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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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2. |
- Bhattacharya, Prosun, 1962-, et al.
(författare)
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Natural Arsenic in Coastal Groundwaters in the Bengal Delta Region in West Bengal, India
- 2010
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Ingår i: Management and Sustainable Development of Coastal Zone Environments. - Dordrecht : Springer Netherlands. - 9789048130672 ; , s. 146-160
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Bokkapitel (refereegranskat)abstract
- Bengal Delta region is currently confronted with largest groundwater arsenic calamity in history of human kind (BGS-DPHE, 2001; Mukherjee and Bhattacharya, 2001; Bhattacharya et al., 2002a; McArthur et al., 2001; Smedley and Kinniburgh, 2002; Mukherjee et al., 2006; Nath et al., 2005, 2007, 2008). Concentrations of arsenic in drinking water wells in the region often exceed the WHO drinking water guideline value (10 μg L-1) and the national safe limit of both India and Bangladesh for arsenic in drinking water (Smedley and Kinniburgh, 2002; RGNDWM, 2002; CGWB, 1999; Bhattacharya et al., 2002a). About one third (35 million) population inhabiting in this region (West Bengal and Bangladesh), currently at risk of long-term arsenic exposure (Bhattacharya et al., 2001; RGNDWM, 2002; Chakraborti et al., 2004; Kapaj et al., 2006), are being diagnosed with a wide spectrum of adverse health impacts including skin disorders such as hyper/hypo-pigmentation, keratosis and melanosis and are also in hot-spot areas of BDP which is reflected in a rise in the number of cancer cases (Guha Mazumdar et al., 1988). The distribution pattern of arsenic occurrence in BDP is patchy and there are numerous hotspots of arsenic contamination in the semi-confined shallow Holocene aquifer (Bhattacharya et al., 1997; Smedley and Kinniburgh, 2002). The scale of the problem is serious both in terms of hotspots and geographic area coverage (173 × 10 3 km2, eastern part of Hoogly-Bhagirathi/Western part of Ganga-Padma-lower Meghna flood plains).
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3. |
- Kumar Ranjan, Rajesh, et al.
(författare)
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Elemental and stable isotope records of organic matter input and its fate in the Pichavaram mangrove–estuarine sediments (Tamil Nadu, India)
- 2011
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Ingår i: Marine Chemistry. - : Elsevier. - 0304-4203 .- 1872-7581. ; 126:1-4, s. 163-172
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Tidskriftsartikel (refereegranskat)abstract
- In order to evaluate the sources and fate of organic matter (OM) in the Pichavaram mangrove–estuarine ecosystem, Corg, Ntot, C/Natm, and stable isotopes (δ13Corg and δ15Norg) of five 210Pb dated sediment cores were investigated. Core A was collected from the Vellar Estuary, cores B, C, and D from mangrove forests, and core E was from the Coleroon Estuary. In mangrove sediments, Corg, Ntot, and C/Natm concentration varied from 1.2 ± 0.52%, 0.08 ± 0.03%, and 16.6 ± 4.1%, respectively. In the estuaries, Corg, Ntot, and C/Natm varied from 0.37 ± 0.19%, 0.03 ± 0.01%, and 12.3 ± 2.9%, respectively. In mangrove forests the δ13Corg and δ15Norg values varied from − 24.3 ± 1.8‰ and 4.2 ± 0.86‰, whereas in estuaries these values were − 23.2 ± 1.6‰ and 5.1 ± 1.3‰, respectively. The variation represents variable inputs of marine and terrestrial OM in these area, OM degradation, replacement of native vegetation due to increasing salinity, and early diagenetic changes. Some of these changes could be attributed to anthropogenic activities that have been happening in the Pichavaram complex over the last few decades. OM once deposited in the sediments is rapidly decomposed or remineralized in both mangrove and estuarine sites. The rate of Corg burial is more in mangrove forests than estuaries. Early diagenetic changes are modeled in the cores based on C/N stoichiometry. This was most applicable in mangrove sediments (core C) where ~ 56% C was remineralized representing a first order diagenetic model.
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