7 most impactful clinical trials focussed on slowing progression of chronic kidney disease

A Thread 🧵

A highly subjective list, but these trials have been included as they have had a meaningful impact on guidelines, patients and clinicians at a global scale. 1) IDNT: Irbesartan Diabetic Nephropathy Trial

Randomized, blinded, placebo-controlled trial designed to assess whether irbesartan or amlodipine slow the progression of nephropathy in patients with type 2 diabetes, independent of effects on systemic blood pressure (BP) lowering

7 Practical Tips for Starting an SGLT2 Inhibitor

A Thread 🧵

SGLT2i inhibitors (eg empagliflozin, dapagliflozin, canagliflozin) have a phenomenal evidence base and have been shown to be beneficial in diabetes, heart disease (particularly heart failure) and kidney disease. 1/x Achieving a good start is important. A bad early experience could turn you off a really beneficial class of medication.

Should patients w/ diabetes, CKD and proteinuria despite RAASi & SGLT2i be considered for add-on therapy with finerenone (triple therapy)?

A thread 🧵 & survey (see end)

Sources
@NEJM @NephJC @goKDIGO @ESC_Journals @CADTH_ACMTS As a Canadian nephrologist, relevant & active national debate in light of @CADTH_ACMTS draft guidelines which suggest finerenone not be funded if on an SGLT2i

cadth.ca/sites/default/…

7 ways the EMPA-KIDNEY trial will impact clinical care in CKD

A Thread 🧵

Sources @NEJM @NephJC @DiabetesCanada @AmDiabetesAssn @goKDIGO @ESC_Journals @hswapnil @kidney_boy EMPA-KIDNEY was a clinical trial testing whether taking a single pill of empagliflozin every day prevents worsening of kidney disease or deaths from heart disease in people who have chronic kidney disease (CKD).