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.
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, 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, 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. 
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, 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, 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, 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. 
Author Interviews, JAMA, Kidney Disease, Race/Ethnic Diversity, UCSF / 17.07.2021

MedicalResearch.com Interview with: [caption id="attachment_57785" align="alignleft" width="150"]Chi-yuan Hsu, MD, MSc (he/him/his) Professor and Division Chief Division of Nephrology  University of California, San Francisco San Francisco, CA 94143-0532 Dr. Chi-yuan Hsu[/caption] Chi-yuan Hsu, MD, MSc (he/him/his) Professor and Division Chief Division of Nephrology University of California, San Francisco San Francisco, CA 94143-0532 MedicalResearch.com: What is the background for this study? Response: There has been a great deal of controversy recently about how race should be considered in medicine, including its use in estimating kidney function (e.g. https://jamanetwork.com/journals/jama/fullarticle/2769035).  A recent paper published in JAMA Network Open by Zelnick et al suggested that removing the race coefficient improves the accuracy of estimating kidney function (https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2775076) in the Chronic Renal Insufficiency Cohort, a NIH-funded study (www.cristudy.org). We are core investigators of the Chronic Renal Insufficiency Cohort Study and were not involved in the Zelnick’s study that was based on a public use dataset.  Because we were surprised by the methodological approach they took and the conclusion they came to, we implemented our own analysis of the data.