Unfortunate there’s no information on amount of KCl initiated, degree of MRA uptitration, d/c of other diuretics or if there were further subsequent changes (up/down-titration, discontinuation) to regimen over the course of the study
#nephjc
Ik it would just be hypothesis generating but it would’ve been nice to see outcomes based on theses subgroups to at least give a bit more information on if effect is independent or dependent of mechanism to increase K
#nephjc
This is just showing baseline MRA use so still unclear if addition or uptitration of existing MRA could be driving the benefit, right?
#nephj
Is time to first event or total cumulative events a more relevant endpoint? #nephjc
Doesn’t this mix of interventions kind of defeat the purpose of an RCT?…. Impossible to determine if any benefits or harms are from K raise or from method of increasing the K…. Too much confounding #nephjc
Thanks for sharing!
Is the sigmoid concentration curve really that big of a difference from the dose response curve? The linear curve certainly would be…
How?? Those are crazy HR’s
I mean. What? Do we believe this? Nothing works in dialysis except...fish oil?
I don’t know of any general history on the development of lab values but there’s literature in hematology on refining ferritin and anemia “normal” values… here’s a few studies if interested:
pubmed.ncbi.nlm.nih.gov/33106588/
pubmed.ncbi.nlm.nih.gov/31074518/
pubmed.ncbi.nlm.nih.gov/1487761/
SABA prn instead of SMART therapy for asthma?
Great negative predictor if normal
Should we take into account renin level when selecting an agent? (For non-PA).
If renin is low, would suggest ACE/ARB would be less efficacious, right? If high, RAASi more useful? Opposite true with diuretics? #nephjc
Age range expanded to 30-79 and more applicable to diverse populations, too! #nephjc
Is “Elevated BP” the best term for 120-129? HTN is elevated BP…. #nephjc
Why not everyone?? #nephjc
Would anyone be willing to share a pdf? No institutional access ☹️
Would you have given an anti-arrhythmic in that scenario or just lowered the K? If so, what would your ideal anti-arrhythmic been?
Everything is relative. Everything is subjective. Nothing in medicine is independent of interpretation
Why 1st HF hospitalization?
Wonderful study! Thanks for sharing.
I assume the absolute risk would be higher in a population with more cardiometabolic risk factors -> higher MACE incidence over time? This is a remarkably healthy cohort compared to the US patient population.
Our new data on subclinical PA and MACE is out in Circulation! For the first time, we show that renin-independant aldosterone production is associated with an increased risk of MACE independently of BP, in people mostly normotensive with low CV risk.
www.ahajournals.org/doi/full/10....
Is there any validated study that correlates X% decrease in UACR with Y% change in eGFR? Or any hard endpoints like RRT initiation, etc?
Emphasizes the need to make these drugs accessible
Why such few women?
You’re right BP meds not addressing underlying cause, but maybe no difference in outcomes due to the medications used or population?
Have this study in mind: BP reduction for ns-MRA/RASi in nocturnal HTN in pts uncontrolled HTN (no assessment hard outcomes ☹️).
pubmed.ncbi.nlm.nih.gov/40178088/
Great figure!
Has pill measuring as a compliance metric been used in other studies? Is this more common in pediatric trials?
What a great study. Thanks for sharing
