Annals Internal Medicine, Author Interviews, Kidney Disease / 28.01.2026

[caption id="attachment_72168" align="alignleft" width="150"]Dustin Mark, MDEmergency Medicine/Critical Care Medicine, East Bay Adjunct Researcher, KPNC Division of Research, CREST Network Dr. Mark[/caption] MedicalResearch.com Interview with: Dustin Mark, MD Emergency Medicine/Critical Care Medicine, East Bay Adjunct Researcher, KPNC Division of Research, CREST Network MedicalResearch.com: What is the background for this study? Response: We examined medical records from 13,988 adults hospitalized with severe hyponatremia between 2008 and 2023 across 21 community hospitals in the Kaiser Permanente Northern California health system. Patients were grouped based on how quickly their sodium levels were corrected within a 24-hour period (< 8 meq/L, 8-12 meq/L, > 12 meq/L) and were followed for up to 90 days. The primary outcome was death or serious delayed neurologic events, such as brain damage, seizures, paralysis, or altered consciousness. The results suggest that there is likely a true independent association between slow sodium correction and adverse outcomes, and that current guidelines promoting slow correction of sodium levels should be re-evaluated accordingly.
Author Interviews, Diabetes, Heart Disease, Kidney Disease / 18.12.2025

MedicalResearch.com Interview with: [caption id="attachment_71837" align="alignleft" width="150"]dr_kramer_headshot Dr. Holly Kramer[/caption] Dr. Holly Kramer MD, MPH Professor of Public Health Sciences and Medicine Division of Nephrology and Hypertension Loyola University Chicago MedicalResearch.com: What is the background for this survey? How is UACR measured? Would you explain the significance of albumin in the urine and what creatinine represents? Response: Approximately 36 million people live with type 2 diabetes (T2D) in the U.S. today, with cardiovascular disease (CVD) being the number one cause of death for this patient population. About 1 in 3 adults with T2D has UACR >30 mg/g with prevalence approaching 40% in older patients. Compared to patients with T2D alone, those with elevated UACR face:
    • 5-times higher risk of hospitalization for heart failure
    • 4-times higher risk of CV mortality
    • 3-times higher risk of myocardial infarction
Interestingly, once thought of as a traditional renal biomarker, urine albumin-to-creatinine ratio (UACR) >30 is also a critical biomarker and urgent signal of cardiovascular (CV) risk. When checking UACR, we look at two things: the amount of albumin leaking into the urine and the creatinine level. Albumin shouldn’t be getting through the kidneys’ filters at all, so when we see a UACR >30 mg/g, it’s a sign of systemic vascular endothelial dysfunction. So, if albumin is leaking through the blood vessels inside the kidneys, there’s also damage in the vessels across other organs, like the heart. UACR is such an important early indicator of CV risk in T2D because even small increases follow a clear ‘rule of three’s’. Healthy kidneys secrete 3 mg/g of albumin to creatinine per day, but when it rises to 30 mg/g, a tenfold increase that signals vascular dysfunction and increasing CV risk. At 300 mg/g, another tenfold increase, the damage is more advanced, and CV risk accelerates. Patients with eGFR >60 BUT UACR >30 mg/g can have up to 3.6 times increased risk of CV mortality. As a nephrologist, I’ve been vocal about the potential for this common urine test that we regularly perform, a UACR test, in helping detect CV risk, not just kidney damage, in more patients.
Author Interviews, Diabetes, Kidney Disease, NYU, Weight Research / 20.10.2025

MedicalResearch.com Interview with: [caption id="attachment_71025" align="alignleft" width="225"]Michael A. Weintraub, MDClinical Assistant Professor Department of Medicine NYU Grossman School of Medicine Dr. Weintraub[/caption] Michael A. Weintraub, MD Clinical Assistant Professor Department of Medicine NYU Grossman School of Medicine MedicalResearch.com: What is the background for this study? Response: The study addresses a critical knowledge gap in diabetes management for dialysis patients. Of the 808,000 people on dialysis in the United States, approximately 60% have diabetes and would be eligible for GLP-1 receptor agonists (GLP-1 RAs). However, these medications have not been well-studied in this population because dialysis dependence is frequently an exclusion criterion in clinical trials.
Kidney Disease, Laboratories / 04.11.2024

[caption id="attachment_64563" align="aligncenter" width="500"]urine testing Image source[/caption] Urine output measurement stands among the core vital signs monitored in clinical settings, providing critical data about patient hemodynamic status, renal function, and overall fluid balance. This guide examines precise measurement techniques, interpretation standards, and clinical applications for healthcare professionals. The data gathered through systematic urine output measurement serves multiple clinical purposes, from basic patient assessment to complex critical care decisions. Medical professionals across specialities rely on these measurements to guide treatment plans, adjust interventions, and monitor patient progress.
Author Interviews, Diabetes, Kidney Disease, Nature, Semaglutide / 31.10.2024

MedicalResearch.com Interview on publication of: [caption id="attachment_64443" align="alignleft" width="200"]Prof. dr. H.J. (Hiddo) Lambers HeerspinkClinical Pharmacologist Faculty of Medical Sciences University of Groningen Prof. Heerspink[/caption] Prof. dr. H.J. (Hiddo) Lambers Heerspink Clinical Pharmacologist Faculty of Medical Sciences University of Groningen MedicalResearch.com: What is the background for this study? What are the main findings? Response: The diabetes drug semaglutide, also known as Ozempic, has a positive effect for patients with chronic kidney damage and obesity. The amount of protein in their urine decreased, as did the degree of inflammation of their kidneys and their blood pressure. Hiddo L. Heerspink got the idea for this study at the beginning of the corona pandemic. Earlier, he had discovered that another class of drugs against diabetes-2, the so-called SGLT2 inhibitors also appeared to work well for patients with chronic kidney damage without diabetes. He therefore wanted to investigate whether semaglutide would also work positively for patients with chronic kidney disease and obesity.
Author Interviews, Cost of Health Care, JAMA, Kidney Disease, Transplantation / 01.07.2024

MedicalResearch.com Interview with: [caption id="attachment_62111" align="alignleft" width="200"]Amal Trivedi, MD, MPHProfessor of Health Services, Policy & Practice Brown University School of Public Health Prof. Trivedi[/caption] Amal Trivedi, MD, MPH Professor of Health Services, Policy & Practice Brown University School of Public Health MedicalResearch.com: What is the background for this study? Response: On January 1st, 2021, the Centers for Medicare & Medicaid Services (CMS) launched the mandatory End-Stage Renal Disease Treatment Choices (ETC) Model, which randomly assigned approximately 30% of U.S. dialysis facilities and managing clinicians to financial incentives to increase the use of home dialysis and kidney transplantation. The program is set to run through 2027, with financial incentives and penalties increasing as the model progresses. Our study sought to assess the ETC’s effect on these outcomes of interest in the first two years, as well as to examine outcome changes by race, ethnicity and socioeconomic status.
Author Interviews, Critical Care - Intensive Care - ICUs, Heart Disease, Kidney Disease, NEJM / 13.06.2024

MedicalResearch.com Interview with: [caption id="attachment_61951" align="alignleft" width="150"]Prof Giovanni Landoni, MDAssociate Professor Università Vita-Salute San Raffaele Milan, Italy Prof. Landoni[/caption] Prof Giovanni Landoni, MD Associate Professor Università Vita-Salute San Raffaele Milan, Italy MedicalResearch.com: What is the background for this study? Response: Acute kidney injury (AKI) affects approximately 10-15% of hospitalized patients, and up to 50% of intensive care unit (ICU) patients. In cardiac surgery one patient out of three will face AKI during the postoperative period, and this will lead to higher morbidity and mortality. AKI is associated with an elevated risk of chronic kidney disease, as well as, in the most severe cases, with the use of renal replacement therapy, which may double hospitalization costs, reduce quality of life, and increase long-term mortality. So far, no preventive measure with level I of evidence did exist for AKI. The PROTECTION trial is a multinational, randomized, double-blind, placebo-controlled trial, conducted at 22 centers in 3 different countries. We recruited 3,511 adult patients undergoing cardiac surgery with cardiopulmonary bypass to receive an intravenous infusion of amino acids (AA) (Isopuramin 10%, Baxter), at 2g/kg/day up to a maximum 100g/day, or an equivalent dose of placebo (Ringer’s solution), for a maximum of 72 hours. The primary outcome was the incidence of any stage of AKI, according to the Kidney Disease: Improving Global Outcomes (KDIGO) 2012 creatinine criteria.
Author Interviews, Kidney Disease / 30.05.2024

MedicalResearch.com Interview with: [caption id="attachment_61821" align="alignleft" width="156"]Silvi Shah, MD,MS,FASN,FACPAssociate Professor Internal Medicine | College of Medicine University of Cincinnati College of Medicine Dr. Shah[/caption] Silvi Shah, MD,MS,FASN,FACP Associate Professor Internal Medicine | College of Medicine University of Cincinnati College of Medicine MedicalResearch.com: What is the background for this study? Response: AKI  (Acute Kidney Injury) is a major contributor to end-stage kidney disease (ESKD). About a third of patients with ESKD recover kidney function due to AKI. The study looked at the health outcomes of 22,922 patients from the U.S. Renal Data System from 2005 to 2014 to construct a clinical scoring system to predict kidney recovery within 90 days and 12 months after the start of dialysis for kidney failure patients due to acute kidney injury (AKI)
Author Interviews, Health Care Systems, Kidney Disease, NEJM, NIH, UT Southwestern / 04.04.2024

MedicalResearch.com Interview with: [caption id="attachment_61529" align="alignleft" width="125"]Miguel A. Vazquez, MDProfessor of Internal Medicine University of Texas Southwestern Medical Center Dr. Vazquez[/caption] Miguel A. Vazquez, MD Professor of Internal Medicine University of Texas Southwestern Medical Center MedicalResearch.com: What is the background for this study? Response: The main reason to conduct our trial was to improve the care of patients with coexistent chronic kidney disease CKD),  type 2 diabetes and hypertension.   Patients with this triad are at high risk for multiple complications, end stage kidney disease and premature death.   There are effective interventions for these conditions.  Unfortunately, detection and awareness of CKD is low and many patients do not receive interventions that could be beneficial In our study in patients with the coexistent triad of chronic kidney disease, type 2 diabetes, and hypertension the use of an electronic algorithm to identify patients from the electronic health record and practice facilitators embedded in four large health systems to assist primary practitioners deliver evidence-based care did not lower hospitalizations when compared to usual care.
Author Interviews, Inflammation, Kidney Disease, Nature, Rheumatology / 08.02.2024

MedicalResearch.com Interview with: [caption id="attachment_61322" align="alignleft" width="150"]A/Prof. Joshua Ooi, PhDHead, Regulatory T-cell Therapies Translational Research Facility Clinical Sciences at Monash Health, Monash University Dr. Ooi[/caption] A/Prof. Joshua Ooi, PhD Head, Regulatory T-cell Therapies Translational Research Facility Clinical Sciences at Monash Health, Monash University MedicalResearch.com: What is the background for this study? Response: In 2017, we published a landmark Nature paper showing that people who are protected from autoimmune disease have specialized molecules on immune cells. These specific molecules are missing in patients that develop autoimmune disease.
Author Interviews, Immunotherapy, Kidney Disease, NEJM / 15.01.2024

MedicalResearch.com Interview with: VisterraMohit Mathur MD, FASN, FNKF, FRCP (Glasgow) Clinical fellow in Nephrology at UofT DM (Nephrology), MRCP.UK (SCE in Nephrology). Director, Clinical Development Visterra Waltham, MA 02451 MedicalResearch.com: What is the background for this study? Would you briefly describe the condition of IgA Nephropathy? Response: IgA Nephropathy is the commonest primary glomerular disease in the world. It is an autoimmune kidney disease that typically presents with urinary abnormalities, elevated blood pressure and reduced kidney function. Until recently IgAN was considered to be a benign disease, but recent studies have indicated that a majority of patients will progress to End stage kidney disease in their lifetime. Steroids have been the mainstay of treatment in IgAN, but they come at a very high burden of side effects. Thus, there is an urgent requirement to develop novel and safe treatment options for patients with IgAN. APRIL is considered to be a key cytokine implicated in the pathogenesis of IgAN, hence we decided to target APRIL as a therapeutic modality in IgAN.
Author Interviews, Cost of Health Care, JAMA, Kidney Disease, Medicare / 11.01.2024

MedicalResearch.com Interview with: [caption id="attachment_61226" align="alignleft" width="134"]Kalli Koukounas, MPHPh.D. Student, Health Services Research Brown University School of Public Health Providence, RI Kalli Koukounas[/caption] Kalli Koukounas, MPH Ph.D. Student, Health Services Research Brown University School of Public Health Providence, RI MedicalResearch.com: What is the background for this study? Response:  On Jan. 1st, 2021, the Centers for Medicare and Medicaid Services (CMS) implemented the End-Stage Renal Disease Treatment Choices (ETC) Model, one of the largest randomized tests of pay-for-performance incentives ever conducted in the US. The goal of the model was to enhance the use of home dialysis and kidney transplant or waitlisting among kidney failure patients in traditional Medicare. The model randomly assigned approximately 30% of US dialysis facilities and nephrologists to receive financial incentives, ranging from bonuses of 4% to penalties of 5%, based on their patients’ use of home dialysis and kidney transplant/waitlisiting. The payment adjustments apply to all Medicare-based reimbursement for dialysis services. Prior research has demonstrated that dialysis facilities that disproportionately serve populations with high social risk have lower use of home dialysis and kidney transplant, raising concerns that these sites may fare poorly in the payment model. Using data released by CMS, we examined the first year of ETC model performance and financial penalties across dialysis facilities, stratified by the measured social risk of the facilities’ incident patients.
Author Interviews, JAMA, Kidney Disease, Salt-Sodium / 03.01.2024

MedicalResearch.com Interview with: [caption id="attachment_61192" align="alignleft" width="150"]Lu Qi, MD, PhD, FAHAInterim Chair, Department of Epidemiolog HCA Regents Distinguished Chair and Professor Tulane University School of Public Health and Tropical Medicine Director, Tulane University Obesity Research Center Director, Tulane Personalized Health Institute  New Orleans, LA 70112 Dr. Lu Qi[/caption] Lu Qi, MD, PhD, FAHA Interim Chair, Department of Epidemiolog HCA Regents Distinguished Chair and Professor Tulane University School of Public Health and Tropical Medicine Director, Tulane University Obesity Research Center Director, Tulane Personalized Health Institute New Orleans, LA 70112 MedicalResearch.com: What is the background for this study? Response: Adding salt to foods is a behavior reflecting long-term preference to salty diets. High sodium intake is a major risk factor for chronic kidney disease. In our previous studies, we have found that adding salt to foods at the table is related to various disorders including cardiovascular diseases, diabetes, and mortality. 
AHA Journals, Author Interviews, Heart Disease, Kidney Disease, Obstructive Sleep Apnea, Sleep Disorders / 15.11.2023

MedicalResearch.com Interview with: Lead Author: Rupak Desai, MBBS Atlanta Veterans Affairs Medical Center Independent Researcher, Atlanta, GA, Presenter: Vamsikalyan Borra, MD Resident Physician, Internal Medicine University of Texas Rio Grande Valley, Weslaco, TX MedicalResearch.com: What is the background for this study? Response: The relationship between sleep apnea (OSA) and chronic kidney disease (CKD) is quite complex. OSA can cause hypoxia, activation of the sympathetic nervous system, and hypertension, all of which can have negative effects on kidney function. On the other hand, in patients with end-stage renal disease (ESRD), intensifying renal replacement therapy has shown some improvement in sleep apnea severity, suggesting a bi-directional relationship between the two conditions. While there are still uncertainties, recent studies have focused on understanding the interplay between OSA and CKD. The role of CPAP therapy, a common treatment for OSA, in relation to CKD is not yet clear. Observational studies present findings regarding the impact of CPAPs on kidney function. However, researchers are actively investigating its cardiovascular benefits and its influence on the progression of CKD. The objective of this study is to analyze the trends in composite cardiovascular events in hospital encounters among geriatric patients with CKD, comparing those with and without obstructive sleep apnea. Additionally, we are also investigating sex and racial disparities in trends of major adverse cardiovascular and cerebrovascular events (MACCE) among geriatric patients with obstructive sleep apnea (OSA). Furthermore, we are assessing the impact of continuous positive airway pressure (CPAP) treatment and dependence on MACCE outcomes in OSA patients
Author Interviews, Kidney Disease, Transplantation / 09.11.2023

MedicalResearch.com Interview with: Collective responses from study authors: MedicalResearch.com: What is the background for this study?
  • Patients with advanced chronic kidney disease (CKD) have the best chance for a longer and healthier life if they receive a kidney transplant.
  • However, due to many barriers, many eligible patients today will never receive a kidney transplant.
  • Advanced CKD care is provided by 26 chronic kidney disease (CKD) programs managed by a government funded provincial renal agency (the Ontario Renal Network)
  • Together these 26 programs treat ~ 24,000 patients each year
  • This care is provided by over 3400 nurses and 230 nephrologists
  • To patients approaching the need for dialysis and those receiving dialysis
  • Approximately half are transplant eligible
    • ~ 600 kidney transplants done in Ontario each year across 6 transplant centres
    • with approximately.30% of kidneys coming from living donors
Author Interviews, Kidney Disease / 28.08.2023

MedicalResearch.com Interview with: [caption id="attachment_60812" align="alignleft" width="109"]Amira Abdelrasoul, Ph.D., P. Eng.Associate Professor, Chemical and Biomedical Engineering Department of Chemical and Biological Engineering Division of Biomedical Engineering University of Saskatchewan Dr. Abdelrasoul[/caption] Amira Abdelrasoul, Ph.D., P. Eng.Associate Professor, Chemical and Biomedical EngineeringDepartment of Chemical and Biological EngineeringDivision of Biomedical EngineeringUniversity of Saskatchewan     MedicalResearch.com: What is the background for this study? Response: The background of this study lies in the pursuit of improving the compatibility of dialysis membranes used in hospitals. My team sought to enhance the performance of these membranes by incorporating heparin, a widely recognized anticoagulant. Existing heparin-grafted membranes carried a negative charge, resulting in adverse blood-membrane interactions and complications for dialysis patients. The study aimed to overcome these issues and create a neutralized membrane surface that maintains the benefits of heparin while minimizing undesirable interactions.
Annals Internal Medicine, Author Interviews, Kidney Disease, UCSF / 21.07.2023

MedicalResearch.com Interview with: [caption id="attachment_60654" align="alignleft" width="150"]Chi-yuan Hsu, MD, MSc (he/him/his)Professor and Division Chief Robert W. Schrier Distinguished Professor Division of Nephrology  University of California, San Francisco Dr. Chi-yuan Hsu[/caption]   Chi-yuan Hsu, MD, MSc (he/him/his) Professor and Division Chief Robert W. Schrier Distinguished Professor Division of Nephrology University of California, San Francisco     MedicalResearch.com: What is the background for this study? Response: Acute kidney injury (AKI) had previously been considered a reversible short-term medical problem among hospitalized patients without long-term sequalae in that there is recovery of kidney function back to baseline should the patient survive the hospitalization. Then about 15 years ago, the concept began to shift as research by us and others showed that for patients with severe AKI (e.g. AKI severe enough to require acute dialysis in the hospital), there was more rapid subsequent loss of renal function.  Now based largely on additional observational studies in humans (and animal models), many nephrologists and opinion leaders think that even mild to moderate cases of AKI have long-term sequelae.  We are concerned that the paradigm has swung too much in the opposite direction and we questioned the results of many published studies which did not fully account for differences in background kidney function among those who did and did not experience AKI.
Anemia, Author Interviews, Diabetes, Kidney Disease, NEJM / 30.05.2023

MedicalResearch.com Interview with: Prof. Heerspink Prof. Hiddo Lambers Heerspink, PhD PHARMD Department of Clinical Pharmacy and Pharmacology University Medical Center Groningen Groningen

MedicalResearch.com: What is the background for this study? What is dapagliflozin primarily indicated for?   Response: Dapagliflozin is a sodium glucose cotransporter 2 (SGLT2) inhibitor. The multinational, double-blinded, randomized, placebo-controlled, DAPA-CKD trial demonstrated the kidney and cardiovascular benefits of dapagliflozin in 4304 patients with chronic kidney disease (CKD) with and without type 2 diabetes (T2D). Based on the results of this and other trials, current guidelines recommend use of SGLT2 inhibitors in patients with CKD, T2D, or heart failure. Anemia is common among patients with CKD and is associated with worse clinical outcomes. Previous studies showed that SGLT2 inhibitors increase hemoglobin and hematocrit levels, but data are lacking in patients with CKD with and without T2D. In this post-hoc analysis of DAPA-CKD, we assessed the effect of dapagliflozin versus placebo on the correction and prevention of anemia in this population.
Author Interviews, Heart Disease, JACC, Kidney Disease, Transplantation / 21.02.2023

MedicalResearch.com Interview with: [caption id="attachment_60034" align="alignleft" width="130"]Shinobu Itagaki, MD, MScAssistant Professor Cardiovascular Surgery Icahn School of Medicine at Mount Sinai, New York, NY Dr. Itagaki[/caption] Shinobu Itagaki, MD, MSc Assistant Professor Cardiovascular Surgery Icahn School of Medicine at Mount Sinai, New York, NY MedicalResearch.com: What is the background for this study? Were the transplants from a single donor? Response: The heart transplantation is the gold standard therapy for end-stage heart failure patients. As the kidney is affected by the heart function, it is common that the heart transplant candidates have some degree of kidney dysfunction as well. In these cases, the candidates are considered for simultaneous heart and kidney transplantation from a same donor. Unlike isolated heart transplantation, where the indication and benefits have been well established, simultaneous heart and kidney transplantation has less clear indication and benefits. This uncertainty is also complicated by the competing interest with isolated kidney transplantation candidates who in general wait longer on the waiting list.
Author Interviews, Coffee, Genetic Research, JAMA, Kidney Disease / 15.02.2023

MedicalResearch.com Interview with: [caption id="attachment_60028" align="alignleft" width="133"]Dr. Sara Mahdavi Dr. Mahdavi[/caption] Dr. Sara Mahdavi, PhD Clinical Scientist and Clinical Instructor Research Appointment in the Faculty of Medicine University of Toronto Toronto, ON MedicalResearch.com: What is the background for this study? Response: This was a long-term study spanning 16 years and began with a population of young adults who were medically assessed on a regular basis. It was remarkable to see just how striking the effects of coffee were in the group that had the susceptible genetic variant, what we termed “slow caffeine metabolizers” yet no effect whatsoever in those who did not were termed “fast metabolizers”.
Author Interviews, Biomarkers, Gender Differences, Kidney Disease, NEJM, Race/Ethnic Diversity / 26.01.2023

MedicalResearch.com Interview with: [caption id="attachment_59955" align="alignleft" width="150"]Prof. dr. Hans Pottel Prof. dr. Pottel[/caption] Prof. dr. Hans Pottel KU Leuven Kulak Department of Public Health and Primary Care Belgium MedicalResearch.com: What is the background for this study? Response:  The glomerular filtration rate (GFR) is used to diagnose patients with chronic kidney disease and is also used to adjust the dose of drugs that are eliminated by the kidneys. An accurate estimation of GFR is considered of importance in the management of kidney health in patients. In 2021 we published a new serum creatinine based equation, called the European Kidney Function Consortium (EKFC) equation (Pottel H. et al, Development and Validation of a Modified Full Age Spectrum Creatinine-Based Equation to Estimate Glomerular Filtration Rate : A Cross-sectional Analysis of Pooled Data. Ann Intern Med (2021) 174: 183-191): EKFC-eGFR = 107.3 / [Biomarker/Q]a x [0.990(Age – 40) if age > 40 years] With a = 0.322 if Biomarker/Q is less than 1, and a = 1.132 if Biomarker/Q is 1 or more. The equation can easily be interpreted: the leading coefficient equals the glomerular filtration rate (GFR) of 107.3 mL/min/1.73m², which is the average GFR in healthy children (aged > 2 years), adolescents and young adults. The average healthy GFR remains constant until the age of 40 years, and starts decreasing beyond that age. The GFR is inversely related to the ‘rescaled’ biomarker. The rescaling factor (Q) is the average biomarker value for healthy people of a specific population (e.g. children, adult men, adult women, white people, black people, …). Biomarker/Q equals ‘1’ for the average healthy person, corresponding with eGFR = 107.3 mL/min/1.73m² (up to 40 years of age). It should be noted that for serum creatinine, the Q-value depends on sex and race. Our hypothesis was that the above equation is valid for any renal biomarker, on the condition that the biomarker is appropriately scaled. We showed that the same equation was able to estimate GFR from 2 years to oldest ages. In the current study we tested and validated our hypothesis by applying the above formula for appropriately ‘rescaled’ cystatin C.
Author Interviews, Clots - Coagulation, Heart Disease, Karolinski Institute, Kidney Disease / 06.10.2022

MedicalResearch.com Interview with: [caption id="attachment_59616" align="alignleft" width="150"]Juan Jesus Carrero Pharm PhD Professor of Epidemiology Cardio-renal Department of Medical Epidemiology and Biostatistics Karolinska Institutet, Stockholm Dr. Carrero[/caption] Juan Jesus Carrero Pharm PhD Professor of Epidemiology Cardio-renal Department of Medical Epidemiology and Biostatistics Karolinska Institutet, Stockholm MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Concerns on the possibility of (direct oral anticoagulants)  DOAC-related nephropathy may limit its use. In this cohort study of non-valvular AF patients from routine clinical practice, initiation of DOAC vs (vitamin K antagonists) VKA was associated with more favorable kidney outcomes, i.e., a lower risk of the composite of kidney failure and sustained 30% eGFR decline, as well as a lower risk of AKI occurrence. In agreement with trial evidence, we also showed that DOAC vs VKA treatment was associated with a lower risk of major bleeding, but a similar risk of the composite of stroke, systemic embolism or death.
Author Interviews, Diabetes, Kidney Disease / 08.06.2022

MedicalResearch.com Interview with: [caption id="attachment_59231" align="alignleft" width="150"]prof. dr. H.J. (Hiddo) Lambers Heerspink Clinical Pharmacologist Department Clinical Pharmacy and Pharmacology University Medical Center Groningen Groningen Prof. Heerspink[/caption] prof. dr. H.J. (Hiddo) Lambers Heerspink Clinical Pharmacologist Department Clinical Pharmacy and Pharmacology University Medical Center Groningen Groningen  MedicalResearch.com:  What is the background for this study?    Response: Tirzepatide is a novel GIP-GLP1 receptor agonist recently FDA approved for the treatment of type 2 diabetes. The SURPASS_4 trial demonstrated that in patients with type 2 diabetes at high cardiovascular risk tirzepatide compared to insulin glargine markedly reduces Hba1c and body weight. About 1 out of 3 patients with type 2 diabetes and CV disease has kidney disease and these patients are at high risk of kidney failure. The aim of this study was to assess whether tirzepatide could slow CKD progression in high risk individuals with type 2 diabetes participating in the SURPASS 4 trial. 
Author Interviews, Gout, JAMA, Kidney Disease / 06.06.2022

MedicalResearch.com Interview with: [caption id="attachment_16840" align="alignleft" width="124"]Csaba P Kovesdy MD Fred Hatch Professor of Medicine Director, Clinical Outcomes and Clinical Trials Program Division of Nephrology, University of Tennessee Health Science Center Nephrology Section Chief, Memphis VA Medical Center Memphis TN, 38163 Dr. .Kovesdy[/caption] Csaba P Kovesdy MD FASN Fred Hatch Professor of Medicine Director, Clinical Outcomes and Clinical Trials Program Division of Nephrology, University of Tennessee Health Science Center Nephrology Section Chief, Memphis VA Medical Center Memphis TN, 38163 MedicalResearch.com:  What is the background for this study?  What are the main findings?  Response: Hyperuricemia has unfavorable metabolic effects and has been associated with higher risk of progressive kidney disease and mortality. Despite this, earlier clinical trials have failed to prove a beneficial impact on kidney disease progression from uric acid lowering therapy in patients with preexisting CKD. The effect of uric acid lowering therapy on the development of new onset CKD in patients with normal kidney function has not been well studied. In our large observational study we did not find a beneficial association between newly initiated uric acid lowering therapy (the majority of which was in the form of allopurinol). On the contrary, uric acid lowering therapy was associated with a slightly higher risk of new onset low eGFR and new onset albuminuria, especially in patients with less elevated baseline serum acid levels.
Author Interviews, Critical Care - Intensive Care - ICUs, JAMA, Kidney Disease / 15.03.2022

MedicalResearch.com Interview with: [caption id="attachment_58881" align="alignleft" width="150"]Susan P. Y. Wong, MD MS Assistant Professor Division of Nephrology University of Washington VA Puget Sound Health Care System Dr. Wong[/caption] Susan P. Y. Wong, MD MS Assistant Professor Division of Nephrology University of Washington VA Puget Sound Health Care System  MedicalResearch.com:  What is the background for this study?  What are the main findings? Response: Very little is known about the care and outcomes of patients who reach the end stages of kidney disease and do not pursue dialysis. We conducted a systematic review of longitudinal studies on patients with advanced kidney disease who forgo dialysis to determine their long-term outcomes. We found that many patients survived several years and experienced sustained quality of life until late in the illness course. However, use of acute care services was common and there was a high degree of variability in access to supportive care services near the end of life.
Author Interviews, Kidney Disease, Rheumatology / 24.01.2022

[caption id="attachment_58695" align="alignleft" width="150"]Stephen Connelly, PhD, Chief Scientific Officer, Equillium Dr. Connelly[/caption] Stephen Connelly, PhD Co-founder & Chief Scientific Officer Equillium, Inc. San Diego, California MedicalResearch.com:  What is the background for this study?    Response: Systemic lupus erythematosus (SLE) is a chronic autoimmune inflammatory disease that predominantly affects women in the reproductive age range. Approximately 50% of SLE patients experience lupus nephritis (LN), a serious complication that is accompanied by significant morbidity and mortality. Progression of LN to chronic kidney disease is common, with 10% of patients with LN developing end-stage kidney disease. T cells, play a central role in the pathogenesis of both SLE and LN by mediating tissue damage and enhancing the production of autoantibodies by promoting B cell differentiation, proliferation, and maturation. These T cells express CD6, a costimulatory receptor that through its binding to activated leukocyte cell adhesion molecule (ALCAM), expressed on immune cells and tissues, modulates both the activity and trafficking of effector T cells (Teff). The expression of both CD6 and ALCAM (CD6-ALCAM pathway) have been associated with pathogenic effector T cell activity and trafficking in multiple autoimmune and inflammatory diseases. Based on a comprehensive screen of more than 1100 urine proteins, soluble urinary ALCAM (uALCAM) was identified as one of only a few molecules that were elevated in the urine of patients with SLE with active renal involvement compared with patients with quiescent or no prior nephritis. However, no studies had been conducted to characterize the cellular sources of the soluble ALCAM and questions remained about the relevance of this protein and whether it was associated with the pathology of the disease.
Author Interviews, Kidney Disease, Race/Ethnic Diversity / 13.01.2022

MedicalResearch.com Interview with: [caption id="attachment_58647" align="alignleft" width="200"]Joshua D. Bundy, PhD, MPH Department of Epidemiology Tulane University School of Public Health and Tropical Medicine and Tulane University Translational Science Institute New Orleans Louisiana Dr. Bundy[/caption] Joshua D. Bundy, PhD, MPH Department of Epidemiology Tulane University School of Public Health and Tropical Medicine and Tulane University Translational Science Institute New Orleans Louisiana MedicalResearch.com: What is the background for this study? What is included in the KFRE score? Response: Kidney function is quantified using estimated glomerular filtration rate (eGFR), which is often calculated in clinical practice using filtration markers like serum creatinine and/or cystatin C, and patient characteristics like age, sex, and race. Recently, new eGFR equations were created that remove race adjustment because of concerns that using a patient’s race may perpetuate racial inequities in healthcare delivery. The Kidney Failure Risk Equation (KFRE) is the most commonly-used tool to predict end-stage kidney disease (ESKD) risk and includes age, sex, eGFR, and urinary albumin-creatinine ratio. We sought to evaluate the impact of removing race from eGFR on prediction of ESKD. 
Annals Internal Medicine, Author Interviews, COVID -19 Coronavirus, Kidney Disease, Vaccine Studies / 16.12.2021

MedicalResearch.com Interview with: Shuchi Anand, MD MS (she/her) Assistant Professor in Medicine Director, Center for Tubulointerstitial Kidney Disease Stanford University School of Medicine  MedicalResearch.com: What is the background for this study? What are the main findings? Response: A majority of  people on dialysis who completed vaccination as of September 2021 have had a decline in antibody response to levels that would render them vulnerable to infection. Antibody response immediately after vaccination and circulating antibody response is strongly associated with risk for breakthrough after the initial vaccination series.
Author Interviews, Cost of Health Care, JAMA, Kidney Disease, Social Issues, Transplantation / 14.12.2021

MedicalResearch.com Interview with: [caption id="attachment_58511" align="alignleft" width="150"]Rebecca Thorsness, PhD Research Associate Department of Health Services, Policy, and Practice Brown University School of Public Health Dr. Thorsness[/caption] Rebecca Thorsness, PhD Research Associate Department of Health Services, Policy, and Practice Brown University School of Public Health  MedicalResearch.com: What is the background for this study? What are the main findings? Response: In 2019, the President signed the Advancing American Kidney Health executive order, which included provisions to increase the use of home dialysis and kidney transplant for Americans living with kidney failure. To carry out this vision, the Centers for Medicare & Medicaid Services (CMS) developed the ESRD Treatment Choices (ETC) payment model, which uses financial incentives and penalties to incentivize dialysis facilities to pursue home dialysis or kidney transplant for their patients. Transplant and home dialysis are optimal care for people with kidney failure, but there are social and clinical reasons that patients with high social risk (such as those exposed to racism, poverty, or housing instability) may not be candidates for these treatments. This means that facilities which serve a large number of patients with high social risk might be disproportionately penalized by this new payment model. Using data immediately prior to the implementation of the ETC model, we found that dialysis facilities that serve high proportions of patients with high social risk have lower rates of home dialysis and kidney transplantation than facilities that care for lower proportions of such patients.