The DOI matches its Crossref record, with a small difference in title or year; 19 of the 19 references it cites were found in a registry or an index.
Effects of Canagliflozin in Patients with Baseline eGFR <30 ml/min per 1.73 m2: Subgroup Analysis of the Randomized CREDENCE Trial
Open accessAbstract
Background and objectives: The Canagliflozin and Renal Events in Diabetes with Established Nephropathy Clinical Evaluation (CREDENCE) trial demonstrated that the sodium glucose cotransporter 2 (SGLT2) inhibitor canagliflozin reduced the risk of kidney failure and cardiovascular events in participants with type 2 diabetes mellitus and CKD. Little is known about the use of SGLT2 inhibitors in patients with eGFR <30 ml/min per 1.73 m 2 . The participants in the CREDENCE study had type 2 diabetes mellitus, a urinary albumin-creatinine ratio >300–5000 mg/g, and an eGFR of 30 to <90 ml/min per 1.73 m 2 at screening. This post hoc analysis evaluated participants with eGFR <30 ml/min per 1.73 m 2 at randomization. Design, setting, participants, & measurements: Effects of eGFR slope through week 130 were analyzed using a piecewise, linear, mixed-effects model. Efficacy was analyzed in the intention-to-treat population, on the basis of Cox proportional hazard models, and safety was analyzed in the on-treatment population. At randomization (an average of 29 days after screening), 174 of 4401 (4%) participants had an eGFR <30 ml/min per 1.73 m 2 (mean [SD] eGFR, 26 [3] ml/min per 1.73 m 2 ). Results: From weeks 3 to 130, there was a 66% difference in the mean rate of eGFR decline with canagliflozin versus placebo (mean slopes, −1.30 versus −3.83 ml/min per 1.73 m 2 per year; difference, −2.54 ml/min per 1.73 m 2 per year; 95% confidence interval [CI], 0.90 to 4.17). Effects of canagliflozin on kidney, cardiovascular, and mortality outcomes were consistent for those with eGFR <30 and ≥30 ml/min per 1.73 m 2 (all P interaction >0.20). The estimate for kidney failure in participants with eGFR <30 ml/min per 1.73 m 2 (hazard ratio, 0.67; 95% CI, 0.35 to 1.27) was similar to those with eGFR ≥30 ml/min per 1.73 m 2 (hazard ratio, 0.70; 95% CI, 0.54 to 0.91; P interaction=0.80). There was no imbalance in the rate of kidney-related adverse events or AKI associated with canagliflozin between participants with eGFR <30 and ≥30 ml/min per 1.73 m 2 (all P interaction >0.12). Conclusions: This post hoc analysis suggests canagliflozin slowed progression of kidney disease, without increasing AKI, even in participants with eGFR <30 ml/min per 1.73 m 2 .
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“In addition, post hoc analyses of CREDENCE and DAPA-CKD demonstrated that participants who met eGFR eligibility at screening but subsequently had lower baseline eGFR prior to randomization ( < 30 ml/min per 1.73 m 2 and < 25 ml/min per 1.73 m 2 , respectively) experienced similar kidney bene fi ts as those with baseline eGFR above eligibility thresholds.”
From KDIGO 2022 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease (2022) · cites this paper as [140]
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“Additional support comes from subgroup analyses of participants in the CREDENCE and DAPA-CKD trials with baseline eGFR <30 mL/min/1.73 m2 (59,60).”
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“Subgroup analyses of individual trials and meta-analyses have consistently demonstrated kidney and cardiovascular benefits across eGFR categories, including participants with eGFR <30 ml/min per 1.73 m 2 and participants without albuminuria.16,17”
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Cites
Brenner, B. M., Cooper, M. E., de Zeeuw, D., Keane, W. F., Mitch, W. E., Parving, H.-H., Remuzzi, G., Snapinn, S. M., Zhang, Z., & Shahinfar, S. (2001) · New England Journal of Medicine · doi:10.1056/nejmoa011161 · Cited by 7,493
Dapagliflozin in Patients with Heart Failure and Reduced Ejection Fraction
McMurray, J. J. V., Solomon, S. D., Inzucchi, S. E., Køber, L., Kosiborod, M. N., Martinez, F. A., Ponikowski, P., Sabatine, M. S., Anand, I. S., Bělohlávek, J., et al. (2019) · New England Journal of Medicine · doi:10.1056/nejmoa1911303 · Cited by 7,140
Canagliflozin and Renal Outcomes in Type 2 Diabetes and Nephropathy
Perkovic, V., Jardine, M. J., Neal, B., Bompoint, S., Heerspink, H. J. L., Charytan, D. M., Edwards, R., Agarwal, R., Bakris, G., Bull, S., et al. (2019) · New England Journal of Medicine · doi:10.1056/nejmoa1811744 · Cited by 6,189
Self-citationLewis, E. J., Hunsicker, L. G., Clarke, W. R., Berl, T., Pohl, M. A., Lewis, J. B., Ritz, E., Atkins, R. C., Rohde, R., & Raz, I. (2001) · New England Journal of Medicine · doi:10.1056/nejmoa011303 · Cited by 5,987
Dapagliflozin in Patients with Chronic Kidney Disease
Heerspink, H. J. L., Stefánsson, B. V., Correa-Rotter, R., Chertow, G. M., Greene, T., Hou, F.-F., Mann, J. F. E., McMurray, J. J. V., Lindberg, M., Rossing, P., et al. (2020) · New England Journal of Medicine · doi:10.1056/nejmoa2024816 · Cited by 5,618
Self-citationThe effect of angiotensin-converting-enzyme inhibition on diabetic nephropathy
Lewis, E. J., Hunsicker, L. G., Bain, R. P., & Rohde, R. D. (1993) · New England Journal of Medicine · doi:10.1056/nejm199311113292004 · Cited by 5,394
Zelniker, T. A., Wiviott, S. D., Raz, I., Im, K., Goodrich, E. L., Bonaca, M. P., Mosenzon, O., Kato, E. T., Cahn, A., Furtado, R. H. M., et al. (2019) · The Lancet · doi:10.1016/s0140-6736(18)32590-x · Cited by 2,845
Clinical manifestations of kidney disease among US adults with diabetes, 1988-2014
Afkarian, M., Zelnick, L. R., Hall, Y. N., Heagerty, P. J., Tuttle, K., Weiss, N. S., & de Boer, I. H. (2016) · JAMA · doi:10.1001/jama.2016.10924 · Cited by 1,026
Levey, A. S., Gansevoort, R. T., Coresh, J., Inker, L. A., Heerspink, H. L., Grams, M. E., Greene, T., Tighiouart, H., Matsushita, K., Ballew, S. H., et al. (2020) · American Journal of Kidney Diseases · doi:10.1053/j.ajkd.2019.06.009 · Cited by 591
Self-citationCherney, D. Z. I., Dekkers, C. C. J., Barbour, S. J., Cattran, D., Abdul Gafor, A. H., Greasley, P. J., Laverman, G. D., Lim, S. K., Di Tanna, G. L., Reich, H. N., et al. (2020) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(20)30162-5 · Cited by 283
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KDIGO 2022 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease
Rossing, P., Caramori, M. L., Chan, J. C. N., Heerspink, H. J. L., Hurst, C., Khunti, K., Liew, A., Michos, E. D., Navaneethan, S. D., Olowu, W. A., et al. (2022) · Kidney International · doi:10.1016/j.kint.2022.06.008 · Cited by 1,373
Self-citationde Boer, I. H., Khunti, K., Sadusky, T., Tuttle, K. R., Neumiller, J. J., Rhee, C. M., Rosas, S. E., Rossing, P., & Bakris, G. (2022) · Diabetes Care · doi:10.2337/dci22-0027 · Cited by 919
“73 m(2).(59,60) Based on these results, direct evidence supporting initiation of an SGLT2i for patients with T2D and eGFR 20–29 ml/min/1.”
BackgroundSelf-citationde Boer, I. H., Khunti, K., Sadusky, T., Tuttle, K. R., Neumiller, J. J., Rhee, C. M., Rosas, S. E., Rossing, P. R., & Bakris, G. L. (2022) · Kidney International · doi:10.1016/j.kint.2022.08.012 · Cited by 389
Self-citationRossing, P., Caramori, M. L., Chan, J. C. N., Heerspink, H. J. L., Hurst, C., Khunti, K., Liew, A., Michos, E. D., Navaneethan, S. D., Olowu, W. A., et al. (2022) · Kidney International · doi:10.1016/j.kint.2022.06.013 · Cited by 274
Self-citationBarrera‐Chimal, J., Lima‐Posada, I., Bakris, G. L., & Jaisser, F. (2021) · Nature Reviews Nephrology · doi:10.1038/s41581-021-00490-8 · Cited by 266
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Metadata
- Authors
- Bakris, G., Oshima, M., Mahaffey, K. W., Agarwal, R., Cannon, C. P., Capuano, G., Charytan, D. M., de Zeeuw, D., Edwards, R., Greene, T., Heerspink, H. J. L., Levin, A., Neal, B., Oh, R., Pollock, C., Rosenthal, N., Wheeler, D. C., Zhang, H., Zinman, B., Jardine, M. J., & Perkovic, V.
- Affiliations
- University of Chicago (US)
- Kanazawa University (JP)
- Stanford Medicine (US)
- Richard L. Roudebush VA Medical Center (US)
- Brigham and Women's Hospital (US)
- Janssen Research & Development (United States) (US)
- NYU Langone Health (US)
- Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- University of Utah (US)
- University Medical Center Groningen (NL)
- University of British Columbia (CA)
- The University of Sydney (AU)
- UNSW Sydney (AU)
- Peking University First Hospital (CN)
- Mount Sinai Hospital (CA)
- Concord Repatriation General Hospital (AU)
- Royal North Shore Hospital (AU)
- ORCID
- Venue
- Clinical Journal of the American Society of Nephrology
- Published
- 2020-11-19
- Volume
- 15
- Issue
- 12
- Pages
- 1705-1714
- ISSN
- 1555-9041 (ISSN-L)
- 1555-905X
- PMC
- PMC7769025
- OpenAlex
- W3101633024
- Cited by
- 142
- References
- 19
- Citations by year
- 2026: 14 · 2025: 15 · 2024: 24 · 2023: 25 · 2022: 42 · 2021: 21 · 2020: 1
- FWCI
- 13.89
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- public-domain
- Locations
- Clinical Journal of the American Society of Nephrology (publishedVersion, public-domain)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion, other-oa)
- UNSWorks (University of New South Wales, Sydney, Australia) (submittedVersion, cc-by-nc-nd)
- IUScholarWorks (Indiana University) (submittedVersion)
- Purdue University Indianapolis (Indiana University) (submittedVersion)
- Spiral (Imperial College London) (submittedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, other-oa)
- Funders
- Janssen Research & Development
- Topics
- Health Sciences › Medicine › Nephrology › Chronic Kidney Disease and Diabetes
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Nephrology › Acute Kidney Injury Research
- Keywords
- canagliflozin, SGLT2 inhibitors, end-stage renal disease, renal failure, estimated glomerular filtration rate decline, type 2 diabetes, chronic kidney disease, CREDENCE trial, cardiovascular events, mortality, renal safety, albuminuria, eGFR slope, post hoc analysis
- MeSH terms
- Canagliflozin, Sodium-Glucose Transporter 2 Inhibitors, Aged, Diabetes Mellitus, Type 2, Diabetic Nephropathies, Double-Blind Method, Female, Glomerular Filtration Rate, Humans, Kidney, Male, Middle Aged, Risk Factors, Time Factors, Treatment Outcome, Disease Progression, Acute Kidney Injury
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