hermann Brenner, Robert J Carroll, John Chalmers, Miao-Li Chee, Miao-Ling Chee, Ching-Yu Cheng, Josef Coresh, Martin H de Borst, Frauke Degenhardt, Kai-Uwe Eckardt, Karlhans Endlich, Andre Franke, Sandra Freitag-Wolf, Piyush Gampawar, Ron T Gansevoort, Mohsen Ghanbari, Christian Gieger, Pavel Hamet, Kevin Ho, Edith Hofer, Bernd Holleczek, Valencia Hui Xian Foo, Nina Hutri-Kähönen, Shih-Jen Hwang, M Arfan Ikram, Navya Shilpa Josyula, Mika Kähönen, Chiea-Chuen Khor, Wolfgang Koenig, Holly Kramer, Bernhard K Krämer, Brigitte Kühnel, Leslie A Lange, Terho Lehtimäki, Wolfgang Lieb, , , Ruth J F Loos, Mary Ann Lukas, Leo-Pekka Lyytikäinen, Christa Meisinger, Thomas Meitinger, Olle Melander, Yuri Milaneschi, Pashupati P Mishra, Nina Mononen, Josyf C Mychaleckyj, Girish N Nadkarni, Matthias Nauck, Kjell Nikus, Boting Ning, Ilja M Nolte, Michelle L O'Donoghue, Marju Orho-Melander, Sarah A Pendergrass, Brenda W J H Penninx, Michael H Preuss, Bruce M Psaty, Laura M Raffield, Olli T Raitakari, Rainer Rettig, Myriam Rheinberger, Kenneth M Rice, Alexander R Rosenkranz, Peter Rossing, Jerome I Rotter, Charumathi Sabanayagam, Helena Schmidt, Reinhold Schmidt, Ben Schöttker, Christina-Alexandra Schulz, Sanaz Sedaghat, Christian M Shaffer, Konstantin Strauch, Silke Szymczak, Kent D Taylor, Johanne Tremblay, Layal Chaker, Pim van der Harst, Peter J van der Most, Niek Verweij, Uwe Völker, Melanie Waldenberger, Lars Wallentin, Dawn M Waterworth, Harvey D White, James G Wilson, Tien-Yin Wong, Mark Woodward, Qiong Yang, Masayuki Yasuda, Laura M Yerges-Armstrong, Yan Zhang, Harold Snieder, Christoph Wanner, Carsten A Böger, Anna Köttgen, Florian Kronenberg, Cristian Pattaro, Iris M Heid,

Rapid decline of glomerular filtration rate estimated from creatinine (eGFRcrea) is associated with severe clinical endpoints. In contrast to cross-sectionally assessed eGFRcrea, the genetic basis for rapid eGFRcrea decline is largely unknown. To help define this, we meta-analyzed 42 genome-wide association studies from the Chronic Kidney Diseases Genetics Consortium and ... Read more >>

Kidney Int (Kidney international)
[2020, :]

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SGLT2 Inhibition for CKD and Cardiovascular Disease in Type 2 Diabetes: Report of a Scientific Workshop Sponsored by the National Kidney Foundation.

Katherine R Tuttle, Frank C Brosius, Matthew A Cavender, Paola Fioretto, Kevin J Fowler, Hiddo J L Heerspink, Tom Manley, Darren K McGuire, Mark E Molitch, Amy K Mottl, Leigh Perreault, Sylvia E Rosas, Peter Rossing, Laura Sola, Volker Vallon, Christoph Wanner, Vlado Perkovic,

Diabetes is the most frequent cause of chronic kidney disease (CKD), leading to nearly half of all cases of kidney failure requiring replacement therapy. The principal cause of death among patients with diabetes and CKD is cardiovascular disease (CVD). Sodium/glucose cotransporter 2 (SGLT2) inhibitors were developed to lower blood glucose ... Read more >>

Diabetes (Diabetes)
[2020, :]

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Virtual reality: the dawn of a new ERA.

Kate I Stevens, Giuseppe Palladino, Juan C Almiron, Monica Fontana, Christoph Wanner,

Nephrol Dial Transplant (Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association)
[2020, :]

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Results from the ERA-EDTA Registry indicate a high mortality due to COVID-19 in dialysis patients and kidney transplant recipients across Europe.

Kitty J Jager, Anneke Kramer, Nicholas C Chesnaye, Cécile Couchoud, J Emilio Sánchez-Álvarez, Liliana Garneata, Fréderic Collart, Marc H Hemmelder, Patrice Ambühl, Julia Kerschbaum, Camille Legeai, María Dolores Del Pino Y Pino, Gabriel Mircescu, Lionel Mazzoleni, Tiny Hoekstra, Rebecca Winzeler, Gert Mayer, Vianda S Stel, Christoph Wanner, Carmine Zoccali, Ziad A Massy,

The aim of this study was to investigate 28-day mortality after COVID-19 diagnosis in the European kidney replacement therapy population. In addition, we determined the role of patient characteristics, treatment factors, and country on mortality risk with the use of ERA-EDTA Registry data on patients receiving kidney replacement therapy in ... Read more >>

Kidney Int (Kidney international)
[2020, :]

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Cardiac and Kidney Benefits of Empagliflozin in Heart Failure Across the Spectrum of Kidney Function: Insights from the EMPEROR-Reduced Trial.

Faiez Zannad, João Pedro Ferreira, Stuart J Pocock, Cordula Zeller, Stefan D Anker, Javed Butler, Gerasimos Filippatos, Sibylle Jenny Hauske, Martina Brueckmann, Egon Pfarr, Janet Schnee, Christoph Wanner, Milton Packer,

Background: In EMPEROR-Reduced, empagliflozin reduced cardiovascular death or HF hospitalization, total HF hospitalizations, and slowed the progressive decline in kidney function in patients with HF and a reduced ejection fraction (HFrEF), with and without diabetes. We aim to study the effect of empagliflozin on cardiovascular and kidney outcomes across the ... Read more >>

Circulation (Circulation)
[2020, :]

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SGLT2 Inhibition for CKD and Cardiovascular Disease in Type 2 Diabetes: Report of a Scientific Workshop Sponsored by the National Kidney Foundation.

Katherine R Tuttle, Frank C Brosius, Matthew A Cavender, Paola Fioretto, Kevin J Fowler, Hiddo J L Heerspink, Tom Manley, Darren K McGuire, Mark E Molitch, Amy K Mottl, Leigh Perreault, Sylvia E Rosas, Peter Rossing, Laura Sola, Volker Vallon, Christoph Wanner, Vlado Perkovic,

Diabetes is the most frequent cause of chronic kidney disease (CKD), leading to nearly half of all cases of kidney failure requiring replacement therapy. The principal cause of death among patients with diabetes and CKD is cardiovascular disease (CVD). Sodium/glucose cotransporter 2 (SGLT2) inhibitors were developed to lower blood glucose ... Read more >>

Am J Kidney Dis (American journal of kidney diseases : the official journal of the National Kidney Foundation)
[2020, :]

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Effect of Finerenone on Chronic Kidney Disease Outcomes in Type 2 Diabetes.

George L Bakris, Rajiv Agarwal, Stefan D Anker, Bertram Pitt, Luis M Ruilope, Peter Rossing, Peter Kolkhof, Christina Nowack, Patrick Schloemer, Amer Joseph, Gerasimos Filippatos, ,

<b>Background: </b>Finerenone, a nonsteroidal, selective mineralocorticoid receptor antagonist, reduced albuminuria in short-term trials involving patients with chronic kidney disease (CKD) and type 2 diabetes. However, its long-term effects on kidney and cardiovascular outcomes are unknown.<br><br><b>Methods: </b>In this double-blind trial, we randomly assigned 5734 patients with CKD and type 2 diabetes ... Read more >>

N Engl J Med (The New England journal of medicine)
[2020, 383(23):2219-2229]

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[Heart failure protection by SGLT2 inhibitors in patients with type 2 diabetes mellitus: evidence and possible mechanisms : A systematic review].

Andreas J Rieth, Christian W Hamm, Christoph Wanner, Veselin Mitrovic, Till Keller,

BACKGROUND:Renal sodium-glucose cotransporter‑2 (SGLT2) inhibitors seem to have a cardioprotective effect beyond the antidiabetic effect. The underlying mechanisms are unclear. METHODS:Selective search in PubMed with a focus on heart failure endpoints and possible mechanisms of action. RESULTS:During treatment with three of the substances analyzed, there were fewer hospitalizations for heart failure compared ... Read more >>

Herz (Herz)
[2020, :]

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International consensus definitions of clinical trial outcomes for kidney failure: 2020.

Adeera Levin, Rajiv Agarwal, William G Herrington, Hiddo L Heerspink, Johannes F E Mann, Shahnaz Shahinfar, Katherine R Tuttle, Jo-Ann Donner, Vivekanand Jha, Masaomi Nangaku, Dick de Zeeuw, Meg J Jardine, Kenneth W Mahaffey, Aliza M Thompson, Mary Beaucage, Kate Chong, Glenda V Roberts, Duane Sunwold, Hans Vorster, Madeleine Warren, Sandrine Damster, Charu Malik, Vlado Perkovic, ,

Kidney failure is an important outcome for patients, clinicians, researchers, healthcare systems, payers, and regulators. However, no harmonized international consensus definitions of kidney failure and key surrogates of progression to kidney failure exist specifically for clinical trials. The International Society of Nephrology convened an international multi-stakeholder meeting to develop consensus ... Read more >>

Kidney Int (Kidney international)
[2020, 98(4):849-859]

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Empagliflozin and Cardiovascular and Kidney Outcomes across KDIGO Risk Categories: Post Hoc Analysis of a Randomized, Double-Blind, Placebo-Controlled, Multinational Trial.

Adeera Levin, Vlado Perkovic, David C Wheeler, Stefan Hantel, Jyothis T George, Maximilian von Eynatten, Audrey Koitka-Weber, Christoph Wanner, ,

BACKGROUND AND OBJECTIVES:In the Empagliflozin Cardiovascular Outcome Event Trial in Type 2 Diabetes Mellitus Patients (EMPA-REG Outcome), empagliflozin, in addition to standard of care, significantly reduced risk of cardiovascular death by 38%, hospitalization for heart failure by 35%, and incident or worsening nephropathy by 39% compared with placebo in patients ... Read more >>

Clin J Am Soc Nephrol (Clinical journal of the American Society of Nephrology : CJASN)
[2020, 15(10):1433-1444]

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Identifying critically important cardiovascular outcomes for trials in hemodialysis: an international survey with patients, caregivers and health professionals.

Emma O'Lone, Martin Howell, Andrea K Viecelli, Jonathan C Craig, Allison Tong, Benedicte Sautenet, William G Herrington, Charles A Herzog, Tazeen H Jafar, Meg Jardine, Vera Krane, Adeera Levin, Jolanta Malyszko, Michael V Rocco, Giovanni Strippoli, Marcello Tonelli, Angela Yee-Moon Wang, Christoph Wanner, Faiez Zannad, Wolfgang C Winkelmayer, David C Wheeler,

BACKGROUND:Cardiovascular disease (CVD) is a major contributor to morbidity and mortality in people on hemodialysis (HD). Cardiovascular outcomes are reported infrequently and inconsistently across trials in HD. This study aimed to identify the priorities of patients/caregivers and health professionals (HPs) for CVD outcomes to be incorporated into a core outcome ... Read more >>

Nephrol Dial Transplant (Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association)
[2020, 35(10):1761-1769]

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The Impact of Empagliflozin on Obstructive Sleep Apnea and Cardiovascular and Renal Outcomes: An Exploratory Analysis of the EMPA-REG OUTCOME Trial.

Ian J Neeland, Bjorn Eliasson, Takatoshi Kasai, Nikolaus Marx, Bernard Zinman, Silvio E Inzucchi, Christoph Wanner, Isabella Zwiener, Brian S Wojeck, Henry K Yaggi, Odd Erik Johansen, ,

OBJECTIVE:To explore the effects of empagliflozin on the incidence of obstructive sleep apnea (OSA) and its effects on metabolic, cardiovascular (CV), and renal outcomes among participants with or without OSA in the EMPA-REG OUTCOME trial. RESEARCH DESIGN AND METHODS:Participants with diabetes and CV disease were randomized to empagliflozin (10 and ... Read more >>

Diabetes Care (Diabetes care)
[2020, 43(12):3007-3015]

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KDIGO 2020 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease.

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Kidney Int (Kidney international)
[2020, 98(4S):S1-S115]

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Quantification of left ventricular mass by echocardiography compared to cardiac magnet resonance imaging in hemodialysis patients.

Sören Jendrik Grebe, Uwe Malzahn, Julian Donhauser, Dan Liu, Christoph Wanner, Vera Krane, Fabian Hammer,

BACKGROUND:Left ventricular hypertrophy (LVH), defined by the left ventricular mass index (LVMI), is highly prevalent in hemodialysis patients and a strong independent predictor of cardiovascular events. Compared to cardiac magnetic resonance imaging (CMR), echocardiography tends to overestimate the LVMI. Here, we evaluate the diagnostic performance of transthoracic echocardiography (TTE) compared ... Read more >>

Cardiovasc Ultrasound (Cardiovascular ultrasound)
[2020, 18(1):39]

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Early benefits of empagliflozin in patients with or without heart failure: findings from EMPA-REG OUTCOME.

Pierpaolo Pellicori, Anne Pernille Ofstad, David Fitchett, Cordula Zeller, Christoph Wanner, Jyothis George, Bernard Zinman, Martina Brueckmann, JoAnn Lindenfeld,

AIMS:The EMPA-REG OUTCOME trial demonstrated reductions in cardiovascular (CV) death and heart failure (HF) outcomes with empagliflozin, a sodium-glucose co-transporter 2 inhibitor, in patients with type 2 diabetes and established CV disease over a study period of 3 years. We aimed to investigate the early benefit-risk profile of empagliflozin in patients ... Read more >>

ESC Heart Fail (ESC heart failure)
[2020, :]

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Cardiovascular Benefit of Empagliflozin Across the Spectrum of Cardiovascular Risk Factor Control in the EMPA-REG OUTCOME Trial.

Silvio E Inzucchi, Kamlesh Khunti, David H Fitchett, Christoph Wanner, Michaela Mattheus, Jyothis T George, Anne Pernille Ofstad, Bernard Zinman,

CONTEXT:Control of multiple cardiovascular (CV) risk factors reduces CV events in individuals with type 2 diabetes. OBJECTIVE:To investigate this association in a contemporary clinical trial population, including how CV risk factor control affects the CV benefits of empagliflozin, a sodium-glucose cotransporter-2 inhibitor. DESIGN:Post hoc analysis. SETTING:Randomized CV outcome trial (EMPA-REG ... Read more >>

J Clin Endocrinol Metab (The Journal of clinical endocrinology and metabolism)
[2020, 105(9):]

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Short-Term Changes in Albuminuria and Risk of Cardiovascular and Renal Outcomes in Type 2 Diabetes Mellitus: A Post Hoc Analysis of the EMPA-REG OUTCOME Trial.

Simke W Waijer, Di Xie, Silvio E Inzucchi, Bernard Zinman, Audrey Koitka-Weber, Michaela Mattheus, Maximillian von Eynatten, Lesley A Inker, Christoph Wanner, Hiddo J L Heerspink,

Background Early reduction in albuminuria with an SGLT2 (sodium-glucose cotransporter 2) inhibitor may be a positive indicator of long-term cardiovascular and renal benefits. We assessed changes in albuminuria during the first 12 weeks of treatment and subsequent long-term cardiovascular and renal risks associated with the SGLT2 inhibitor, empagliflozin, in the EMPA-REG ... Read more >>

J Am Heart Assoc (Journal of the American Heart Association)
[2020, 9(18):e016976]

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Cardiovascular and Renal Outcomes with Empagliflozin in Heart Failure.

Milton Packer, Stefan D Anker, Javed Butler, Gerasimos Filippatos, Stuart J Pocock, Peter Carson, James Januzzi, Subodh Verma, Hiroyuki Tsutsui, Martina Brueckmann, Waheed Jamal, Karen Kimura, Janet Schnee, Cordula Zeller, Daniel Cotton, Edimar Bocchi, Michael Böhm, Dong-Ju Choi, Vijay Chopra, Eduardo Chuquiure, Nadia Giannetti, Stefan Janssens, Jian Zhang, Jose R Gonzalez Juanatey, Sanjay Kaul, Hans-Peter Brunner-La Rocca, Bela Merkely, Stephen J Nicholls, Sergio Perrone, Ileana Pina, Piotr Ponikowski, Naveed Sattar, Michele Senni, Marie-France Seronde, Jindrich Spinar, Iain Squire, Stefano Taddei, Christoph Wanner, Faiez Zannad, ,

BACKGROUND:Sodium-glucose cotransporter 2 (SGLT2) inhibitors reduce the risk of hospitalization for heart failure in patients regardless of the presence or absence of diabetes. More evidence is needed regarding the effects of these drugs in patients across the broad spectrum of heart failure, including those with a markedly reduced ejection fraction. ... Read more >>

N Engl J Med (The New England journal of medicine)
[2020, 383(15):1413-1424]

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Funding kidney research as a public health priority: challenges and opportunities.

Carmine Zoccali, Raymond Vanholder, Carsten A Wagner, Hans-Joachim Anders, Peter J Blankestijn, Annette Bruchfeld, Giovambattista Capasso, Mario Cozzolino, Friedo W Dekker, Danilo Fliser, Denis Fouque, Ron T Gansevoort, Dimitrios Goumenos, Kitty J Jager, Ziad A Massy, Tom A J Oostrom, Ivan Rychlık, Maria Jose Soler, Kate Stevens, Goce Spasovski, Christoph Wanner,

Medical societies have a social responsibility to disseminate knowledge and inform health authorities on threats to public health posed by various diseases. Advocacy for health protection programmes and for medical research funding is now embedded into the missions of most scientific societies. To promote kidney research funding in Europe, the ... Read more >>

Nephrol Dial Transplant (Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association)
[2020, :]

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Heart failure and renal outcomes according to baseline and achieved blood pressure in patients with type 2 diabetes: results from EMPA-REG OUTCOME.

Michael Böhm, David Fitchett, Anne Pernille Ofstad, Martina Brueckmann, Stefan Kaspers, Jyothis T George, Isabella Zwiener, Bernard Zinman, Christoph Wanner, Nikolaus Marx, Giuseppe Mancia, Stefan D Anker, Felix Mahfoud,

BACKGROUND:The sodium-glucose co-transporter 2 (SGLT2) inhibitor empagliflozin reduced cardiovascular death or heart failure hospitalizations in type 2 diabetes (T2D) in addition to a reduction of SBP. As heart failure patients often present with low SBP, which can challenge treatment initiation, we explored if empagliflozin's effect on SBP was independent of ... Read more >>

J Hypertens (Journal of hypertension)
[2020, 38(9):1829-1840]

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