News

One of the important highlights of the recent ISN World Congress of Nephrology was the Late Breaking Clinical Trials session, which might be remembered as the start of a new era in the management of diabetic kidney disease.

Three trials were presented during this 90-minute session in Melbourne (Australia), including the Study of Diabetic Nephropathy with Atrasentan (SONAR) trial, the Canagliflozin and Renal Endpoints in Diabetes with Established Nephropathy Clinical Evaluation (CREDENCE) trial and the long term follow up of A Clinical Trial of IntensiVE (ACTIVE) Dialysis Study.

Results were also streamed live from the session room to ISN members worldwide.

What is each trial about? Most importantly, what effect will the results have on the future care of patients with diabetic kidney disease?

LONG-TERM FOLLOW UP OF ACTIVE DIALYSIS

This important study did not provide evidence of a mortality benefit from longer dialysis sessions, but the authors cautioned that there remains insufficient evidence to determine the true impact of more intensive hemodialysis on survival.

• 200 participants were randomized to 12 months of extended hours (a total of 24 hours per week) or standard hours (12 hours per week)
• After five years: no difference in mortality between the groups.

SONAR: THE ROLE OF ATRASENTAN

This ground-breaking study shows that Atrasentan (an endothelin receptor A antagonist) slows progression of diabetic kidney disease, although its role in management remains to be further defined.

• 2648 participants with diabetic nephropathy were randomized to Atrasentan or placebo
• 35% reduction in the composite of doubling of serum creatinine, end-stage kidney disease or death from kidney failure.

CREDENCE: SGLT2 INHIBITORS COME OF AGE

This study was the star of the congress and represents an exciting advance in the management of diabetic kidney disease.

• 4401 patients with diabetic nephropathy were randomized to Canagliflozin or placebo
• 30% reduction in the composite of end-stage kidney disease, doubling of serum creatinine, or death from renal or cardiovascular causes
• 32% reduction in end-stage kidney disease.

Watch the full recorded session on the ISN Academy.