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- Ruilope, LM, et al.
(författare)
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Design and Baseline Characteristics of the Finerenone in Reducing Cardiovascular Mortality and Morbidity in Diabetic Kidney Disease Trial
- 2019
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Ingår i: American journal of nephrology. - : S. Karger AG. - 1421-9670 .- 0250-8095. ; 50:5, s. 345-356
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Tidskriftsartikel (refereegranskat)abstract
- <b><i>Background:</i></b> Among people with diabetes, those with kidney disease have exceptionally high rates of cardiovascular (CV) morbidity and mortality and progression of their underlying kidney disease. Finerenone is a novel, nonsteroidal, selective mineralocorticoid receptor antagonist that has shown to reduce albuminuria in type 2 diabetes (T2D) patients with chronic kidney disease (CKD) while revealing only a low risk of hyperkalemia. However, the effect of finerenone on CV and renal outcomes has not yet been investigated in long-term trials. <b><i>Patients and</i></b> <b><i>Methods:</i></b> The Finerenone in Reducing CV Mortality and Morbidity in Diabetic Kidney Disease (FIGARO-DKD) trial aims to assess the efficacy and safety of finerenone compared to placebo at reducing clinically important CV and renal outcomes in T2D patients with CKD. FIGARO-DKD is a randomized, double-blind, placebo-controlled, parallel-group, event-driven trial running in 47 countries with an expected duration of approximately 6 years. FIGARO-DKD randomized 7,437 patients with an estimated glomerular filtration rate ≥25 mL/min/1.73 m<sup>2</sup> and albuminuria (urinary albumin-to-creatinine ratio ≥30 to ≤5,000 mg/g). The study has at least 90% power to detect a 20% reduction in the risk of the primary outcome (overall two-sided significance level α = 0.05), the composite of time to first occurrence of CV death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure. <b><i>Conclusions:</i></b> FIGARO-DKD will determine whether an optimally treated cohort of T2D patients with CKD at high risk of CV and renal events will experience cardiorenal benefits with the addition of finerenone to their treatment regimen. Trial Registration: EudraCT number: 2015-000950-39; ClinicalTrials.gov identifier: NCT02545049.
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- Hodlmoser, S, et al.
(författare)
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Sex differences in chronic kidney disease awareness among US adults, 1999 to 2018
- 2020
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Ingår i: PloS one. - : Public Library of Science (PLoS). - 1932-6203. ; 15:12, s. e0243431-
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Tidskriftsartikel (refereegranskat)abstract
- Chronic kidney disease (CKD) is less prevalent among men than women, but more men than women initiate kidney replacement therapy. Differences in CKD awareness may contribute to this gender gap, which may further vary by race/ethnicity. We aimed to investigate trends in CKD awareness and the association between individual characteristics and CKD awareness among US men versus women.Methods and findingsWe conducted a serial, cross-sectional analysis of 10 cycles (1999–2018) from the National Health and Nutrition Examination Survey (NHANES). Adult participants with CKD stages G3-G5 (estimated glomerular filtration rate [eGFR] <60 mL/min/1.73m2) were included, unless they were on dialysis or medical information was missing. Serum creatinine was measured during NHANES medical exams. CKD stage was classified by eGFR, based on the CKD-EPI formula. CKD awareness was assessed with the question: “Have you ever been told by a health care professional you had weak or failing kidneys”, asked in standardized NHANES questionnaires on each survey. Using logistic regression models, we evaluated the association between sex and CKD awareness, adjusting for potential confounders including age, race/ethnicity and comorbidities. We stratified CKD awareness by 5 pre-defined calendar-year periods and conducted all analyses for the complete study population as well as the Caucasian and African American subpopulations. We found that among 101871 US persons participating in NHANES, 4411 (2232 women) had CKD in stages G3-G5. These participants were, on average, 73±10 years old, 25.3% reported diabetes, 78.0% reported hypertension or had elevated blood pressure during medical examinations and 39.8% were obese (percentages were survey-weighted). CKD awareness was more prevalent among those with higher CKD stage, younger age, diabetes, hypertension and higher body mass index. CKD awareness was generally low (<22.5%), though it increased throughout the study period, remaining consistently higher among men compared to women, with a decreasing gender gap over time (adjusted odds ratio [men-to-women] for CKD awareness = 2.71 [1.31–5.64] in period 1; = 1.32 [0.82–2.12] in period 5). The sex difference in CKD awareness was smaller in African American participants, in whom CKD awareness was generally higher. Using serum creatinine rather than eGFR as the CKD-defining exposure, CKD awareness increased with rising serum creatinine, in a close to identical fashion among both sexes during 1999–2008, while during 2009–2018, CKD awareness among women increased earlier than among men (i.e. with lower serum creatinine levels).ConclusionsCKD awareness is lower among US women than men. The narrowing gap between the sexes in more recent years and the results on CKD awareness by serum creatinine indicate that health care professionals have previously been relying on serum creatinine to inform patients about their condition, but in more recent years have been using eGFR, which accounts for women’s lower serum creatinine levels due to their lower muscle mass. Additional efforts should be made to increase CKD awareness among both sexes.
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- Guri, G., et al.
(författare)
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Blended learning : Quality framework for a Pan-European universities network
- 2019
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Ingår i: EDULEARN19. - : IATED. ; , s. 5254-5262
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Konferensbidrag (refereegranskat)abstract
- Blended Learning (BL) offers advantages for all the stakeholders involved in the educational process (students, teachers, management), and has a positive impact on the quality of students' learning and degree of knowledge acquisition [1] [2]. It is an institutionalized methodology with respective implementation policy and learning approach implications, although assessing the quality of BL (QBL) remains a complex task [3] [4]. Developed in a partnership of currently 18( )(1)European universities (EIT Digital Network), the EIT Digital Master School offers education not only in the technical major components of its master programmes in ICT but also in an Innovation and Entrepreneurship (I&E) minor, which counts for 30 ECTS (European Credits Transfer System) in the 120 ECTS master programmes. To harmonize the I&E education across the network of universities, enhance pedagogical cooperation and enable distribution of pedagogical material among partner universities, the best teaching materials, co-designed and co-produced by partners, constitute a data-base of online contents made available through a common repository [5]. In a BL approach, the shared contents constitute the online component of the I&E courses taught by each partner university and is combined with face-to-face (F2F) pedagogic activities, employing different BL models (flipped class, online pre-packaged content, independent learning, etc.). Online contents are organized in sets of around 5-10 min videos, which teachers can select, combine and package in various ways, in accordance with the needs to structure and deploy their I&E courses. The same online content is available for all universities, but their combination and the blending models applied depend on the courses, allowing for a level of differentiation on top of the harmonized online contents. This context of networked partners using shared online contents, with the opportunity to employ different BL models, has led EIT Digital to conduct a set of experiments and define a quality framework to assess the learning impact of BL models implemented in I&E education and provide insights on how to select and/or improve these models. To have comparable results and share lessons learned, the EIT Digital partner universities have conducted experiments based on a common frame for setting them up and for reporting the experiments' results. Drawing upon this methodology, the paper describes an approach to define a framework - based on four components efficiency, effectiveness, impact and scalability- to assess the courses QBL in a pan-European network of universities. Moreover, the paper explores how to valorize the collected results for improving the quality of BL models and methods used in the courses. Such findings may be relevant in the context of other European Universities networks - sharing similar characteristics as an approach to leverage the value of such networks for increasing the education quality.
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