Clinical Journal of the American Society of Nephrology最新文献

{"title":"Finerenone and Clinical Outcomes in Chronic Kidney Disease and Type 2 Diabetes by Frailty Index: FIDELITY Post Hoc Analysis.","authors":"Peter Rossing,Andreas L Birkenfeld,Paola Fioretto,Janet B McGill,Stefan D Anker,Bertram Pitt,Katja Rohwedder,Andrea Scalise,Charlie Scott,Gerasimos Filippatos,","doi":"10.2215/cjn.0000000700","DOIUrl":"https://doi.org/10.2215/cjn.0000000700","url":null,"abstract":"INTRODUCTIONFrailty is associated with a higher risk of adverse outcomes. It is believed that people with a higher frailty index may be less tolerant to new treatments, often leading to inappropriate prescribing. This post hoc analysis of FIDELITY, a prespecified, pooled analysis of the FIDELIO-DKD and FIGARO-DKD phase 3 clinical trials, investigated the efficacy and safety of finerenone versus placebo according to baseline frailty index.METHODSBetween September 2015 and October 2018, 12,990 people with chronic kidney disease (CKD) and type 2 diabetes (T2D) receiving the maximum tolerated dose of a renin-angiotensin system inhibitor were randomized to receive finerenone 10 or 20 mg once daily or placebo. Baseline frailty index was calculated using the Rockwood cumulative deficit approach including 30 clinical characteristics. Primary efficacy outcomes included a kidney (kidney failure, sustained decrease of ≥57% in estimated glomerular filtration rate [eGFR], or kidney-related death) and a cardiovascular (CV) composite outcome (CV death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure). Changes in urine albumin-to-creatinine ratio (UACR) and eGFR were measured across the study period.RESULTSOverall, kidney and CV event rates increased with increasing frailty. Finerenone reduced the risk of primary kidney and CV composite outcomes irrespective of baseline frailty (P interaction=0.93 and 0.35, respectively). Compared with placebo, finerenone also demonstrated significant reductions in UACR across all frailty subgroups (P<0.01 for all visits) and significant attenuation of eGFR decline from baseline to month 48 in the three most frail quartiles (>Q1 to ≤Q2, P=0.001; >Q2 to ≤Q3, P<0.001; >Q3, P<0.001, respectively). The incidence of serious adverse events and hyperkalemia increased with increasing frailty in both treatment arms.CONCLUSIONFinerenone reduced the risk of CV and kidney events in people with CKD and T2D versus placebo irrespective of baseline frailty status.REGISTRATIONFIDELIO-DKD (NCT02540993) and FIGARO-DKD (NCT02545049).","PeriodicalId":50681,"journal":{"name":"Clinical Journal of the American Society of Nephrology","volume":"6 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143903104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Noninvasive Diagnostic Strategies for Membranous Nephropathy in the Nephrotic Syndrome Study Network.","authors":"Jarcy Zee, Jonathan J Hogan, Ahmed Abdullah, Lili Liu, Krzysztof Kiryluk, Laurence H Beck","doi":"10.2215/CJN.0000000671","DOIUrl":"10.2215/CJN.0000000671","url":null,"abstract":"","PeriodicalId":50681,"journal":{"name":"Clinical Journal of the American Society of Nephrology","volume":" ","pages":"697-705"},"PeriodicalIF":8.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12097183/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143527971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High-Diversity Plant-Based Diets in CKD: Key Considerations from a Patient's Perspective.","authors":"Edson Arakaki","doi":"10.2215/CJN.0000000712","DOIUrl":"10.2215/CJN.0000000712","url":null,"abstract":"","PeriodicalId":50681,"journal":{"name":"Clinical Journal of the American Society of Nephrology","volume":" ","pages":"591"},"PeriodicalIF":8.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12097177/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combination Automated Microfluidics Measurement of Urine C-C Motif Ligand 2, CXC-Motif Chemokine 9, CXC-Motif Chemokine 10, and Vascular Endothelial Growth Factor A for Monitoring Patients with a Kidney Transplant.","authors":"Michael E Seifert, Alvin T Kho, Lea Sheward, Nancy Rodig, Sarah Goldberg, Margaret Diehl, David Zurakowski, Roslyn B Mannon, Vikas R Dharnidharka, Oriol Bestard, Tom D Blydt-Hansen, David M Briscoe","doi":"10.2215/CJN.0000000666","DOIUrl":"10.2215/CJN.0000000666","url":null,"abstract":"","PeriodicalId":50681,"journal":{"name":"Clinical Journal of the American Society of Nephrology","volume":" ","pages":"719-732"},"PeriodicalIF":8.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12097184/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum Metabolomic Markers of Dietary Potassium and Risk of CKD.","authors":"Lauren Bernard, Jiaqi Yang, Jingsha Chen, Valerie K Sullivan, Bing Yu, Eugene P Rhee, Paul A Welling, Casey M Rebholz","doi":"10.2215/CJN.0000000675","DOIUrl":"10.2215/CJN.0000000675","url":null,"abstract":"","PeriodicalId":50681,"journal":{"name":"Clinical Journal of the American Society of Nephrology","volume":" ","pages":"642-651"},"PeriodicalIF":8.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12097188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High-Diversity Plant-Based Diet and Gut Microbiome, Plasma Metabolome, and Symptoms in Adults with CKD.","authors":"Jordan Stanford, Anita Stefoska-Needham, Xiaotao Jiang, Brett McWhinney, Hicham I Cheikh Hassan, Emad El-Omar, Karen Charlton, Kelly Lambert","doi":"10.2215/CJN.0000000682","DOIUrl":"10.2215/CJN.0000000682","url":null,"abstract":"","PeriodicalId":50681,"journal":{"name":"Clinical Journal of the American Society of Nephrology","volume":" ","pages":"619-631"},"PeriodicalIF":8.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12097182/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"KRT Initiation for AKI: Evolving from \"When\" to \"If\" to \"How\".","authors":"Michael Heung, Lenar Yessayan","doi":"10.2215/CJN.0000000719","DOIUrl":"10.2215/CJN.0000000719","url":null,"abstract":"","PeriodicalId":50681,"journal":{"name":"Clinical Journal of the American Society of Nephrology","volume":"20 5","pages":"592-594"},"PeriodicalIF":8.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12097181/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144025108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting Kidney Outcomes in Autosomal Dominant Polycystic Kidney Disease: A Comprehensive Biomarker Analysis.","authors":"Thomas Bais, Martine G E Knol, Laixi Xue, Paul Geertsema, Priya Vart, Franz Reichel, Sita Arjune, Roman-Ulrich Müller, Shosha E I Dekker, Mahdi Salih, Esther Meijer, Ron T Gansevoort","doi":"10.2215/CJN.0000000680","DOIUrl":"10.2215/CJN.0000000680","url":null,"abstract":"","PeriodicalId":50681,"journal":{"name":"Clinical Journal of the American Society of Nephrology","volume":" ","pages":"608-618"},"PeriodicalIF":8.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12097190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interdisciplinary Care for Geriatric Syndromes in CKD: A Qualitative Study.","authors":"Aishwarya Subash, Maya Levinson, Kemberlee Bonnet, Rasheeda K Hall, Fahad Saeed, Christine K Liu, Totini S Chatterjee, Amanda S Mixon, Edward R Gould, Sara N Horst, Ebele M Umeukeje, Rachel A Burdick, Warren D Taylor, Kerri L Cavanaugh, David G Schlundt, Devika Nair","doi":"10.2215/CJN.0000000658","DOIUrl":"10.2215/CJN.0000000658","url":null,"abstract":"","PeriodicalId":50681,"journal":{"name":"Clinical Journal of the American Society of Nephrology","volume":" ","pages":"652-664"},"PeriodicalIF":8.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12097189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143631021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metabolomic Signature of Dietary Potassium Intake: A Novel Approach to Understanding CKD Onset?","authors":"Laetitia Koppe, Sandra Wagner","doi":"10.2215/CJN.0000000720","DOIUrl":"10.2215/CJN.0000000720","url":null,"abstract":"","PeriodicalId":50681,"journal":{"name":"Clinical Journal of the American Society of Nephrology","volume":"20 5","pages":"595-597"},"PeriodicalIF":8.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12097174/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144038822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}