Navigation Links
Advancing understanding of treatment through clinical trials

Three late-breaking studies presented during the American Society of Nephrology's Annual Kidney Week provide new information on drugs being tested in patients with diabetes or kidney disease.

Hans-Henrik Parving, MD (University of Copenhagen, in Denmark) and his colleagues investigated whether the drug aliskiren might improve the prognosis of patients with type 2 diabetes who are at high risk for developing heart and kidney problems. The randomized double-blind ALTITUDE trial included 8561 individuals who received aliskiren (300 mg once daily) or placebo on top of a drug that blocks the renin-angiotensin-aldosterone system (RAAS), a complex hormone system that regulates blood pressure and fluid balance. (Drugs that target the RAAS have limited effectiveness in part due to feedback responses, such as compensatory increases in an enzyme called renin. Aliskiren is a direct renin inhibitor and may help overcome these shortcomings because it suppresses the reactive rise in renin activity stimulated by other RAAS blockers.) After an average follow-up of 32.9 months:

  • 17.9% of patients receiving aliskiren and 16.8% of those receiving placebo experienced a heart attack or stroke, developed kidney disease, or died of cardiovascular disease.
  • Stroke occurred in 3.4% of patients taking aliskiren, compared with 2.7% of patients taking placebo.
  • Patients taking aliskiren experienced significantly increased blood potassium levels and hypotension.

"The trial does not support administration of aliskiren on top of standard therapy with RAAS blockade in type 2 diabetic patients at high risk for cardiovascular and renal events, and may even be harmful," the authors concluded.

Another team led by Vicente Torres, MD, PhD (Mayo Clinic) tested the potential of a vasopressin V2 receptor antagonist (tolvaptan) to inhibit cyst growth and slow kidney function decline in patients with autosomal dominant polycystic kidney disease (ADPKD). This condition causes kidney cysts often associated with pain, hypertension, and kidney failure. The phase 3, multi-center, double-blind, placebo-controlled, 3-year trial included 1445 ADPKD patients who were randomized 2:1 to split dose tolvaptan (45/15, 60/30 or 90/30 mg daily as tolerated) or placebo.

  • Total kidney volume increase over 3 years was halved in patients treated with tolvaptan compared to placebo (2.80%/year versus 5.51%/year).
  • Patients taking tolvaptan were 61% less likely to experience a certain level of worsening kidney function and 36% less likely to experience kidney pain requiring treatment.
  • Tolvaptan slowed the rate of kidney function decline compared with placebo.

"Tolvaptan demonstrated clinically meaningful disease-specific benefits for ADPKD patients which may be clinically meaningful," said Dr. Torres. While the trial findings are encouraging, tolvaptan has not yet been approved for this indication.

A third trial, called EVOLVE, was designed to test the hypothesis that treatment with cinacalcet compared with placebo reduces the risk of premature death or non-fatal heart-related events among dialysis patients with secondary hyperparathyroidism. (Secondary hyperparathyroidism, when the parathyroid gland produces excess amounts of parathyroid hormone, arises in most patients with chronic kidney disease as their disease progresses. It can lead to a number of complications, including cardiovascular problems.) Results from analyses using multivariable adjustment and censoring data 6 months after patients stopped taking the drug will be presented, along with safety data, by Glenn Chertow, MD (Stanford University School of Medicine).


Contact: Adrienne Lea
American Society of Nephrology

Related medicine news :

1. Advancing the treatment of trauma
2. Researchers closer to understanding actions of cells involved in atherosclerosis
3. Studies seek better understanding and treatment of depression
4. Wayne State develops better understanding of memory retrieval between children and adults
5. Understanding flirtation in negotiation, shooter bias, love during marriage, and more
6. Discovery improves understanding of early onset inflammatory disease
7. Cedars-Sinai researchers, with stem cells, advance understanding of spinal muscular atrophy
8. Understanding the links between inflammation and chronic disease
9. Understanding and promoting mental health - Insights from psychological science
10. Researchers gain better understanding of mechanism behind tau spreading in the brain
11. Mayo Clinic identifies promising treatment for inherited form of kidney disease
Post Your Comments:
(Date:11/30/2015)... ... November 30, 2015 , ... ... announce the speakers for “Value-Based Payer-Provider Partnerships: Three Case Studies,” an upcoming ... value-based care arrangements: Essentia Health and UCare, MissionPoint Health Partners, and Intel ...
(Date:11/30/2015)... EMIGSVILLE, PA (PRWEB) , ... November 30, 2015 ... ... (CCMS) software provider, has verified that their Vasont Universal Integrator (VUI) extension unites ... handle creating, editing, and managing content as a continuous process with the latest ...
(Date:11/30/2015)... ... November 30, 2015 , ... ... is one of a select few plastic surgeons in the New York City ... , SculpSure™ is the world’s first heat-induced laser treatment for fat loss in ...
(Date:11/30/2015)... ... November 30, 2015 , ... TransPack Volume 6 features 30 customizable transitions created ... web-styled transitions to wipes with blur & drop shadow options. Utilize the controls ... from one clip to the next with TransPack's easily customizable styles. , ...
(Date:11/30/2015)... , ... November 30, 2015 ... ... Inc. are pleased to announce their strategic partnership at the Radiological Society ... Transcription Service, Inc., and Winscribe, global providers of cutting-edge dictation and speech-enabled ...
Breaking Medicine News(10 mins):
(Date:11/30/2015)... Calif. , Nov. 30, 2015 /PRNewswire/ ... the norm in U.S. medical imaging is ... increasingly popular accountable care payer-provider contracts are ... and, in their wake, alter provider-vendor relationships. ... payments will push forward new purchasing frameworks ...
(Date:11/30/2015)... JERUSALEM , Nov. 30, 2015 Oramed ... company focused on the development of oral drug delivery ... investment agreements valued at up to $50,000,000 with Hefei Tianhui Incubator of ... Oramed,s oral insulin capsule, ORMD-0801, in China ... Macau . The agreements were signed ...
(Date:11/30/2015)... N.H. , Nov. 30, 2015 ... that it will feature its latest solutions for ... early identification of cancer at the Radiological Society ... Chicago from November 29 ... recent product advances including iReveal®, an automated breast ...
Breaking Medicine Technology: