Nephrology

Integrated BP, glucose, and BMI control linked to fewer CVD and CKD events in CKD cohort

In 42,763 CKD patients, achieving management of all assessed metabolic risk factors reduced CVD (HR 0.69) and CKD progression (HR 0.79). The combination of blood pressure, glucose, and BMI control showed the strongest protection for both CVD (HR 0.66) and CKD progression. Effects were dose-dependent across the number of risk factors controlled over up to 64,699 person-years. This is an observational cohort; residual confounding and unmeasured care differences may influence effect sizes. 1

Renal impairment and hemodialysis substantially increase nacubactam exposure

Nacubactam clearance fell markedly with worsening renal function, producing AUC increases of 2-fold, 3.7-fold, and 6.6-fold for mild, moderate, and severe impairment respectively. Renal clearance reductions paralleled total clearance declines, demonstrating near-exclusive renal elimination. Hemodialysis removed >60% of a single 1 g IV dose during a 4-hour session. Safety after a single 1 g dose was acceptable across groups, but dosing recommendations should account for renal function and dialysis removal. 2

NT-proBNP discriminates cardiovascular risk in CKD patients with HFrEF more than renal outcomes

In 14,758 propensity-matched CKD patients with HF, HFrEF had higher NT-proBNP and greater risks of mortality (HR 1.09) and MACE (HR 1.17) over three years. Major adverse kidney events did not differ between HFrEF and HFpEF groups, limiting NT-proBNP's renal prognostic utility. Elevated NT-proBNP strongly associated with adverse cardiovascular outcomes within the HFrEF subgroup. Results are retrospective and may not define NT-proBNP thresholds for clinical decision-making in CKD. 3