American Journal of Kidney Diseases, Journal Year: 2023, Volume and Issue: 82(1), P. A11 - A13
Published: June 21, 2023
Language: Английский
Circulation, Journal Year: 2023, Volume and Issue: 148(24), P. 1982 - 2004
Published: Nov. 10, 2023
Cardiovascular-kidney-metabolic (CKM) syndrome is a novel construct recently defined by the American Heart Association in response to high prevalence of metabolic and kidney disease. Epidemiological data demonstrate higher absolute risk both atherosclerotic cardiovascular disease (CVD) heart failure as an individual progresses from CKM stage 0 3, but optimal strategies for assessment need be refined. Absolute with goal match type intensity interventions predicted expected treatment benefit remains cornerstone primary prevention. Given growing number therapies our armamentarium that simultaneously address all 3 axes, prediction equations are needed incorporate predictors outcomes relevant context. This should also include social determinants health, which key upstream drivers CVD, more equitably estimate risk. scientific statement summarizes background, rationale, clinical implications newly developed sex-specific, race-free equations: PREVENT (AHA Predicting Risk CVD Events). The enable 10- 30-year estimates total (composite failure), estimated glomerular filtration rate predictor, adjust competing non-CVD death among adults 30 79 years age. Additional models accommodate enhanced predictive utility addition factors when clinically indicated measurement (urine albumin-to-creatinine ratio hemoglobin A1c) or health (social deprivation index) available. Approaches implement risk-based prevention using across various settings discussed.
Language: Английский
Citations
190
American Journal of Kidney Diseases, Journal Year: 2024, Volume and Issue: unknown
Published: Nov. 1, 2024
Language: Английский
Citations
17
Disease-a-Month, Journal Year: 2025, Volume and Issue: unknown, P. 101848 - 101848
Published: Jan. 1, 2025
Language: Английский
Citations
1
Current Medical Research and Opinion, Journal Year: 2024, Volume and Issue: 40(3), P. 377 - 383
Published: Jan. 9, 2024
Type 2 Diabetes (T2D) is a major cause of morbidity and mortality. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) sodium-glucose cotransporter-2 inhibitors (SGLT2i) are highly effective but underutilized. Our objective was to assess racial/ethnic other sociodemographic disparities in GLP-1RA/SGLT2i use among US adults with T2D.
Language: Английский
Citations
7
Cureus, Journal Year: 2025, Volume and Issue: unknown
Published: Jan. 8, 2025
The underutilization of sodium-glucose co-transporter type 2 inhibitors (SGLT2i), despite their proven cardiovascular and renal benefits, raises concerns about healthcare equity. SGLT2i effectively reduces proteinuria, a key indicator kidney disease, making them an essential treatment for individuals with or without diabetes, particularly those at higher risk, such as the Black American population, who have prevalence proteinuria. However, studies show disparities in prescriptions race, ethnicity, socioeconomic status contributing to lower utilization rates among vulnerable populations. This study aims explore prescription patterns Maryland, focusing on patients proteinuria address these improve access care. objective was identify racial SGLT2i. retrospective cohort utilized de-identified electronic health records (EHR) sourced from Epic database across University Maryland Medical System (UMMS), spanning 10-year period January 1, 2014, December 31, 2023, evaluated Of 5,866,616 UMMS system, 28,136 were diagnosed whom 4,360 (15.5%) prescribed medications. Among receiving prescriptions, 37.9% self-identified American, while 54.7% identified White American. Notable geographical observed rates. In affluent areas Fulton, MD (zip code 20759), only 0.046% received compared 1.4% lower-income area West Baltimore, 21223). Bivariate analysis revealed significant rates, having odds (OR = 0.68, p < 0.001) like Fulton showing significantly Baltimore 0.31, 0.001). These persisted multivariate analysis, where had adjusted PR (AOR) 0.72 (p 0.002) relative patients, residents (AOR 1.72, 0.01) reduced 0.35, 0.02). reveals United States, highlighting influence factors vital treatments. Despite established benefits managing reducing risk systemic inequities persist, potentially leaving high-risk populations underserved. findings call deeper examination structural barriers disparities, well development strategies promote equitable Ensuring that all regardless background status, evidence-based therapies is improving outcomes inequities.
Language: Английский
Citations
0
Diabetes Obesity and Metabolism, Journal Year: 2025, Volume and Issue: unknown
Published: Jan. 9, 2025
Abstract Aim SGLT2 inhibitors may be underused in older adults with type 2 diabetes due to concerns about safety and tolerability. This pooled analysis of the CANVAS Program CREDENCE trial examined efficacy canagliflozin according age. Methods Pooled individual participant data from ( n = 10 142) 4401) were analysed by baseline age (<65 years, 65 <75 ≥75 years). A range adjudicated clinical outcomes assessed, including major adverse cardiovascular events CKD progression, as well outcomes. Cox proportional hazards models Fine Gray competing risk used. Results Among 14 543 participants, 7927 (54.5%) <65 5281 (36.3%) years 1335 (9.2%) years. Older participants had higher rates atherosclerotic disease heart failure, longer duration lower mean eGFR. Reductions kidney consistent across categories (all p trend >0.10), although there was some evidence that effects on death all‐cause attenuated 0.02 0.03, respectively). Although incidence increased age, acute injury, volume depletion, urinary tract infections hypoglycaemia, not modified >0.10). Conclusions In patients varying degrees function, reduced outcomes, regardless no additional identified patients.
Language: Английский
Citations
0
American Heart Journal, Journal Year: 2025, Volume and Issue: unknown
Published: Feb. 1, 2025
Language: Английский
Citations
0
JAMA Network Open, Journal Year: 2025, Volume and Issue: 8(4), P. e256372 - e256372
Published: April 22, 2025
Importance Women veterans are the fastest-growing veteran subpopulation in US. often experience military service–related health issues addition to conditions common all women. Because women more likely receive care civilian setting than through Department of Veterans Affairs (VA), women’s clinicians should be equipped provide patient-centered for veterans. The requires evidence-based informed by population-specific scientific literature. An updated evidence map evaluating veteran–focused literature is needed. Objective To scope and breadth veterans’ published from 2016 2023. Evidence Review In this systematic review, MEDLINE, Embase, CINAHL Complete were searched eligible articles Articles reporting about US outcomes or on providing included. Included required report patient-level that included either data only reported results separately grouped primary focus area based categories previously established VA Women’s Health research agendas prior maps. Findings volume between 2023 932 was double 8 years. largest portion focused chronic medical (137 [15%]), general mental (203 [22%]), interpersonal violence (121 3[13%]). Areas greatest growth reproductive (physical mental), pain, suicide, nonsuicidal self-injury. Additionally, emerging areas inquiry found, including military-related toxic exposures harassment within setting. Conclusions Relevance review veterans, found have doubled expanded important aligned with priorities. However, despite related several gaps remain field study. Research addressing pertinent a growing aging population will require rigorous program evaluations.
Language: Английский
Citations
0
Journal of General Internal Medicine, Journal Year: 2023, Volume and Issue: 39(6), P. 921 - 930
Published: Dec. 14, 2023
The sodium-glucose cotransporter type 2 inhibitor dapagliflozin reduces the risk of progressive kidney disease and cardiovascular events in patients with chronic disease, without diabetes. Whether its effects are uniform across spectrum age among men women is unknown.
Language: Английский
Citations
9
Cureus, Journal Year: 2023, Volume and Issue: unknown
Published: Sept. 11, 2023
The best overall measure of kidney function is glomerular filtration rate (GFR) as commonly estimated from serum creatinine concentrations (eGFR
Language: Английский
Citations
8