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MRAs in diabetic kidney disease

{SCOpenGraph description=Trial results webinar, interviews with the investigators, and ask the experts} {SCOpenGraph twitter:image=http://ukidney.com/images/ukidney-og-image.jpeg} {SCOpenGraph image=http://ukidney.com/images/fidekio-eblast.png} {SCOpenGraph title=UKidney's FIDELIO-DKD trial resource} p.uk-margin-top.uk-margin-remove-bottom.uk-article-meta { display: none; } #jf_mm_menu ul {list-style: none} div#sppb-addon-wrapper-1608306128087 { display: none; } div#column-id-1583133364027 .sppb-column-addons {background-color:#fff} div#mobileMenu { display: none } @media (max-width:824px){ div#fidelio-video-hint { line-height: 1.5 !important; } } @media (min-width:1154px) { div#mobileMenu { display: none } } @media (max-width:1153px){ nav.g-main-nav {display:none} } .modal-video { background-color: rgb(0 0 0 / 80%); } .sppb-btn-primary { color: #fff; background-color: #cc0000; border-color: #cc0000; } .sppb-btn-primary:hover, .sppb-btn-primary:focus { color: #fff; background-color: #9c0000; border-color: #9c0000; } h1 { display: none } .mfp-iframe-holder .mfp-content { max-width: 1000px } div#interview-table div { text-align: center; padding: 20px; width: 33%; } div#interview-table button { background-color: #9a9a9a; border-color: #9c9c9c; padding: 5px 26px; margin-top: 10px; } dl.article-info.muted, dd.createdby { display: none !important; } .sppb-tab-content.sppb-tab-modern-content { padding: 20px; } ul.sppb-nav.sppb-nav-modern { border-bottom: 1px solid #e8eff1; } .sp-page-builder .page-content #section-id-1608380707660 { padding: 30px 16px 50px 16px; background: #f5f5f5; margin-top: 20px; } #column-id-1608380707659 { box-shadow: 0 0 0 0 #fff; background: #fff; padding: 20px; } .sppb-addon.sppb-addon-video iframe { box-shadow: 0 0 10px #afafaf inset; padding: 17px; } .fa-rocketchat:before { content: "\f3e8"; FONT-FAMILY: INHERIT !IMPORTANT; } #section-id-1608307963398 .sppb-row-container { width: 100% } .sppb-nav-modern>li>a { background: #fff; color: #000 } .sppb-tab-icon i { color: #cc0000 } .sppb-nav-modern>li>a { font-size: 24px; } .sppb-person-image { padding: 14px; } .sppb-person-image img { border-radius: 50%; box-shadow: 0 0 10px #555; padding: 10px; } .fidelio-faq { padding: 10px; border: 1px solid #fff; border-radius: 4px } .fidelio-faq:hover { background: #fff9f9; border: 1px solid #b3b3b3; } #column-id-1583139735906 { padding: 30px 0 0 0 !important } #section-id-1583133364028 .sppb-container-inner { overflow: hidden } #qa-form-link, #qa-link:hover { cursor: pointer } .sppb-nav-modern>li.active>a, .sppb-nav-modern>li.active>a:focus, .sppb-nav-modern>li.active>a:hover { color: #000 !important; } @media (max-width:700px) { div#interview-table div { width: 100%; } .interview-cell { width: 100% !important; display: block !important; } } @media (max-width:1500px) { .sppb-nav-modern>li>a { font-size: 12px; } } @media (max-width:991px) { .sppb-nav-modern>li>a { font-size: 12px; } } @media (max-width:962px) { .sppb-nav-modern { padding-left: 0 !important; } .sppb-nav-modern>li { width: 100%; } .sppb-nav-modern li.active a { border-left: 7px solid #cc0000; border-radius: 0 !important; background: #f9f9f9 !important; } .sppb-nav-modern li a { border-radius: 0; background: #fff; border: 0; } } @media (max-width:1153px) { div#mobileMenu { display: block; } } @media (max-width:767px){ #column-id-1583139735906 { padding: 0px 0 0 0 !important; } } @media (max-width:812px){ #column-id-1608380707659 { padding: 20px 0; } } .sppb-nav-modern>li>a { font-size: 18px; } Webinar Effect of MRAs on Chronic Kidney Disease Outcomes in Type 2 Diabetes Panelists Webinar Interviews Ask the Expert Questions & Answers Article Meet our Panelists David Cherney, MD CM PhD FRCPC Professor of Medicine, University of Toronto Clinician Scientist, Division of Nephrology, University Health Network Senior Scientist, Toronto General Hospital Research Institute Director, Renal Physiology Laboratory, University Health Network Toronto, ON Adeera Levin, MD FRCPC FCAHS CM Professor of Medicine, University of British Columbia Head Division of Nephrology Executive Director BC Renal Consulting Nephrologist St Paul’s Hospital Vancouver, BC George L. Bakris, MD F.A.S.N. F.A.H.A. Professor of Medicine Director, Am. Heart Assoc Comprehensive Hypertension Center Chicago, IL Rajiv Agarwal, MD MS FASN Professor of Medicine, Indiana University School of Medicine Indianapolis, IN Ask the Experts Please use the form below to ask a question to our panelists. You will receieve a response by email and all responses will be compiled and available here . First Name Last Name Email * Please fill the required field. What is your question? * Please fill the required field. PHA+PHN0cm9uZz5Gcm9tOjwvc3Ryb25nPnt7Zmlyc3QtbmFtZX19IHt7bGFzdC1uYW1lfX08L3A+CjxwPjxzdHJvbmc+RW1haWw6PC9zdHJvbmc+e3tlbWFpbH19PC9wPgo8cD48c3Ryb25nPlF1ZXN0aW9uOjwvc3Ryb25nPnt7bWVzc2FnZX19PC9wPg== 3 + 4 = ? Submit Question Article Journal link | Visual Abstract 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. METHODS In this double-blind trial, we randomly assigned 5734 patients with CKD and type 2 diabetes in a 1:1 ratio to receive finerenone or placebo. Eligible patients had a urinary albumin-to-creatinine ratio (with albumin measured in milligrams and creatinine measured in grams) of 30 to less than 300, an estimated glomerular filtration rate (eGFR) of 25 to less than 60 ml per minute per 1.73 m2 of body-surface area, and diabetic retinopathy, or they had a urinary albumin-to-creatinine ratio of 300 to 5000 and an eGFR of 25 to less than 75 ml per minute per 1.73 m2. All the patients were treated with renin–angiotensin system blockade that had been adjusted before randomization to the maximum dose on the manufacturer’s label that did not cause unacceptable side effects. The primary composite outcome, assessed in a time-to-event analysis, was kidney failure, a sustained decrease of at least 40% in the eGFR from baseline, or death from renal causes. The key secondary composite outcome, also assessed in a time-to-event analysis, was death from cardiovascular causes, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure. RESULTS During a median follow-up of 2.6 years, a primary outcome event occurred in 504 of 2833 patients (17.8%) in the finerenone group and 600 of 2841 patients (21.1%) in the placebo group (hazard ratio, 0.82; 95% confidence interval [CI], 0.73 to 0.93; P=0.001). A key secondary outcome event occurred in 367 patients (13.0%) and 420 patients (14.8%) in the respective groups (hazard ratio, 0.86; 95% CI, 0.75 to 0.99; P=0.03). Overall, the frequency of adverse events was similar in the two groups. The incidence of hyperkalemia-related discontinuation of the trial regimen was higher with finerenone than with placebo (2.3% and 0.9%, respectively). CONCLUSIONS In patients with CKD and type 2 diabetes, treatment with finerenone resulted in lower risks of CKD progression and cardiovascular events than placebo. (Funded by Bayer; FIDELIO-DKD ClinicalTrials.gov number, NCT02540993)
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