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Cited by 116Blood Pressure and Hypertension StudiesDiabetes Treatment and ManagementChronic Kidney Disease and Diabetes

Blood Pressure Effects of Canagliflozin and Clinical Outcomes in Type 2 Diabetes and Chronic Kidney Disease: Insights From the CREDENCE Trial

Open access
Ye, Nan, Jardine, Meg J., Oshima, Megumi, Hockham, Carinna, Heerspink, Hiddo J.L., Agarwal, Rajiv, Bakris, George, Schutte, Aletta E. +15 more·2021·Circulation
DOI 10.1161/circulationaha.120.048740
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Abstract

Background: People with type 2 diabetes and chronic kidney disease experience a high burden of hypertension, but the magnitude and consistency of blood pressure (BP) lowering with canagliflozin in this population are uncertain. Whether the effects of canagliflozin on kidney and cardiovascular outcomes vary by baseline BP or BP-lowering therapy is also unknown. Methods: The CREDENCE trial (Canagliflozin and Renal Events in Diabetes with Established Nephropathy Clinical Evaluation) randomized people with type 2 diabetes and chronic kidney disease to canagliflozin or placebo. In a post hoc analysis, we investigated the effect of canagliflozin on systolic BP across subgroups defined by baseline systolic BP, number of BP-lowering drug classes, and history of apparent treatment-resistant hypertension (BP ≥130/80 mm Hg while receiving ≥3 classes of BP-lowering drugs, including a diuretic). We also assessed whether effects on clinical outcomes differed across these subgroups. Results: The trial included 4401 participants, of whom 3361 (76.4%) had baseline systolic BP ≥130 mm Hg, and 1371 (31.2%) had resistant hypertension. By week 3, canagliflozin reduced systolic BP by 3.50 mm Hg (95% CI, –4.27 to –2.72), an effect maintained over the duration of the trial, with similar reductions across BP and BP-lowering therapy subgroups (all P interaction ≥0.05). Canagliflozin also reduced the need for initiation of additional BP-lowering agents during the trial (hazard ratio, 0.68 [95% CI, 0.61–0.75]). The effect of canagliflozin on kidney failure, doubling of serum creatinine, or death caused by kidney or cardiovascular disease (hazard ratio, 0.70 [95% CI, 0.59–0.82]) was consistent across BP and BP-lowering therapy subgroups (all P interaction ≥0.35), as were effects on other key kidney, cardiovascular, and safety outcomes. Conclusions: In people with type 2 diabetes and chronic kidney disease, canagliflozin lowers systolic BP across all BP-defined subgroups and reduces the need for additional BP-lowering agents. These findings support use of canagliflozin for end-organ protection and as an adjunct BP-lowering therapy in people with chronic kidney disease. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT02065791.

Integrity signals

Registry

Crossref · 10.1161/circulationaha.120.048740

Cites

42 of 42 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 32 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    Effects on other kidney outcomes including dialysis, transplant or death due to kidney disease were similar in sensitivity analyses adjusting for the competing risk of death.

    “Effects on other kidney outcomes, including dialysis, transplant or death due to kidney disease, are summarized in Supplemental Figure 1, with similar results observed in sensitivity analyses adjusting for the competing risk of death (Supplemental Table 6).”
    Quote in the paperNot a substantial claim
  • Findingown data

    Effects on other cardiovascular and mortality outcomes were similar in sensitivity analyses adjusting for the competing risk of death.

    “Effects on other cardiovascular and mortality outcomes are summarized in Supplemental Figure 2, with similar findings in sensitivity analyses adjusting for the competing risk of death (Supplemental Table 6).”
    Quote in the paperNot a substantial claim
  • Findingown data

    Systolic blood pressure reductions with canagliflozin were sustained over the trial (mean difference -3.30 mmHg, 95% CI -3.87 to -2.73).

    “Reductions in systolic BP were sustained over the duration of the trial (mean difference -3.30mmHg, 95% CI, -3.87 to -2.73; Supplemental Table 5)”
    Quote in the paperSubstantial claim
  • Findingown data

    The effect of canagliflozin on volume depletion and acute kidney injury did not vary across baseline systolic blood pressure, number of blood pressure-lowering drug classes, or resistant hypertension history (all P-interaction >0.10).

    “The effect of canagliflozin on volume depletion and on acute kidney injury also did not vary across these subgroups (all P-interaction>0.10; Figure 6).”
    Quote in the paperSubstantial claim
  • Findingown data

    The effect of canagliflozin on cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke did not vary by baseline systolic blood pressure or number of blood pressure-lowering drug classes (P-interaction=0.52 and 0.25).

    “The effect on cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke (HR 0.80, 95% CI 0.67-0.95)did not vary by baseline systolic BP or number of BP lowering drug classes (P-interaction= 0.52 and 0.25, respectively), although there was some evidence that the magnitude of benefit varied by history of resistant hypertension (P-interaction=0.04; Figure 5).”
    Quote in the paperSubstantial claim
  • Classified as probably not a substantial claim. 20
  • May combine two claims. 23
  • The quote only partly states this claim. 2

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    77.2% were taking at least two classes of blood pressure-lowering therapies; the most common regimens were renin-angiotensin system blockade plus calcium channel blocker (12.5%) or renin-angiotensin system inhibitor plus diuretic (10.3%).

    “3,394 participants (77.2%) were taking ≥2 classes of BP lowering therapies, the most common regimens being RAS blockade plus calcium channel blocker (12.5%) or RAS inhibitor plus diuretic (10.3%).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    1,130 (25.7%) and 901 (20.5%) participants were receiving three and four or more classes of blood pressure-lowering drugs at baseline, respectively.

    “1,130 (25.7%).901 (20.5%) participants were receiving 3 and 4 or more classes of BP lowering drugs respectively at baseline.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    At baseline, 48.4% were receiving a calcium channel blocker, 40.2% a beta blocker, and 46.7% a diuretic.

    “2,129 (48.4%) were receiving a calcium channel blocker, 1,770 (40.2%) a beta blocker and 2,057 (46.7%) a diuretic (Supplemental Table 4).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Effects on amputation, fracture, and all kidney-related adverse events were similar across subgroups.

    “Effects on amputation, fracture and all kidney-related adverse events were also similar across subgroups (Supplemental Figure 3).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    CREDENCE included 4401 randomized participants with type 2 diabetes and chronic kidney disease, mean age 63 years, blood pressure 140/78 mmHg, eGFR 56 mL/min/1.73m2, median UACR 927 mg/g, followed for a median of 2.6 years.

    “The CREDENCE trial included 4401 randomized participants with T2DM and CKD (mean age 63 years, BP 140/78 mmHg, eGFR 56 mL/min/1.73m 2 , and median UACR 927 mg/g) who were followed for a median of 2.6 years.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    The prevalence of resistant hypertension at baseline was 31.4%.

    “The prevalence of resistant hypertension at baseline was 31.4% (Supplemental Table 2).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    The CREDENCE population had a high burden of elevated blood pressure: all had severely increased albuminuria, almost 60% had starting eGFR below 60, and almost half were treated with three or more classes of blood pressure-lowering therapies.

    “All participants had severely increased albuminuria, almost 60% had a starting eGFR <60 mL/min/1.73m 2 , and almost half were treated with three or more classes of BP lowering therapies.”
    Quote in the paperNot a substantial claim

  • The quote only partly states this claim.

    Findingcitation

    Canagliflozin reduced systolic blood pressure by 3.30 mmHg over the duration of the trial compared with placebo (95% CI -3.87 to -2.73).

    “Change in SBP over duration of the trial -3.30 mmHg (95% CI -3.87, -2.73)”
    Quote in the paperSubstantial claim

  • The quote only partly states this claim.

    Findingcitation

    Canagliflozin reduced systolic blood pressure by 3.50 mmHg at week 3 compared with placebo (95% CI -4.27 to -2.72).

    “Change in SBP at week 3 -3.50 mmHg (95% CI -4.27, -2.72)”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    In the EMPA-REG BP trial, empagliflozin reduced mean 24-hour ambulatory systolic blood pressure by approximately 3-4 mmHg after 12 weeks, with consistent reductions irrespective of the number of background blood pressure-lowering drugs.

    “In the EMPA-REG BP trial, empagliflozin reduced mean 24 hour ambulatory systolic BP by approximately 3-4 mmHg after 12 weeks, 16 with consistent reductions irrespective of the number of background BP lowering drugs.17”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [16] source

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    • cites [17] source

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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    Sensitivity analyses for main kidney and cardiovascular outcomes adjusted for the competing risk of death using the Fine and Gray method.

    “We performed sensitivity analyses for the main kidney and cardiovascular outcomes adjusting for the competing risk of death using the Fine and Gray method.13”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [13] source

      Not checked in the free run.

  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductnone given

    CREDENCE was a large, well-conducted, randomized, double-blind, placebo-controlled trial.

    “The strength of this study lies in the high quality of data obtained from the CREDENCE trial, which was a large, well-conducted, randomized, double-blind, placebo-controlled trial.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationcitation

    Unlike other blood pressure-lowering agents, there appears to be no association between baseline blood pressure values and the magnitude of blood pressure reduction with SGLT2 inhibition, an observation extended to people with chronic kidney disease.

    “An important distinction is that unlike other BP lowering agents, 24 there appears to be no association between baseline values and the magnitude of BP reduction, an observation which we have extended to people with CKD.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [24] source

      Not checked in the free run.

  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductown data

    The analysis was post-hoc and was not specifically designed to assess blood pressure-lowering effects in individual subgroups or clinical outcomes in each systolic blood pressure category.

    “This was a post-hoc analysis and was not specifically designed to assess BP lowering effects in individual subgroups or effects on clinical outcomes in each category of systolic BP.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    The glycosuric effect of SGLT2 inhibition diminishes substantially as kidney function declines, while effects on systolic blood pressure appear preserved across the spectrum of eGFR studied to date, including eGFR below 30.

    “While the glycosuric effect of SGLT2 inhibition diminishes substantially as kidney function declines, effects on systolic BP appear preserved across the spectrum of eGFR studied to date, including down to an eGFR <30 mL/min/1.73m 2 .[25][26][27]”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [25] source

      Not checked in the free run.

    • cites [26] source

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    • cites [27] source

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  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Similar findings have been reported in short-term trials of other SGLT2 inhibitors, and longer-term blood pressure-lowering effects in type 2 diabetes with relatively preserved kidney function have been demonstrated in large cardiovascular outcome trials.

    “Similar findings have been reported in short-term trials of other SGLT2 inhibitors, 6,18,19 and the longer-term BP lowering effects of SGLT2 inhibitors in individuals with T2DM and relatively preserved kidney function have been demonstrated in large cardiovascular outcome trials.5,20,21”
    Quote in the paperNot a substantial claim0 of 6 sources checked
    • cites [6] source

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    • cites [18] source

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    • cites [19] source

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    • cites [5] source

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    • cites [20] source

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    • cites [21] source

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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    In the CRIC study, approximately 40% of participants with established chronic kidney disease had apparent treatment-resistant hypertension.

    “In the CRIC (Chronic Renal Insufficiency Cohort) study, approximately 40% of participants with established CKD had apparent treatment-resistant hypertension.22”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [22] source

      Not checked in the free run.

  • May combine two claims.

    Study design and conductreasoning

    Mediation analyses were observational without adjustment for confounders between change in systolic blood pressure and clinical outcomes, so estimates of treatment effect explained should be interpreted as association and causality cannot be directly inferred.

    “Because the mediation analyses were observational without adjustment for confounders between change in systolic BP and clinical outcomes, estimates of the proportion of treatment effects explained by reductions in systolic BP should be interpreted as a measure of association and thus causality cannot be directly inferred.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    Randomization was performed centrally using a computer-generated schedule with randomly permuted blocks stratified by pre-randomization eGFR.

    “Randomization was performed centrally based on a computer-generated randomization schedule, using randomly permuted blocks stratified by pre-randomization eGFR (30 to <45, 45 to <60, 60 to <90 mL/min/1.73m 2 ).”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductown data

    Effects on kidney and cardiovascular outcomes were assessed using Cox regression stratified by screening eGFR with an intention-to-treat approach.

    “The effects of canagliflozin on all kidney and cardiovascular outcomes were assessed using Cox regression models stratified by screening eGFR using an intention-to-treat approach.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationown data

    The absence of clear differences in adverse outcomes across systolic blood pressure levels, particularly volume depletion and acute kidney injury, is reassuring and underscores canagliflozin safety in type 2 diabetes and chronic kidney disease.

    “The absence of any clear difference in risk of adverse outcomes across different levels of systolic BP, in particular volume depletion and acute kidney injury, is reassuring and underscores the safety of canagliflozin in patients with T2DM and CKD.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    Analyses of change in systolic blood pressure were based on-treatment using complete data, as pre-specified.

    “Analyses of change in systolic BP were based on-treatment analyses using complete data, as pre-specified in the statistical analysis plan and to be consistent with the primary trial report.9”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [9] source

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  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    Blood pressure was measured at baseline and each clinic visit with three consecutive measurements at least 1 minute apart, and the average was recorded.

    “As mandated in the study protocol, 3 consecutive BP measurements were taken at intervals of at least 1 minute apart, and the average of the 3 readings was recorded.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    In CREDENCE, canagliflozin reduced kidney failure risk by 30% and heart failure hospitalization risk by 40% in patients with type 2 diabetes and chronic kidney disease.

    “In the Canagliflozin and Renal Events in Diabetes with Established Nephropathy Clinical Evaluation (CREDENCE) Trial, canagliflozin reduced the risk of kidney failure and of hospitalization for heart failure in patients with T2DM and CKD by 30 and 40% respectively.9”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [9] source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Interaction P values were not adjusted for multiple comparisons.

    “The reported interaction P values were not adjusted for multiple comparisons and should be interpreted appropriately.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationcitation

    CREDENCE data confirm and strengthen the observation that systolic blood pressure effects are preserved across eGFR, including one of the largest numbers of participants with eGFR below 45 among SGLT2 inhibitor outcome trials.

    “This observation is confirmed and strengthened by the CREDENCE data, which includes one of the largest number of participants with eGFR <45 mL/min/1.73m 2 of any SGLT2 inhibitor outcome trial to date.28”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [28] source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    4361 participants (99.1%) completed the study; 13 (0.6%) in the canagliflozin arm and 9 (0.4%) in the placebo arm were lost to follow-up.

    “4361 participants (99.1%) completed the study; 13 (0.6%) and 9 (0.4%) participants in the canagliflozin and placebo arms respectively were lost to follow-up.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    All participants, care providers, investigators, and outcome assessors were blinded to treatment allocation until trial end.

    “All participants, care providers, investigators and outcome assessors were blinded to randomized treatment allocation until the end of the trial.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationcitation

    The pattern of blood pressure-lowering therapy use and resistant hypertension prevalence in CREDENCE is consistent with prior chronic kidney disease data, suggesting the findings are likely directly applicable to routine care of patients with type 2 diabetes and chronic kidney disease.

    “The pattern of use of BP lowering therapies and prevalence of resistant hypertension in CREDENCE is consistent with these data, and suggest that our findings are likely to be directly applicable to the routine care of patients with T2DM and CKD, where the burden of resistant hypertension and use of multiple BP lowering therapies is high.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [22] source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Compared with the general population, resistant hypertension is at least twice as common in people with chronic kidney disease and becomes increasingly common as eGFR declines.

    “Compared to the general population, resistant hypertension is at least twice as common in people with CKD and becomes increasingly so as eGFR declines.4”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [4] source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    All kidney and cardiovascular outcomes were adjudicated by expert committees blinded to treatment allocation.

    “All kidney and cardiovascular outcomes were adjudicated by expert committees blinded to treatment allocation.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Recent experimental data showed that chemical denervation in a neurogenic hypertensive animal model reduced SGLT2 expression, and dapagliflozin reduced norepinephrine levels in kidney tissue, providing evidence of crosstalk between SGLT2 inhibitors and sympatho-inhibition.

    “Recent experimental data showed that chemical denervation in a neurogenic hypertensive animal model reduced SGLT2 expression, and that dapagliflozin reduced norepinephrine levels in kidney tissue, providing evidence of crosstalk between SGLT2 inhibitors and sympatho-inhibition. 31”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [31] source

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  • May combine two claims.

    Interpretationown data

    The high burden of hypertension and multiple blood pressure therapies in CREDENCE allowed extension of previous observations on SGLT2 inhibitor blood pressure lowering to chronic kidney disease and assessment of consistency and durability across subgroups.

    “The high burden of hypertension in the study population and use of multiple classes of BP lowering therapies allowed us to extend previous observations on the BP lowering effects of SGLT2 inhibition to the CKD population and assess the consistency and durability of this effect across a number of clinically important subgroups.”
    Quote in the paperSubstantial claim
33 of 33

  • The paper relies on this without support.

    Before this analysis, the magnitude and consistency of canagliflozin's systolic blood pressure-lowering effect across baseline systolic blood pressure levels, number of blood pressure-lowering drug classes, and resistant hypertension status were unclear.

    “While canagliflozin also lowered systolic BP, the magnitude and consistency of this effect across different levels of baseline systolic BP, number of BP lowering drug classes, and in patients with and without resistant hypertension, is unclear.”

  • The paper relies on this without support.

    Whether canagliflozin's effects on kidney, cardiovascular, and safety outcomes vary across these blood pressure-defined subgroups was uncertain.

    “Whether the effects of canagliflozin on kidney, cardiovascular and safety outcomes vary across these subgroups is also uncertain.”

  • The paper relies on this without support.

    Initiation of additional blood pressure-lowering agents during the trial reflects an unmet need for blood pressure lowering.

    “and reduced the need for additional blood pressure lowering agents.”
3 of 3

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • A recent meta-analysis including seven randomized controlled trials demonstrated that SGLT2 inhibitors were associated with an average reduction of 3.6/1.7 mmHg systolic/diastolic in 24-hour ambulatory blood pressure, comparable with efficacy of low-dose hydrochlorothiazide.

    “A recent meta-analysis including seven RCTs demonstrated that SGLT2 inhibitors were associated with an average reduction of 3.6/1.7 mmHg (systolic/diastolic) in 24 h ambulatory BP, which is comparable with efficacy of low-dose hydrochlorothiazide.”

    From 2023 ESC guidelines for the management of cardiovascular disease in patients with diabetes. (2023) · cites this paper as [224]

  • SGLT2 inhibitors induced a larger blood-pressure decrease than did GLP-1 receptor agonists without changing heart rate.

    “SGLT2 inhibitors induced a larger BP decrease than did GLP-1 RAs without changing heart rate.”

    From 2023 ESC guidelines for the management of cardiovascular disease in patients with diabetes. (2023) · cites this paper as [224]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Placebo initiation percentage does not match the reported count

    Major

    The reported 836 participants cannot be 61.3% of the placebo arm: Table 2 lists 2,169 placebo participants, of whom 836 would be 38.54%. The randomized arm was not smaller than that week-3 population.

    Reported 61.3 · recomputed 38.543107

  • Canagliflozin initiation percentage does not match the reported count

    Major

    The paper reports 627 participants starting an additional BP-lowering agent as 39.8%. Using the 2,172 canagliflozin participants listed in Table 2 gives 28.87%, not 39.8%; the randomized arm was not smaller than that week-3 population.

    Reported 39.8 · recomputed 28.867403

  • Region percentages use a different denominator from the table columns

    Minor

    Table 1 places 334 North American participants in the subgroup of 1,040 with systolic BP below 130 mmHg. That is 32.12%, rather than the reported 28.3%; the region percentages appear to use region totals instead of the subgroup denominators used elsewhere in the table.

    Reported 28.3 · recomputed 32.115385

  • Discussion overstates consistency across cardiovascular subgroups

    Minor

    The discussion says the cardiovascular benefits were consistent across BP-defined subgroups, but the results report evidence that benefit varied by resistant-hypertension history for one cardiovascular outcome (interaction P=0.04).

4 of 4

Cites

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Research works printed but not linked: 1

  1. 10.1681/asn.2019111168 · DOI

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Related

Authors
Ye, N., Jardine, M. J., Oshima, M., Hockham, C., Heerspink, H. J. L., Agarwal, R., Bakris, G., Schutte, A. E., Arnott, C., Chang, T. I., Górriz, J. L., Cannon, C. P., Charytan, D. M., de Zeeuw, D., Levin, A., Mahaffey, K. W., Neal, B., Pollock, C., Wheeler, D. C., Luca Di Tanna, G., Cheng, H., Perkovic, V., & Neuen, B. L.
Affiliations
  • Capital Medical University (CN)
  • Concord Repatriation General Hospital (AU)
  • Kanazawa University (JP)
  • UNSW Sydney (AU)
  • University Medical Center Groningen (NL)
  • Richard L. Roudebush VA Medical Center (US)
  • University of Chicago (US)
  • Royal Prince Alfred Hospital (AU)
  • Stanford Medicine (US)
  • Department of Nephrology, Hospital Clínico Universitario, Valencia, Spain (J.L.G.).
  • Brigham and Women's Hospital (US)
  • NYU Langone Health (US)
  • Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen, The Netherlands (H.J.L.H., D.d.Z.).
  • University of British Columbia (CA)
  • The University of Sydney (AU)
  • The George Institute for Global Health (GB)
  • The George Institute for Global Health (N.Y., M.J.J., M.O., C.H., A.E.S., C.A., B.N., D.C.W., G.L.D.T., V.P., B.L.N.), University of New South Wales, Sydney, Australia.
  • Royal North Shore Hospital (AU)
ORCID
Venue
Circulation
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2021-05-04
Volume
143
Issue
18
Pages
1735-1749
ISSN
  • 0009-7322 (ISSN-L)
  • 1524-4539
DOI
10.1161/circulationaha.120.048740
OpenAlex
W3126553617
Semantic Scholar
737a7cef38e8d90b20d17272ac016a6f4c544266
Cited by
115
References
39
Citations by year
2026: 5 · 2025: 30 · 2024: 20 · 2023: 23 · 2022: 23 · 2021: 14
FWCI
13.41
Type
journal article
Language
en
Open access
Licence
public-domain
Locations
  • Circulation (publishedVersion, public-domain)
  • PubMed (publishedVersion)
  • UNSWorks (University of New South Wales, Sydney, Australia) (submittedVersion, cc-by-nc-nd)
  • Spiral (Imperial College London) (submittedVersion, public-domain)
  • UCL Discovery (University College London) (submittedVersion)
  • University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, other-oa)
  • IUScholarWorks (Indiana University) (submittedVersion)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
  • Health Sciences › Medicine › Nephrology › Chronic Kidney Disease and Diabetes
Keywords
canagliflozin, type 2 diabetes, chronic kidney disease, hypertension, systolic blood pressure, resistant hypertension, blood pressure-lowering therapy, SGLT2 inhibitors, renal failure, cardiovascular outcomes, CREDENCE trial, subgroup analysis, diuretics, renal outcomes, safety outcomes, adverse events, hypoglycemia
MeSH terms
Canagliflozin, Sodium-Glucose Transporter 2 Inhibitors, Diabetes Mellitus, Type 2, Female, Humans, Male, Middle Aged, Renal Insufficiency, Chronic

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