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Lyubov Chaykovska - One of the best experts on this subject based on the ideXlab platform.

  • Urinary cGMP predicts major adverse Renal events in patients with Mild Renal Impairment and/or diabetes mellitus before exposure to contrast medium
    PloS one, 2018
    Co-Authors: Lyubov Chaykovska, Fabian Heunisch, Gina Von Einem, Axel Kretschmer, Carl-friedrich Hocher, Oleg Tsuprykov, Mira Pavkovic, Peter Sandner, Chang Chu, Saban Elitok
    Abstract:

    Background The use of iodine-based contrast agents entails the risk of contrast induced nephropathy (CIN). Radiocontrast agents elicit the third most common cause of nephropathy among hospitalized patients, accounting for 11–12% of cases. CIN is connected with clinically significant consequences, including increased morbidity, prolonged hospitalization, increased risk of complications, potential need for dialysis, and increased mortality rate. The number of in-hospital examinations using iodine-based contrast media has been significantly increasing over the last decade. In order to protect patients from possible complications of such examinations, new biomarkers are needed that are able to predict a risk of contrast-induced nephropathy. Urinary and plasma cyclic guanosine monophosphate (cGMP) concentrations are influenced by Renal function. Urinary cGMP is primarily of Renal cellular origin. Therefore, we assessed if urinary cGMP concentration may predict major adverse Renal events (MARE) after contrast media exposure during coronary angiography. Methods Urine samples were prospectively collected from non-randomized consecutive patients with either diabetes or preexisting impaired kidney function receiving intra-arterial contrast medium (CM) for emergent or elective coronary angiography at the Charite Campus Mitte, University Hospital Berlin. Urinary cGMP concentration in spot urine was analyzed 24 hours after CM exposure. Patients were followed up over 90 days for occurrence of death, initiation of dialysis, doubling of plasma creatinine concentration or MARE. Results In total, 289 consecutive patients were included into the study. Urine cGMP/creatinine ratio 24 hours before CM exposure expressed as mean±SD was predictive for the need of dialysis (no dialysis: 89.77±92.85 μM/mM, n = 277; need for dialysis: 140.3±82.90 μM/mM, n = 12, p = 0.008), death (no death during follow-up: 90.60±92.50 μM/mM, n = 280; death during follow-up: 169.88±81.52 μM/mM, n = 9; p = 0.002), and the composite endpoint MARE (no MARE: 86.02±93.17 μM/mM, n = 271; MARE: 146.64±74.68 μM/mM, n = 18, p

  • urinary cgmp predicts major adverse Renal events in patients with Mild Renal Impairment and or diabetes mellitus before exposure to contrast medium
    PLOS ONE, 2018
    Co-Authors: Fabian Heunisch, Lyubov Chaykovska, Gina Von Einem, Carl-friedrich Hocher, Oleg Tsuprykov, Mira Pavkovic, Peter Sandner, Axel Kretschmer
    Abstract:

    Background The use of iodine-based contrast agents entails the risk of contrast induced nephropathy (CIN). Radiocontrast agents elicit the third most common cause of nephropathy among hospitalized patients, accounting for 11–12% of cases. CIN is connected with clinically significant consequences, including increased morbidity, prolonged hospitalization, increased risk of complications, potential need for dialysis, and increased mortality rate. The number of in-hospital examinations using iodine-based contrast media has been significantly increasing over the last decade. In order to protect patients from possible complications of such examinations, new biomarkers are needed that are able to predict a risk of contrast-induced nephropathy. Urinary and plasma cyclic guanosine monophosphate (cGMP) concentrations are influenced by Renal function. Urinary cGMP is primarily of Renal cellular origin. Therefore, we assessed if urinary cGMP concentration may predict major adverse Renal events (MARE) after contrast media exposure during coronary angiography. Methods Urine samples were prospectively collected from non-randomized consecutive patients with either diabetes or preexisting impaired kidney function receiving intra-arterial contrast medium (CM) for emergent or elective coronary angiography at the Charite Campus Mitte, University Hospital Berlin. Urinary cGMP concentration in spot urine was analyzed 24 hours after CM exposure. Patients were followed up over 90 days for occurrence of death, initiation of dialysis, doubling of plasma creatinine concentration or MARE. Results In total, 289 consecutive patients were included into the study. Urine cGMP/creatinine ratio 24 hours before CM exposure expressed as mean±SD was predictive for the need of dialysis (no dialysis: 89.77±92.85 μM/mM, n = 277; need for dialysis: 140.3±82.90 μM/mM, n = 12, p = 0.008), death (no death during follow-up: 90.60±92.50 μM/mM, n = 280; death during follow-up: 169.88±81.52 μM/mM, n = 9; p = 0.002), and the composite endpoint MARE (no MARE: 86.02±93.17 μM/mM, n = 271; MARE: 146.64±74.68 μM/mM, n = 18, p<0.001) during the follow-up of 90 days after contrast media application. cGMP/creatinine ratio stayed significantly increased at values exceeding 120 μM/mM in patients who developed MARE, required dialysis or died. Conclusions Urinary cGMP/creatinine ratio ≥ 120 μM/mM before CM exposure is a promising biomarker for the need of dialysis and all-cause mortality 90 days after CM exposure in patients with preexisting Renal Impairment or diabetes.

  • adma predicts major adverse Renal events in patients with Mild Renal Impairment and or diabetes mellitus undergoing coronary angiography
    Medicine, 2017
    Co-Authors: Fabian Heunisch, Lyubov Chaykovska, Gina Von Einem, Markus Alter, Thomas Dschietzig, Axel Kretschmer, Karl-heinz Kellner, Berthold Hocher
    Abstract:

    AbstractAsymmetric dimethylarginine (ADMA) is a competitive inhibitor of the nitric oxide (NO)-synthase and a biomarker of endothelial dysfunction (ED). ED plays an important role in the pathogenesis of contrast-induced nephropathy (CIN). The aim of our study was to evaluate serum ADMA concentration

  • ADMA predicts major adverse Renal events in patients with Mild Renal Impairment and/or diabetes mellitus undergoing coronary angiography.
    Medicine, 2017
    Co-Authors: Fabian Heunisch, Lyubov Chaykovska, Gina Von Einem, Markus Alter, Thomas Dschietzig, Axel Kretschmer, Karl-heinz Kellner, Berthold Hocher
    Abstract:

    AbstractAsymmetric dimethylarginine (ADMA) is a competitive inhibitor of the nitric oxide (NO)-synthase and a biomarker of endothelial dysfunction (ED). ED plays an important role in the pathogenesis of contrast-induced nephropathy (CIN). The aim of our study was to evaluate serum ADMA concentration

Axel Kretschmer - One of the best experts on this subject based on the ideXlab platform.

  • Urinary cGMP predicts major adverse Renal events in patients with Mild Renal Impairment and/or diabetes mellitus before exposure to contrast medium
    PloS one, 2018
    Co-Authors: Lyubov Chaykovska, Fabian Heunisch, Gina Von Einem, Axel Kretschmer, Carl-friedrich Hocher, Oleg Tsuprykov, Mira Pavkovic, Peter Sandner, Chang Chu, Saban Elitok
    Abstract:

    Background The use of iodine-based contrast agents entails the risk of contrast induced nephropathy (CIN). Radiocontrast agents elicit the third most common cause of nephropathy among hospitalized patients, accounting for 11–12% of cases. CIN is connected with clinically significant consequences, including increased morbidity, prolonged hospitalization, increased risk of complications, potential need for dialysis, and increased mortality rate. The number of in-hospital examinations using iodine-based contrast media has been significantly increasing over the last decade. In order to protect patients from possible complications of such examinations, new biomarkers are needed that are able to predict a risk of contrast-induced nephropathy. Urinary and plasma cyclic guanosine monophosphate (cGMP) concentrations are influenced by Renal function. Urinary cGMP is primarily of Renal cellular origin. Therefore, we assessed if urinary cGMP concentration may predict major adverse Renal events (MARE) after contrast media exposure during coronary angiography. Methods Urine samples were prospectively collected from non-randomized consecutive patients with either diabetes or preexisting impaired kidney function receiving intra-arterial contrast medium (CM) for emergent or elective coronary angiography at the Charite Campus Mitte, University Hospital Berlin. Urinary cGMP concentration in spot urine was analyzed 24 hours after CM exposure. Patients were followed up over 90 days for occurrence of death, initiation of dialysis, doubling of plasma creatinine concentration or MARE. Results In total, 289 consecutive patients were included into the study. Urine cGMP/creatinine ratio 24 hours before CM exposure expressed as mean±SD was predictive for the need of dialysis (no dialysis: 89.77±92.85 μM/mM, n = 277; need for dialysis: 140.3±82.90 μM/mM, n = 12, p = 0.008), death (no death during follow-up: 90.60±92.50 μM/mM, n = 280; death during follow-up: 169.88±81.52 μM/mM, n = 9; p = 0.002), and the composite endpoint MARE (no MARE: 86.02±93.17 μM/mM, n = 271; MARE: 146.64±74.68 μM/mM, n = 18, p

  • urinary cgmp predicts major adverse Renal events in patients with Mild Renal Impairment and or diabetes mellitus before exposure to contrast medium
    PLOS ONE, 2018
    Co-Authors: Fabian Heunisch, Lyubov Chaykovska, Gina Von Einem, Carl-friedrich Hocher, Oleg Tsuprykov, Mira Pavkovic, Peter Sandner, Axel Kretschmer
    Abstract:

    Background The use of iodine-based contrast agents entails the risk of contrast induced nephropathy (CIN). Radiocontrast agents elicit the third most common cause of nephropathy among hospitalized patients, accounting for 11–12% of cases. CIN is connected with clinically significant consequences, including increased morbidity, prolonged hospitalization, increased risk of complications, potential need for dialysis, and increased mortality rate. The number of in-hospital examinations using iodine-based contrast media has been significantly increasing over the last decade. In order to protect patients from possible complications of such examinations, new biomarkers are needed that are able to predict a risk of contrast-induced nephropathy. Urinary and plasma cyclic guanosine monophosphate (cGMP) concentrations are influenced by Renal function. Urinary cGMP is primarily of Renal cellular origin. Therefore, we assessed if urinary cGMP concentration may predict major adverse Renal events (MARE) after contrast media exposure during coronary angiography. Methods Urine samples were prospectively collected from non-randomized consecutive patients with either diabetes or preexisting impaired kidney function receiving intra-arterial contrast medium (CM) for emergent or elective coronary angiography at the Charite Campus Mitte, University Hospital Berlin. Urinary cGMP concentration in spot urine was analyzed 24 hours after CM exposure. Patients were followed up over 90 days for occurrence of death, initiation of dialysis, doubling of plasma creatinine concentration or MARE. Results In total, 289 consecutive patients were included into the study. Urine cGMP/creatinine ratio 24 hours before CM exposure expressed as mean±SD was predictive for the need of dialysis (no dialysis: 89.77±92.85 μM/mM, n = 277; need for dialysis: 140.3±82.90 μM/mM, n = 12, p = 0.008), death (no death during follow-up: 90.60±92.50 μM/mM, n = 280; death during follow-up: 169.88±81.52 μM/mM, n = 9; p = 0.002), and the composite endpoint MARE (no MARE: 86.02±93.17 μM/mM, n = 271; MARE: 146.64±74.68 μM/mM, n = 18, p<0.001) during the follow-up of 90 days after contrast media application. cGMP/creatinine ratio stayed significantly increased at values exceeding 120 μM/mM in patients who developed MARE, required dialysis or died. Conclusions Urinary cGMP/creatinine ratio ≥ 120 μM/mM before CM exposure is a promising biomarker for the need of dialysis and all-cause mortality 90 days after CM exposure in patients with preexisting Renal Impairment or diabetes.

  • adma predicts major adverse Renal events in patients with Mild Renal Impairment and or diabetes mellitus undergoing coronary angiography
    Medicine, 2017
    Co-Authors: Fabian Heunisch, Lyubov Chaykovska, Gina Von Einem, Markus Alter, Thomas Dschietzig, Axel Kretschmer, Karl-heinz Kellner, Berthold Hocher
    Abstract:

    AbstractAsymmetric dimethylarginine (ADMA) is a competitive inhibitor of the nitric oxide (NO)-synthase and a biomarker of endothelial dysfunction (ED). ED plays an important role in the pathogenesis of contrast-induced nephropathy (CIN). The aim of our study was to evaluate serum ADMA concentration

  • ADMA predicts major adverse Renal events in patients with Mild Renal Impairment and/or diabetes mellitus undergoing coronary angiography.
    Medicine, 2017
    Co-Authors: Fabian Heunisch, Lyubov Chaykovska, Gina Von Einem, Markus Alter, Thomas Dschietzig, Axel Kretschmer, Karl-heinz Kellner, Berthold Hocher
    Abstract:

    AbstractAsymmetric dimethylarginine (ADMA) is a competitive inhibitor of the nitric oxide (NO)-synthase and a biomarker of endothelial dysfunction (ED). ED plays an important role in the pathogenesis of contrast-induced nephropathy (CIN). The aim of our study was to evaluate serum ADMA concentration

Fabian Heunisch - One of the best experts on this subject based on the ideXlab platform.

  • Urinary cGMP predicts major adverse Renal events in patients with Mild Renal Impairment and/or diabetes mellitus before exposure to contrast medium
    PloS one, 2018
    Co-Authors: Lyubov Chaykovska, Fabian Heunisch, Gina Von Einem, Axel Kretschmer, Carl-friedrich Hocher, Oleg Tsuprykov, Mira Pavkovic, Peter Sandner, Chang Chu, Saban Elitok
    Abstract:

    Background The use of iodine-based contrast agents entails the risk of contrast induced nephropathy (CIN). Radiocontrast agents elicit the third most common cause of nephropathy among hospitalized patients, accounting for 11–12% of cases. CIN is connected with clinically significant consequences, including increased morbidity, prolonged hospitalization, increased risk of complications, potential need for dialysis, and increased mortality rate. The number of in-hospital examinations using iodine-based contrast media has been significantly increasing over the last decade. In order to protect patients from possible complications of such examinations, new biomarkers are needed that are able to predict a risk of contrast-induced nephropathy. Urinary and plasma cyclic guanosine monophosphate (cGMP) concentrations are influenced by Renal function. Urinary cGMP is primarily of Renal cellular origin. Therefore, we assessed if urinary cGMP concentration may predict major adverse Renal events (MARE) after contrast media exposure during coronary angiography. Methods Urine samples were prospectively collected from non-randomized consecutive patients with either diabetes or preexisting impaired kidney function receiving intra-arterial contrast medium (CM) for emergent or elective coronary angiography at the Charite Campus Mitte, University Hospital Berlin. Urinary cGMP concentration in spot urine was analyzed 24 hours after CM exposure. Patients were followed up over 90 days for occurrence of death, initiation of dialysis, doubling of plasma creatinine concentration or MARE. Results In total, 289 consecutive patients were included into the study. Urine cGMP/creatinine ratio 24 hours before CM exposure expressed as mean±SD was predictive for the need of dialysis (no dialysis: 89.77±92.85 μM/mM, n = 277; need for dialysis: 140.3±82.90 μM/mM, n = 12, p = 0.008), death (no death during follow-up: 90.60±92.50 μM/mM, n = 280; death during follow-up: 169.88±81.52 μM/mM, n = 9; p = 0.002), and the composite endpoint MARE (no MARE: 86.02±93.17 μM/mM, n = 271; MARE: 146.64±74.68 μM/mM, n = 18, p

  • urinary cgmp predicts major adverse Renal events in patients with Mild Renal Impairment and or diabetes mellitus before exposure to contrast medium
    PLOS ONE, 2018
    Co-Authors: Fabian Heunisch, Lyubov Chaykovska, Gina Von Einem, Carl-friedrich Hocher, Oleg Tsuprykov, Mira Pavkovic, Peter Sandner, Axel Kretschmer
    Abstract:

    Background The use of iodine-based contrast agents entails the risk of contrast induced nephropathy (CIN). Radiocontrast agents elicit the third most common cause of nephropathy among hospitalized patients, accounting for 11–12% of cases. CIN is connected with clinically significant consequences, including increased morbidity, prolonged hospitalization, increased risk of complications, potential need for dialysis, and increased mortality rate. The number of in-hospital examinations using iodine-based contrast media has been significantly increasing over the last decade. In order to protect patients from possible complications of such examinations, new biomarkers are needed that are able to predict a risk of contrast-induced nephropathy. Urinary and plasma cyclic guanosine monophosphate (cGMP) concentrations are influenced by Renal function. Urinary cGMP is primarily of Renal cellular origin. Therefore, we assessed if urinary cGMP concentration may predict major adverse Renal events (MARE) after contrast media exposure during coronary angiography. Methods Urine samples were prospectively collected from non-randomized consecutive patients with either diabetes or preexisting impaired kidney function receiving intra-arterial contrast medium (CM) for emergent or elective coronary angiography at the Charite Campus Mitte, University Hospital Berlin. Urinary cGMP concentration in spot urine was analyzed 24 hours after CM exposure. Patients were followed up over 90 days for occurrence of death, initiation of dialysis, doubling of plasma creatinine concentration or MARE. Results In total, 289 consecutive patients were included into the study. Urine cGMP/creatinine ratio 24 hours before CM exposure expressed as mean±SD was predictive for the need of dialysis (no dialysis: 89.77±92.85 μM/mM, n = 277; need for dialysis: 140.3±82.90 μM/mM, n = 12, p = 0.008), death (no death during follow-up: 90.60±92.50 μM/mM, n = 280; death during follow-up: 169.88±81.52 μM/mM, n = 9; p = 0.002), and the composite endpoint MARE (no MARE: 86.02±93.17 μM/mM, n = 271; MARE: 146.64±74.68 μM/mM, n = 18, p<0.001) during the follow-up of 90 days after contrast media application. cGMP/creatinine ratio stayed significantly increased at values exceeding 120 μM/mM in patients who developed MARE, required dialysis or died. Conclusions Urinary cGMP/creatinine ratio ≥ 120 μM/mM before CM exposure is a promising biomarker for the need of dialysis and all-cause mortality 90 days after CM exposure in patients with preexisting Renal Impairment or diabetes.

  • adma predicts major adverse Renal events in patients with Mild Renal Impairment and or diabetes mellitus undergoing coronary angiography
    Medicine, 2017
    Co-Authors: Fabian Heunisch, Lyubov Chaykovska, Gina Von Einem, Markus Alter, Thomas Dschietzig, Axel Kretschmer, Karl-heinz Kellner, Berthold Hocher
    Abstract:

    AbstractAsymmetric dimethylarginine (ADMA) is a competitive inhibitor of the nitric oxide (NO)-synthase and a biomarker of endothelial dysfunction (ED). ED plays an important role in the pathogenesis of contrast-induced nephropathy (CIN). The aim of our study was to evaluate serum ADMA concentration

  • ADMA predicts major adverse Renal events in patients with Mild Renal Impairment and/or diabetes mellitus undergoing coronary angiography.
    Medicine, 2017
    Co-Authors: Fabian Heunisch, Lyubov Chaykovska, Gina Von Einem, Markus Alter, Thomas Dschietzig, Axel Kretschmer, Karl-heinz Kellner, Berthold Hocher
    Abstract:

    AbstractAsymmetric dimethylarginine (ADMA) is a competitive inhibitor of the nitric oxide (NO)-synthase and a biomarker of endothelial dysfunction (ED). ED plays an important role in the pathogenesis of contrast-induced nephropathy (CIN). The aim of our study was to evaluate serum ADMA concentration

Samuel S. Engel - One of the best experts on this subject based on the ideXlab platform.

  • Safety and Efficacy of Sitagliptin (SITA) Compared with Dapagliflozin (DAPA) in Subjects with T2D, Mild Renal Impairment, and Inadequate Glycemic Control on Metformin (MET) ± a Sulfonylurea (SU)
    Diabetes, 2018
    Co-Authors: Russell S. Scott, Edward A. O'neill, Keith D. Kaufman, Samuel S. Engel, Jerry D. Morgan, Zachary Zimmer, Raymond L. H. Lam, Annaswamy Raji
    Abstract:

    While choice of AHAs may be modified in patients with T2D and moderate or severe Renal insufficiency, this is generally not the case in patients with Mild Renal insufficiency. Clinical trial data focused on this population, which represents ∼40% of patients with T2D, are lacking. In a randomized, double-blind, active comparator-controlled clinical trial, the safety and efficacy of adding SITA (100 mg qd) or DAPA (10 mg qd) to treatment of patients with eGFR ≥60 and 2 and A1C ≥7.0% and ≤9.5% while on MET ± SU were assessed. The primary efficacy endpoint was change from baseline A1C at Week 24 (analyzed with a constrained longitudinal data analysis model), with a primary hypothesis of non-inferiority of SITA to DAPA based on the prespecified criterion of the upper bound of the between-treatment difference 95% CI (SITA minus DAPA) Treatment groups were well-balanced at baseline ( n = 307 and 306, mean A1C [%] = 7.7 and 7.8, mean eGFR [mL/min/1.73 m 2 ] = 79.4 and 76.9 for SITA and DAPA, respectively). At Week 24, LS mean changes from baseline A1C were -0.51% (SITA) and -0.36% (DAPA); between-group difference = -0.15%, 95% CI (-0.26, -0.04), p=0.006, confirming both non-inferiority and superiority of SITA vs. DAPA. The pre-specified analysis of 2 hour post-prandial glycemic excursion showed no significant difference between groups. The A1C goal of In summary, SITA treatment over 24 weeks resulted in greater glycemic efficacy and greater % of patients at A1C goal than DAPA in patients with T2D and Mild Renal Impairment who were inadequately controlled on MET ± SU. Disclosure R.S. Scott: None. J.D. Morgan: Employee; Self; Merck & Co., Inc. Z. Zimmer: Employee; Self; Merck & Co., Inc. R.L.H. Lam: Employee; Self; Merck & Co., Inc. E.A. O9Neill: Employee; Self; Merck & Co., Inc. K.D. Kaufman: Employee; Self; Merck & Co., Inc. S.S. Engel: Employee; Self; Merck & Co., Inc.. Stock/Shareholder; Self; Merck & Co., Inc. A. Raji: Employee; Self; Merck & Co., Inc..

  • Comparison of Treatment with Sitagliptin or Sulfonylurea in Patients with Type 2 Diabetes Mellitus and Mild Renal Impairment: A Post Hoc Analysis of Clinical Trials
    Diabetes Therapy, 2015
    Co-Authors: Elizabeth S. Ommen, Edward A. O'neill, Barry J. Goldstein, Keith D. Kaufman, Samuel S. Engel
    Abstract:

    Introduction Impaired Renal function is a major complication of type 2 diabetes mellitus (T2DM). Mild Renal Impairment is present in 38% of patients with T2DM and may impact choice of antihyperglycemic agent. Sulfonylureas and dipeptidyl peptidase-4 (DPP-4) inhibitors are commonly used to treat hyperglycemia in patients with T2DM and Renal Impairment. Although in general sulfonylurea use is associated with an increased risk of hypoglycemia and weight gain, while DPP-4 inhibitor use is associated with a low risk of hypoglycemia, and is weight neutral, the relative efficacy and tolerability of these agents in patients with Mild Renal Impairment has not been evaluated.

  • Comparison of treatment with sitagliptin or sulfonylurea in patients with type 2 diabetes mellitus and Mild Renal Impairment: a post hoc analysis of clinical trials.
    Diabetes therapy : research treatment and education of diabetes and related disorders, 2015
    Co-Authors: Elizabeth S. Ommen, Edward A. O'neill, Barry J. Goldstein, Keith D. Kaufman, Samuel S. Engel
    Abstract:

    Impaired Renal function is a major complication of type 2 diabetes mellitus (T2DM). Mild Renal Impairment is present in 38% of patients with T2DM and may impact choice of antihyperglycemic agent. Sulfonylureas and dipeptidyl peptidase-4 (DPP-4) inhibitors are commonly used to treat hyperglycemia in patients with T2DM and Renal Impairment. Although in general sulfonylurea use is associated with an increased risk of hypoglycemia and weight gain, while DPP-4 inhibitor use is associated with a low risk of hypoglycemia, and is weight neutral, the relative efficacy and tolerability of these agents in patients with Mild Renal Impairment has not been evaluated. In a post hoc analysis, data from 1,211 subjects with T2DM and Mild Renal Impairment (estimated glomerular filtration rates of 60 to <90 mL/min/1.73 m(2)), who completed 25 or 30 weeks of one of three double-blind clinical trials comparing the DPP-4 inhibitor sitagliptin 100 mg/day with sulfonylureas in titrated doses, were pooled. The analysis compared change from baseline in glycated hemoglobin (HbA1c), fasting plasma glucose (FPG), body weight, incidence of symptomatic hypoglycemia and the percentages of subjects meeting a composite endpoint of HbA1c decrease >0.5% without symptomatic hypoglycemia or body weight gain between sitagliptin and sulfonylurea treatment groups. HbA1c and FPG decreased similarly with sitagliptin or sulfonylurea. A lower incidence of hypoglycemia was observed with sitagliptin. Body weight decreased with sitagliptin but increased with sulfonylurea. A greater percentage of subjects treated with sitagliptin (41.1%) than treated with sulfonylurea (16.9%) achieved the composite endpoint of >0.5% HbA1c reduction with no symptomatic hypoglycemia or body weight gain. In this analysis of subjects with T2DM and Mild Renal Impairment, treatment with sitagliptin provided glycemic efficacy similar to sulfonylurea, with less hypoglycemia and with body weight loss compared to body weight gain seen with sulfonylurea. ClinicalTrials.gov #NCT00482079, #NCT00094770, #NCT00701090.

Gina Von Einem - One of the best experts on this subject based on the ideXlab platform.

  • Urinary cGMP predicts major adverse Renal events in patients with Mild Renal Impairment and/or diabetes mellitus before exposure to contrast medium
    PloS one, 2018
    Co-Authors: Lyubov Chaykovska, Fabian Heunisch, Gina Von Einem, Axel Kretschmer, Carl-friedrich Hocher, Oleg Tsuprykov, Mira Pavkovic, Peter Sandner, Chang Chu, Saban Elitok
    Abstract:

    Background The use of iodine-based contrast agents entails the risk of contrast induced nephropathy (CIN). Radiocontrast agents elicit the third most common cause of nephropathy among hospitalized patients, accounting for 11–12% of cases. CIN is connected with clinically significant consequences, including increased morbidity, prolonged hospitalization, increased risk of complications, potential need for dialysis, and increased mortality rate. The number of in-hospital examinations using iodine-based contrast media has been significantly increasing over the last decade. In order to protect patients from possible complications of such examinations, new biomarkers are needed that are able to predict a risk of contrast-induced nephropathy. Urinary and plasma cyclic guanosine monophosphate (cGMP) concentrations are influenced by Renal function. Urinary cGMP is primarily of Renal cellular origin. Therefore, we assessed if urinary cGMP concentration may predict major adverse Renal events (MARE) after contrast media exposure during coronary angiography. Methods Urine samples were prospectively collected from non-randomized consecutive patients with either diabetes or preexisting impaired kidney function receiving intra-arterial contrast medium (CM) for emergent or elective coronary angiography at the Charite Campus Mitte, University Hospital Berlin. Urinary cGMP concentration in spot urine was analyzed 24 hours after CM exposure. Patients were followed up over 90 days for occurrence of death, initiation of dialysis, doubling of plasma creatinine concentration or MARE. Results In total, 289 consecutive patients were included into the study. Urine cGMP/creatinine ratio 24 hours before CM exposure expressed as mean±SD was predictive for the need of dialysis (no dialysis: 89.77±92.85 μM/mM, n = 277; need for dialysis: 140.3±82.90 μM/mM, n = 12, p = 0.008), death (no death during follow-up: 90.60±92.50 μM/mM, n = 280; death during follow-up: 169.88±81.52 μM/mM, n = 9; p = 0.002), and the composite endpoint MARE (no MARE: 86.02±93.17 μM/mM, n = 271; MARE: 146.64±74.68 μM/mM, n = 18, p

  • urinary cgmp predicts major adverse Renal events in patients with Mild Renal Impairment and or diabetes mellitus before exposure to contrast medium
    PLOS ONE, 2018
    Co-Authors: Fabian Heunisch, Lyubov Chaykovska, Gina Von Einem, Carl-friedrich Hocher, Oleg Tsuprykov, Mira Pavkovic, Peter Sandner, Axel Kretschmer
    Abstract:

    Background The use of iodine-based contrast agents entails the risk of contrast induced nephropathy (CIN). Radiocontrast agents elicit the third most common cause of nephropathy among hospitalized patients, accounting for 11–12% of cases. CIN is connected with clinically significant consequences, including increased morbidity, prolonged hospitalization, increased risk of complications, potential need for dialysis, and increased mortality rate. The number of in-hospital examinations using iodine-based contrast media has been significantly increasing over the last decade. In order to protect patients from possible complications of such examinations, new biomarkers are needed that are able to predict a risk of contrast-induced nephropathy. Urinary and plasma cyclic guanosine monophosphate (cGMP) concentrations are influenced by Renal function. Urinary cGMP is primarily of Renal cellular origin. Therefore, we assessed if urinary cGMP concentration may predict major adverse Renal events (MARE) after contrast media exposure during coronary angiography. Methods Urine samples were prospectively collected from non-randomized consecutive patients with either diabetes or preexisting impaired kidney function receiving intra-arterial contrast medium (CM) for emergent or elective coronary angiography at the Charite Campus Mitte, University Hospital Berlin. Urinary cGMP concentration in spot urine was analyzed 24 hours after CM exposure. Patients were followed up over 90 days for occurrence of death, initiation of dialysis, doubling of plasma creatinine concentration or MARE. Results In total, 289 consecutive patients were included into the study. Urine cGMP/creatinine ratio 24 hours before CM exposure expressed as mean±SD was predictive for the need of dialysis (no dialysis: 89.77±92.85 μM/mM, n = 277; need for dialysis: 140.3±82.90 μM/mM, n = 12, p = 0.008), death (no death during follow-up: 90.60±92.50 μM/mM, n = 280; death during follow-up: 169.88±81.52 μM/mM, n = 9; p = 0.002), and the composite endpoint MARE (no MARE: 86.02±93.17 μM/mM, n = 271; MARE: 146.64±74.68 μM/mM, n = 18, p<0.001) during the follow-up of 90 days after contrast media application. cGMP/creatinine ratio stayed significantly increased at values exceeding 120 μM/mM in patients who developed MARE, required dialysis or died. Conclusions Urinary cGMP/creatinine ratio ≥ 120 μM/mM before CM exposure is a promising biomarker for the need of dialysis and all-cause mortality 90 days after CM exposure in patients with preexisting Renal Impairment or diabetes.

  • adma predicts major adverse Renal events in patients with Mild Renal Impairment and or diabetes mellitus undergoing coronary angiography
    Medicine, 2017
    Co-Authors: Fabian Heunisch, Lyubov Chaykovska, Gina Von Einem, Markus Alter, Thomas Dschietzig, Axel Kretschmer, Karl-heinz Kellner, Berthold Hocher
    Abstract:

    AbstractAsymmetric dimethylarginine (ADMA) is a competitive inhibitor of the nitric oxide (NO)-synthase and a biomarker of endothelial dysfunction (ED). ED plays an important role in the pathogenesis of contrast-induced nephropathy (CIN). The aim of our study was to evaluate serum ADMA concentration

  • ADMA predicts major adverse Renal events in patients with Mild Renal Impairment and/or diabetes mellitus undergoing coronary angiography.
    Medicine, 2017
    Co-Authors: Fabian Heunisch, Lyubov Chaykovska, Gina Von Einem, Markus Alter, Thomas Dschietzig, Axel Kretschmer, Karl-heinz Kellner, Berthold Hocher
    Abstract:

    AbstractAsymmetric dimethylarginine (ADMA) is a competitive inhibitor of the nitric oxide (NO)-synthase and a biomarker of endothelial dysfunction (ED). ED plays an important role in the pathogenesis of contrast-induced nephropathy (CIN). The aim of our study was to evaluate serum ADMA concentration