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Sodium zirconium cyclosilicate for MRAs optimization in HFrEF: lessons learned from the REALIZE-K trial.
Heart Fail Rev
January 2025
Centre d'Investigations Cliniques Plurithématique 1433 and INSERM U1116, CHRU Nancy, FCRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists), Institut Lorrain du Coeur Et Des Vaisseaux, CHRU de Nancy, Université de Lorraine, Nancy, France.
Mineralocorticoid receptor antagonists (MRAs) are a cornerstone of guideline-directed medical therapy for heart failure with reduced ejection fraction (HFrEF), offering significant benefits in reducing mortality and hospitalizations. However, their use is often constrained by the risk of hyperkalemia, particularly in patients with chronic kidney disease. Patiromer and sodium zirconium cyclosilicate (SZC), two novel potassium binders, have emerged as highly effective and safe tools for managing hyperkalemia and enabling the optimization of MRA therapy.
View Article and Find Full Text PDFPublic and patient involvement (PPI) in the design, execution and dissemination of a trial: the BISTRO trial.
Health Technol Assess
January 2025
School of Medicine, Keele University, Keele, Staffordshire, UK.
Background: For people receiving haemodialysis, a balance has to be struck between removing sufficient but not too much fluid during a treatment session and maintaining any remaining kidney function they might have. In the BISTRO trial, this study sought to establish if getting the balance right might be improved by the additional use of bioimpedance, a device that measures body fluid composition to help decide how much fluid to remove during dialysis. Designing and executing this trial, which incorporated complex and repeated trial procedures that would be dependent on participant engagement, presented challenges that demanded effective public and patient involvement.
View Article and Find Full Text PDFTransforming Transplantation Access: A Federal Directive for Comprehensive Pre-Waitlisting Data Collection.
Am J Transplant
January 2025
Division of Nephrology, Department of Medicine, Vagelos College of Physicians & Surgeons, Columbia University, New York, NY; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY.
There is substantial variation in access to transplantation across the United States that is not entirely explained by the availability of donor organs. Barriers to transplantation and variation in care among patients with end-stage organ disease exist prior to patients' placement on a transplant waiting list as well as following waitlist placement. However, there are currently no national data available to examine rates and variations in key care processes related to pre-listing, including transplant referral, evaluation, or candidate selection.
View Article and Find Full Text PDFThe secreted protease ADAMTS18 links early isoform transformation and maturation of glomerular basement membrane macromolecules to the integrity of the glomerular filtration barrier.
Biochem Biophys Res Commun
January 2025
Department of Biochemistry and Molecular Cell Biology, Shanghai Jiao Tong University School of Medicine, Shanghai, China. Electronic address:
The glomerular filtration barrier (GFB) has a unique spatial structure, including porous capillary endothelial cells, glomerular basal membrane (GBM) and highly specialized podocytes. This special structure is essential for the hemofiltration process of nephrons. GBM is the central meshwork structure of GFB formed by the assembly and fusion of various extracellular matrix (ECM) macromolecules, such as laminins and collagens, which undergo isoform transformation and maturation that may require precise regulation by metalloproteinases.
View Article and Find Full Text PDFTaming the transplant troll: Exploring racial and ethnic disparities in cytomegalovirus infection among kidney transplant patients.
PLoS One
January 2025
Division of Transplant Nephrology, Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM, United States of America.
Background: Cytomegalovirus (CMV) infection poses a significant risk to kidney transplant recipients. This study investigated CMV disease incidence, outcomes, and management challenges in racial and ethnic minority populations following kidney transplantation.
Methods: This single-center, mixed-methods study included a retrospective cohort analysis of kidney transplant recipients (n = 58) and qualitative surveys of healthcare providers.
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