Nephro Trial Files: Lower Dose PD vs. Intermittent HD in AKI, Semaglutide for CKD in T2DM, and Posoleucel for BK Viremia
Lower Dosage Acute Peritoneal Dialysis versus Acute Intermittent Hemodialysis in Acute Kidney Injury
Parapiboon W et al. CJASN (May 2024)
Bottom Line: This multicenter randomized controlled trial compared the outcomes between acute lower dosage PD and intermittent HD in patients with AKI. The primary outcome was 28-day mortality rate and secondary outcomes included dialysis-free survival, kidney recovery, metabolic profile, and procedure-related complications. The study found no significant difference in 28-day mortality between the two groups. However, there were more frequent intradialytic hypotension in the intermittent HD group and more frequent hypokalemia in the PD group. The study suggests that acute PD may be a viable alternative to intermittent HD in patients with AKI.
Effects of Semaglutide on Chronic Kidney Disease in Patients with Type 2 Diabetes
Perkovic V et al. NEJM (May 2024)
Bottom Line: This randomized controlled trial, with a median follow-up of 3.4 years, evaluated the efficacy and safety of subcutaneous semaglutide at a dose of 1.0 mg weekly in patients with type 2 diabetes and chronic kidney disease. The primary outcome was major kidney disease events, and the results showed a 24% lower risk in the semaglutide group compared to the placebo group. Secondary outcomes, including the mean annual eGFR slope, risk of major cardiovascular events, and risk of death from any cause, also favored semaglutide. Serious adverse events were reported in a lower percentage of participants in the semaglutide group. In conclusion, semaglutide reduced the risk of clinically important kidney outcomes and death from cardiovascular causes in this patient population.
Posoleucel in Kidney Transplant Recipients with BK Viremia
Chandraker A et al. JASN (May 2024)
Bottom Line: This phase 2, double-blind study evaluated the safety and efficacy of posoleucel, an off-the-shelf, allogeneic, multivirus-specific T-cell investigational therapy, in kidney transplant recipients with BK viremia. Participants were randomized to receive posoleucel or placebo for 12 weeks and followed for an additional 12 weeks. The primary outcome was a reduction in BK viremia, which was significantly greater in posoleucel recipients compared to placebo. Posoleucel was generally safe and well tolerated, with no serious adverse events or treatment-related deaths. The presence and persistence of posoleucel was confirmed by T-cell receptor sequencing. This study suggests that posoleucel may be a promising treatment for BK virus infection in kidney transplant recipients, but further research is needed to confirm these findings.
Nephro Trial Files Issue #NPH-2024-12
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