Drs Sparks and Neuen discuss the proper use of SGLT2 inhibitors to prevent chronic kidney disease, including how to start them and monitor them and their possible side effects.

Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/971884). The topics and discussions are planned, produced, and reviewed independently of advertiser. This podcast is intended only for US healthcare professionals.

Resources

SGLT2 Inhibitors in Primary Care: 'All Hands on Deck' for Improving Heart Failure Outcomes https://www.medscape.com/viewarticle/965473

Canagliflozin and Cardiovascular and Renal Events in Type 2 Diabetes https://www.nejm.org/doi/full/10.1056/nejmoa1611925

Canagliflozin and Renal Outcomes in Type 2 Diabetes and Nephropathy https://www.nejm.org/doi/full/10.1056/nejmoa1811744

CKD Epidemiology Collaboration CKD-EPI Consortium https://www.tuftsmedicalcenter.org/research-clinical-trials/institutes-centers-labs/chronic-kidney-disease-epidemiology-collaboration/overview

Effect of Finerenone on Chronic Kidney Disease Outcomes in Type 2 Diabetes https://www.nejm.org/doi/full/10.1056/NEJMoa2025845

Net Effects of Sodium-Glucose Co-Transporter-2 Inhibition in Different Patient Groups: A Meta-Analysis of Large Placebo-Controlled Randomized Trials https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(21)00443-0/fulltext

EMPA-KIDNEY (The Study of Heart and Kidney Protection With Empagliflozin) https://www.empakidney.org/

FDA Removes Boxed Warning About Risk of Leg and Foot Amputations for the Diabetes Medicine Canagliflozin (Invokana, Invokamet, Invokamet XR) https://www.fda.gov/drugs/fda-drug-safety-podcasts/fda-removes-boxed-warning-about-risk-leg-and-foot-amputations-diabetes-medicine-canagliflozin

What do primary care providers need to know to improve care for people with chronic kidney disease? Drs Matthew Sparks and Ian de Boer provide key clinical takeaways that can't be ignored.

Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/971885). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.

Resources

KDIGO 2020 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease https://www.kidney-international.org/article/S0085-2538(20)30718-3/fulltext

KDIGO 2022 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease https://kdigo.org/wp-content/uploads/2022/03/KDIGO-2022-Diabetes-Management-GL_Public-Review-draft_1Mar2022.pdf

Effects of SGLT2 Inhibitors on EGFR in Type 2 Diabetic Patients—The Role of Antidiabetic and Antihypertensive Medications https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8099726/

Drs Sparks and Kumar go behind the scenes and discuss the preparation, surgery, and outcome of the pig-to-human kidney xenotransplantation at The University of Alabama.

Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/971886). The topics and discussions are planned, produced, and reviewed independently of advertiser. This podcast is intended only for US healthcare professionals.

Resources

The Advancing American Kidney Health Initiative https://www.kidney.org/advocacy/advancing-american-kidney-health-initiative

Nearly 106,000 U.S. Residents Are Waiting for a Lifesaving Transplant https://www.washingtonpost.com/health/2022/05/24/organ-transplant-waiting-list-numbers/

UNOS Patients on the Waiting List vs. Transplants Performed by Organ (2021) https://www.organdonor.gov/learn/organ-donation-statistics/detailed-description#fig1

First Clinical-Grade Porcine Kidney Xenotransplant Using a Human Decedent Model https://onlinelibrary.wiley.com/doi/abs/10.1111/ajt.16930

Mathieu Jaboulay's (1860–1913) Contribution to Xenotransplantation https://onlinelibrary.wiley.com/doi/10.1111/xen.12765

Alexis Carrel - Biographical https://www.nobelprize.org/prizes/medicine/1912/carrel/biographical/

5 Things to Know About CRISPR https://www.medscape.com/viewarticle/899354

Organ Donation and Transplantation Alliance https://www.organdonationalliance.org/

When Pigs Fly https://onlinelibrary.wiley.com/doi/10.1111/ajt.16963

C4d Staining in Renal Allograft Biopsies With Early Acute Rejection and Subsequent Clinical Outcome https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3087790/

Results of Two Cases of Pig-to-Human Kidney Xenotransplantation https://www.nejm.org/doi/10.1056/NEJMoa2120238

University of Maryland School of Medicine Faculty Scientists and Clinicians Perform Historic First Successful Transplant of Porcine Heart Into Adult Human With End-stage Heart Disease https://www.medschool.umaryland.edu/news/2022/University-of-Maryland-School-of-Medicine-Faculty-Scientists-and-Clinicians-Perform-Historic-First-Successful-Transplant-of-Porcine-Heart-into-Adult-Human-with-End-Stage-Heart-Disease.html

Thomas E. Starzl Transplantation Institute http://www.stiresearch.health.pitt.edu/about

Join experts Drs Matthew Sparks and Dinushika Mohottige as they discuss disparities in care for individuals who have chronic kidney disease in the United States.

Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/971887). The topics and discussions are planned, produced, and reviewed independently of advertiser. This podcast is intended only for US healthcare professionals.

Resources

Chronic Kidney Disease (CKD) https://emedicine.medscape.com/article/238798-overview

2020 Census Illuminates Racial and Ethnic Composition of the Country https://www.census.gov/library/stories/2021/08/improved-race-ethnicity-measures-reveal-united-states-population-much-more-multiracial.html

Race, Ethnicity, & Kidney Disease https://www.niddk.nih.gov/health-information/kidney-disease/race-ethnicity

Prevalence of Chronic Kidney Disease in the United States https://jamanetwork.com/journals/jama/fullarticle/209357

Racial/ethnic and Socioeconomic Disparities in the Use of Newer Diabetes Medications in the Look AHEAD Study https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8920048/

Life Course Socioeconomic Status, Allostatic Load, and Kidney Health in Black Americans https://cjasn.asnjournals.org/content/15/3/341.long

Understanding African American and Non-African American eGFR Laboratory Results https://www.kidney.org/atoz/content/race-and-egfr-what-controversy

National Kidney Foundation https://www.kidney.org/

American Society of Nephrology https://www.asn-online.org/

A Unifying Approach for GFR Estimation: Recommendations of the NKF-ASN Task Force on Reassessing the Inclusion of Race in Diagnosing Kidney Disease https://www.ajkd.org/article/S0272-63862100828-3/fulltext

How do you talk to patients about kidney health, lifestyle risks, or a plan for transplantation? In this episode, Drs Sparks, Diamantidis, and Farouk discuss the science, current studies, and their clinical experience.

Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/971888). The topics and discussions are planned, produced, and reviewed independently of advertiser. This podcast is intended only for US healthcare professionals.

Resources

Kidney Transplantation https://emedicine.medscape.com/article/430128-overview

Kidney Transplantation https://www.medscape.com/viewarticle/443490_5

The Advancing American Kidney Health Initiative https://www.kidney.org/advocacy/advancing-american-kidney-health-initiative

System Interventions to Achieve Early and Equitable Transplants (STEPS) Study https://clinicaltrials.gov/ct2/show/NCT05014256?titles=system+interventions+to+achieve+early+and+equitable+transplants&draw=2&rank=1

Evaluation for Kidney Transplant https://www.kidney.org/atoz/content/kidney-transplant-evaluation

What Do Acute Kidney Injury Survivors Want to Know About Their Condition: A Qualitative Study https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9044096/

Drs Sparks and Bansal discuss the screening and treatment for CKD as a primary care physician, including testing, cardiovascular risk, new treatments, and when to refer a patient to a nephrologist.

Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/971889). The topics and discussions are planned, produced, and reviewed independently of advertiser. This podcast is intended only for US healthcare professionals.

Resources

Estimated GFR Can Widely Diverge From Measured GFR https://www.medscape.com/viewarticle/976533

Kidney Failure Risk Equation Works Without Race Adjustment https://www.medscape.com/viewarticle/966313

The Kidney Failure Risk Equation https://kidneyfailurerisk.com/

Don't Routinely Stop RAS Inhibitors in Advanced Kidney Disease https://www.medscape.com/viewarticle/943717

What Is the Role of Mineralocorticoid Receptor Antagonists (MRAs) in the Treatment of Proteinuria? https://www.medscape.com/answers/238158-93529/what-is-the-role-of-mineralocorticoid-receptor-antagonists-mras-in-the-treatment-of-proteinuria

What Is the Role of SGLT2 Inhibitors in the Treatment of Chronic Kidney Disease (CKD)? https://www.medscape.com/answers/238798-105205/what-is-the-role-of-sglt2-inhibitors-in-the-treatment-of-chronic-kidney-disease-ckd

Sodium-Glucose Cotransporter 2 Inhibitors: Safety Concerns https://www.medscape.com/viewarticle/892957_6

finerenone (Rx) https://reference.medscape.com/drug/kerendia-finerenone-4000168

Cardiovascular Disease in Chronic Kidney Disease https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.120.050686

Join experts Drs Matthew Sparks and James Matthew Luther as they discuss how and why they're using mineralocorticoid receptor antagonists to treat patients with diabetic kidney disease in their practice.

Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/991189). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.

Resources

Chronic Kidney Disease (CKD) https://emedicine.medscape.com/article/238798-overview

Physiology, Aldosterone https://www.ncbi.nlm.nih.gov/books/NBK470339/

Angiotensin II https://www.ncbi.nlm.nih.gov/books/NBK499912/

Primary Aldosteronism https://emedicine.medscape.com/article/127080-overview

Epithelial Sodium Channel (ENaC) and the Control of Blood Pressure https://pubmed.ncbi.nlm.nih.gov/24721652/

Hypertension Treatment & Management https://emedicine.medscape.com/article/241381-treatment

Hypertension Medication https://emedicine.medscape.com/article/241381-medication#2

Mineralocorticoid Receptor Antagonists in Diabetic Kidney Disease - Mechanistic and Therapeutic Effects https://pubmed.ncbi.nlm.nih.gov/34675379/

Malignant Hypertension https://emedicine.medscape.com/article/241640-overview

Androgenetic Alopecia https://emedicine.medscape.com/article/1070167-overview

Effect of Finerenone on Chronic Kidney Disease Outcomes in Type 2 Diabetes https://pubmed.ncbi.nlm.nih.gov/33264825/

Cardiovascular Events With Finerenone in Kidney Disease and Type 2 Diabetes https://pubmed.ncbi.nlm.nih.gov/34449181/

Regression to the Mean https://www.britannica.com/topic/regression-to-the-mean

Sodium-glucose Transport Protein 2 (SGLT2) Inhibitors https://www.ncbi.nlm.nih.gov/books/NBK576405/

Potassium Binders for Chronic Hyperkalaemia in People With Chronic Kidney Disease https://pubmed.ncbi.nlm.nih.gov/32588430/

Join experts Drs Matt Sparks and Dawn Caster as they discuss the complexities around the management of lupus nephritis. What tools do we have now? What is on the horizon? Tune in to find out.

Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/991602). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.

Resources

Novel Aspects in the Pathophysiology and Diagnosis of Glomerular Diseases https://pubmed.ncbi.nlm.nih.gov/36535746/

Derivation and Validation of the Systemic Lupus International Collaborating Clinics Classification Criteria for Systemic Lupus Erythematosus https://pubmed.ncbi.nlm.nih.gov/22553077

EULAR/ACR Classification Criteria for SLE https://pubmed.ncbi.nlm.nih.gov/31779843/

Sensitivity and Specificity of ANA and Anti-dsDNA in the Diagnosis of Systemic Lupus Erythematosus: A Comparison Using Control Sera Obtained From Healthy Individuals and Patients With Multiple Medical Problems https://pubmed.ncbi.nlm.nih.gov/24383972/

Podocyte Foot Process Effacement Precedes Albuminuria and Glomerular Hypertrophy in CD2-Associated Protein Deficient Mice https://pubmed.ncbi.nlm.nih.gov/34568396/ 

KDIGO 2023 Clinical Practice Guideline for the Management of Lupus Nephritis https://kdigo.org/wp-content/uploads/2023/03/KDIGO-2023-Lupus-Nephritis-Guideline_Public-Review_9-Mar-2023.pdf

Management of Lupus Nephritis: A Systematic Literature Review Informing the 2019 Update of the Joint EULAR and European Renal Association-European Dialysis and Transplant Association (EULAR/ERA-EDTA) Recommendations https://pubmed.ncbi.nlm.nih.gov/32699043/

Nonrenal Disease Activity Following Mycophenolate Mofetil or Intravenous Cyclophosphamide as Induction Treatment for Lupus Nephritis: Findings in a Multicenter, Prospective, Randomized, Open-Label, Parallel-Group Clinical Trial https://pubmed.ncbi.nlm.nih.gov/20039429/

Immunosuppressive Therapy in Lupus Nephritis: The Euro-Lupus Nephritis Trial, a Randomized Trial of Low-Dose Vs High-Dose Intravenous Cyclophosphamide https://pubmed.ncbi.nlm.nih.gov/12209517/

Voclosporin: A Novel Calcineurin Inhibitor for the Treatment of Lupus Nephritis https://pubmed.ncbi.nlm.nih.gov/35168373

Safety and Efficacy of Belimumab in Patients With Lupus Nephritis: Open-Label Extension of BLISS-LN Study https://pubmed.ncbi.nlm.nih.gov/36302567/

Anti-CD19 CAR T Cell Therapy for Refractory Systemic Lupus Erythematosus https://pubmed.ncbi.nlm.nih.gov/36109639/

Dapagliflozin in People With Chronic Kidney Disease https://pubmed.ncbi.nlm.nih.gov/37257897/

Empagliflozin in Patients With Chronic Kidney Disease https://pubmed.ncbi.nlm.nih.gov/36331190/