{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T22:20:43Z","timestamp":1791498043818,"version":"4.3.4"},"reference-count":93,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2024,11,13]],"date-time":"2024-11-13T00:00:00Z","timestamp":1731456000000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000769","name":"University of Oxford","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000769","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100001003","name":"Boehringer Ingelheim","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100001003","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000274","name":"British Heart Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000274","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100023699","name":"Health Data Research UK","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100023699","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,5,30]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Patients with chronic kidney disease (CKD) are at risk of progressive loss of kidney function, heart failure, and cardiovascular death despite current proven therapies, including renin-angiotensin system inhibitors (RASi), sodium glucose co-transporter-2 inhibitors (SGLT2i), and statin-based regimens. RASi and SGLT2i reduce risk of CKD progression irrespective of primary cause of kidney disease, suggesting they target final common pathways. Targeting aldosterone overactivity with a nonsteroidal mineralocorticoid receptor antagonist (MRA) also reduces cardiorenal risk in patients with albuminuric diabetic kidney disease already treated with RASi. Together, these observations provide the rationale for trials to assess effects of inhibiting the aldosterone pathway in a broader range of patients with CKD, including those with non-diabetic causes of CKD or low albuminuria. Aldosterone synthase inhibitors (ASi) have emerged as an alternative to MRAs for aldosterone pathway inhibition. Phase II data from 586 patients with albuminuric CKD have shown that 10\u00a0mg of an ASi, vicadrostat (BI 690517), reduced urine albumin-to-creatinine ratio by \u223c40% compared with placebo, with or without concurrent empagliflozin treatment. MRA and ASi increase risk of hyperkalaemia. Combining their use with an SGLT2i may mitigate some of this risk, improving tolerability, and allowing a wider range of patients to be treated (including those with higher levels of blood potassium than in previous trials). The EASi-KIDNEY (NCT06531824) double-blind placebo-controlled trial will test this approach by assessing the safety and cardiorenal efficacy of vicadrostat in combination with empagliflozin in \u223c11\u2009000 patients with CKD. It will be sufficiently large to assess effects in patients with and without diabetes separately.<\/jats:p>","DOI":"10.1093\/ndt\/gfae263","type":"journal-article","created":{"date-parts":[[2024,11,11]],"date-time":"2024-11-11T15:21:01Z","timestamp":1731338461000},"page":"1175-1186","source":"Crossref","is-referenced-by-count":76,"title":["The potential for improving cardio-renal outcomes in chronic kidney disease with the aldosterone synthase inhibitor vicadrostat (BI 690517): a rationale for the EASi-KIDNEY trial"],"prefix":"10.1093","volume":"40","author":[{"given":"Parminder K","family":"Judge","sequence":"first","affiliation":[{"name":"University of Oxford Renal Studies Group, Clinical Trial Service Unit & Epidemiological Studies Unit, Nuffield Department of Population Health, , Oxford ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2235-0103","authenticated-orcid":false,"given":"Katherine R","family":"Tuttle","sequence":"additional","affiliation":[{"name":"Spokane, WA and University of Washington Providence Inland Northwest Health, , Seattle, WA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalie","family":"Staplin","sequence":"additional","affiliation":[{"name":"University of Oxford Renal Studies Group, Clinical Trial Service Unit & Epidemiological Studies Unit, Nuffield Department of Population Health, , Oxford ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sibylle J","family":"Hauske","sequence":"additional","affiliation":[{"name":"Boehringer Ingelheim International GmbH , Ingelheim ,","place":["Germany"]},{"name":"University Medical Center Mannheim, Heidelberg University Vth Department of Medicine, , Mannheim ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doreen","family":"Zhu","sequence":"additional","affiliation":[{"name":"University of Oxford Renal Studies Group, Clinical Trial Service Unit & Epidemiological Studies Unit, Nuffield Department of Population Health, , Oxford ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Sardell","sequence":"additional","affiliation":[{"name":"University of Oxford Renal Studies Group, Clinical Trial Service Unit & Epidemiological Studies Unit, Nuffield Department of Population Health, , Oxford ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Cronin","sequence":"additional","affiliation":[{"name":"Boehringer Ingelheim International GmbH , Ingelheim ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer B","family":"Green","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute , Durham, NC ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikita","family":"Agrawal","sequence":"additional","affiliation":[{"name":"University of Oxford Renal Studies Group, Clinical Trial Service Unit & Epidemiological Studies Unit, Nuffield Department of Population Health, , Oxford ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryoki","family":"Arimoto","sequence":"additional","affiliation":[{"name":"University of Oxford Renal Studies Group, Clinical Trial Service Unit & Epidemiological Studies Unit, Nuffield Department of Population Health, , Oxford ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5695-0270","authenticated-orcid":false,"given":"Kaitlin J","family":"Mayne","sequence":"additional","affiliation":[{"name":"University of Oxford Renal Studies Group, Clinical Trial Service Unit & Epidemiological Studies Unit, Nuffield Department of Population Health, , Oxford ,","place":["UK"]},{"name":"College of Medical and Veterinary Life Sciences, University of Glasgow School of Cardiovascular and Metabolic Health, , Glasgow ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8647-0366","authenticated-orcid":false,"given":"Emily","family":"Sammons","sequence":"additional","affiliation":[{"name":"University of Oxford Renal Studies Group, Clinical Trial Service Unit & Epidemiological Studies Unit, Nuffield Department of Population Health, , Oxford ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Brueckmann","sequence":"additional","affiliation":[{"name":"Boehringer Ingelheim International GmbH , Ingelheim ,","place":["Germany"]},{"name":"University Medical Center Mannheim, Heidelberg University Ist Department of Medicine, , Mannheim ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shimoli V","family":"Shah","sequence":"additional","affiliation":[{"name":"Boehringer Ingelheim International GmbH , Ingelheim ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1531-4294","authenticated-orcid":false,"given":"Peter","family":"Rossing","sequence":"additional","affiliation":[{"name":"Steno Diabetes Center Copenhagen , Copenhagen ,","place":["Denmark"]},{"name":"University of Copenhagen Department of Clinical Medicine, , Copenhagen ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaomi","family":"Nangaku","sequence":"additional","affiliation":[{"name":"University of Tokyo Hospital Division of Nephrology and Endocrinology, , Tokyo ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6646-827X","authenticated-orcid":false,"given":"Martin J","family":"Landray","sequence":"additional","affiliation":[{"name":"University of Oxford Renal Studies Group, Clinical Trial Service Unit & Epidemiological Studies Unit, Nuffield Department of Population Health, , Oxford ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9507-5301","authenticated-orcid":false,"given":"Christoph","family":"Wanner","sequence":"additional","affiliation":[{"name":"University of Oxford Renal Studies Group, Clinical Trial Service Unit & Epidemiological Studies Unit, Nuffield Department of Population Health, , Oxford ,","place":["UK"]},{"name":"W\u00fcrzburg University Clinic of W\u00fcrzburg, ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4856-7420","authenticated-orcid":false,"given":"Colin","family":"Baigent","sequence":"additional","affiliation":[{"name":"University of Oxford Renal Studies Group, Clinical Trial Service Unit & Epidemiological Studies Unit, Nuffield Department of Population Health, , Oxford ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1179-0023","authenticated-orcid":false,"given":"Richard","family":"Haynes","sequence":"additional","affiliation":[{"name":"University of Oxford Renal Studies Group, Clinical Trial Service Unit & Epidemiological Studies Unit, Nuffield Department of Population Health, , Oxford ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1172-8243","authenticated-orcid":false,"given":"William G","family":"Herrington","sequence":"additional","affiliation":[{"name":"University of Oxford Renal Studies Group, Clinical Trial Service Unit & Epidemiological Studies Unit, Nuffield Department of Population Health, , Oxford ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,11,12]]},"reference":[{"key":"2025053005064673500_bib1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lana.2023.100625","article-title":"Reducing the gap of chronic kidney disease in low- and middle-income countries: what is missing?","volume-title":"Lancet Reg Health Am","author":"L\u00f3pez","year":"2023"},{"key":"2025053005064673500_bib2","doi-asserted-by":"publisher","first-page":"e0264393","DOI":"10.1371\/journal.pone.0264393","article-title":"Prevalence of chronic kidney disease stages 3-5 in low- and middle-income countries in Asia: a systematic review and meta-analysis","volume":"17","author":"Suriyong","year":"2022","journal-title":"PLoS One"},{"key":"2025053005064673500_bib3","doi-asserted-by":"publisher","first-page":"165","DOI":"10.1016\/S0140-6736(11)60178-5","article-title":"Chronic kidney disease","volume":"379","author":"Levey","year":"2012","journal-title":"Lancet"},{"key":"2025053005064673500_bib4","doi-asserted-by":"publisher","first-page":"92","DOI":"10.1038\/sj.ki.5002273","article-title":"Chronic kidney disease management in the United Kingdom: NEOERICA project results","volume":"72","author":"Stevens","year":"2007","journal-title":"Kidney Int"},{"key":"2025053005064673500_bib5","doi-asserted-by":"publisher","first-page":"1238","DOI":"10.1016\/S0140-6736(16)32064-5","article-title":"Chronic kidney disease","volume":"389","author":"Webster","year":"2017","journal-title":"Lancet"},{"key":"2025053005064673500_bib6","doi-asserted-by":"publisher","first-page":"1662","DOI":"10.1016\/S0140-6736(12)61350-6","article-title":"Associations of kidney disease measures with mortality and end-stage renal disease in individuals with and without diabetes: a meta-analysis","volume":"380","author":"Fox","year":"2012","journal-title":"Lancet"},{"key":"2025053005064673500_bib7","doi-asserted-by":"publisher","first-page":"749","DOI":"10.1093\/ckj\/sfy090","article-title":"The potential for improving cardio-renal outcomes by sodium-glucose co-transporter-2 inhibition in people with chronic kidney disease: a rationale for the EMPA-KIDNEY study","volume":"11","author":"Herrington","year":"2018","journal-title":"Clin Kidney J"},{"key":"2025053005064673500_bib8","doi-asserted-by":"publisher","first-page":"2671","DOI":"10.1161\/HYPERTENSIONAHA.122.19354","article-title":"Determining the relationship between blood pressure, kidney function, and chronic kidney disease: insights from genetic epidemiology","volume":"79","author":"Staplin","year":"2022","journal-title":"Hypertension"},{"key":"2025053005064673500_bib9","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1053\/j.ajkd.2013.12.013","article-title":"Evaluating the contribution of the cause of kidney disease to prognosis in CKD: results from the Study of Heart and Renal protection (SHARP)","volume":"64","author":"Haynes","year":"2014","journal-title":"Am J Kidney Dis"},{"key":"2025053005064673500_bib10","doi-asserted-by":"publisher","first-page":"1456","DOI":"10.1056\/NEJM199311113292004","article-title":"The effect of angiotensin-converting-enzyme inhibition on diabetic nephropathy","volume":"329","author":"Lewis","year":"1993","journal-title":"N Engl J Med"},{"key":"2025053005064673500_bib11","doi-asserted-by":"publisher","first-page":"851","DOI":"10.1056\/NEJMoa011303","article-title":"Renoprotective effect of the angiotensin-receptor antagonist irbesartan in patients with nephropathy due to type 2 diabetes","volume":"345","author":"Lewis","year":"2001","journal-title":"N Engl J Med"},{"key":"2025053005064673500_bib12","doi-asserted-by":"publisher","first-page":"861","DOI":"10.1056\/NEJMoa011161","article-title":"Effects of losartan on renal and cardiovascular outcomes in patients with type 2 diabetes and nephropathy","volume":"345","author":"Brenner","year":"2001","journal-title":"N Engl J Med"},{"key":"2025053005064673500_bib13","doi-asserted-by":"publisher","first-page":"73","DOI":"10.7326\/0003-4819-135-2-200107170-00007","article-title":"Angiotensin-converting enzyme inhibitors and progression of nondiabetic renal disease: a meta-analysis of patient-level data","volume":"135","author":"Jafar","year":"2001","journal-title":"Ann Intern Med"},{"key":"2025053005064673500_bib14","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1056\/NEJMoa2204233","article-title":"Empagliflozin in patients with chronic kidney disease","volume":"388","author":"The EMPA-KIDNEY Collaborative Group","year":"2023","journal-title":"N Engl J Med"},{"key":"2025053005064673500_bib15","doi-asserted-by":"publisher","first-page":"1436","DOI":"10.1056\/NEJMoa2024816","article-title":"Dapagliflozin in patients with chronic kidney disease","volume":"383","author":"Heerspink","year":"2020","journal-title":"N Engl J Med"},{"key":"2025053005064673500_bib16","doi-asserted-by":"publisher","first-page":"1788","DOI":"10.1016\/S0140-6736(22)02074-8","article-title":"Impact of diabetes on the effects of sodium glucose co-transporter-2 inhibitors on kidney outcomes: collaborative meta-analysis of large placebo-controlled trials","volume":"400","author":"Nuffield Department of Population Health Renal Studies Group and the SMART-Consortium","year":"2022","journal-title":"Lancet"},{"key":"2025053005064673500_bib17","doi-asserted-by":"publisher","first-page":"323","DOI":"10.1056\/NEJMoa1515920","article-title":"Empagliflozin and progression of kidney disease in type 2 diabetes","volume":"375","author":"Wanner","year":"2016","journal-title":"N Engl J Med"},{"key":"2025053005064673500_bib18","doi-asserted-by":"publisher","first-page":"291","DOI":"10.1681\/ASN.2021070948","article-title":"Acute treatment effects on GFR in randomized clinical trials of kidney disease progression","volume":"33","author":"Neuen","year":"2022","journal-title":"J Am Soc Nephrol"},{"key":"2025053005064673500_bib19","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1038\/ki.1997.2","article-title":"Understanding the nature of renal disease progression","volume":"51","author":"Remuzzi","year":"1997","journal-title":"Kidney Int"},{"key":"2025053005064673500_bib20","doi-asserted-by":"publisher","first-page":"587","DOI":"10.1161\/CIRCULATIONAHA.113.005081","article-title":"Renal hemodynamic effect of sodium-glucose cotransporter 2 inhibition in patients with type 1 diabetes mellitus","volume":"129","author":"Cherney","year":"2014"},{"key":"2025053005064673500_bib21","doi-asserted-by":"publisher","first-page":"408","DOI":"10.1016\/j.kint.2024.05.006","article-title":"Evaluation of glomerular hemodynamic changes by sodium-glucose-transporter 2 inhibition in type 2 diabetic rats using in vivo imaging","volume":"106","author":"Wada","year":"2024","journal-title":"Kidney Int"},{"key":"2025053005064673500_bib22","doi-asserted-by":"publisher","first-page":"310","DOI":"10.1186\/s12882-023-03339-3","article-title":"UK Kidney Association Clinical Practice Guideline: sodium-glucose co-transporter-2 (SGLT-2) inhibition in adults with kidney disease 2023 UPDATE","volume":"24","author":"Roddick","year":"2023","journal-title":"BMC Nephrol"},{"key":"2025053005064673500_bib23","doi-asserted-by":"crossref","first-page":"S117","DOI":"10.1016\/j.kint.2023.10.018","article-title":"Kidney Disease: Improving Global Outcomes (KDIGO). KDIGO 2024 Clinical Practice Guideline for the evaluation and management of chronic kidney disease","volume":"105","year":"2024","journal-title":"Kidney Int"},{"key":"2025053005064673500_bib24","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1016\/S2213-8587(23)00322-4","article-title":"Impact of primary kidney disease on the effects of empagliflozin in patients with chronic kidney disease: secondary analyses of the EMPA-KIDNEY trial","volume":"12","author":"EMPA-KIDNEY Collaborative Group","year":"2024","journal-title":"Lancet Diabetes Endocrinol"},{"key":"2025053005064673500_bib25","doi-asserted-by":"crossref","first-page":"2073","DOI":"10.1016\/S0140-6736(10)60674-5","article-title":"Association of estimated glomerular filtration rate and albuminuria with all-cause and cardiovascular mortality in general population cohorts: a collaborative meta-analysis","volume":"375","author":"Matsushita","year":"2010","journal-title":"Lancet"},{"key":"2025053005064673500_bib26","doi-asserted-by":"publisher","first-page":"1296","DOI":"10.1056\/NEJMoa041031","article-title":"Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization","volume":"351","author":"Go","year":"2004","journal-title":"N Engl J Med"},{"key":"2025053005064673500_bib27","doi-asserted-by":"publisher","first-page":"2504","DOI":"10.1681\/ASN.2014070714","article-title":"Cause of death in patients with reduced kidney function","volume":"26","author":"Thompson","year":"2015","journal-title":"J Am Soc Nephrol"},{"key":"2025053005064673500_bib28","doi-asserted-by":"publisher","first-page":"198","DOI":"10.1053\/j.ajkd.2004.04.024","article-title":"Kidney disease as a risk factor for recurrent cardiovascular disease and mortality","volume":"44","author":"Weiner","year":"2004","journal-title":"Am J Kidney Dis"},{"key":"2025053005064673500_bib29","doi-asserted-by":"publisher","first-page":"S112","DOI":"10.1053\/ajkd.1998.v32.pm9820470","article-title":"Clinical epidemiology of cardiovascular disease in chronic renal disease","volume":"32","author":"Foley","year":"1998","journal-title":"Am J Kidney Dis"},{"key":"2025053005064673500_bib30","doi-asserted-by":"publisher","first-page":"2512","DOI":"10.1681\/ASN.2014101034","article-title":"Cause-specific deaths in non-dialysis-dependent CKD","volume":"26","author":"Navaneethan","year":"2015","journal-title":"J Am Soc Nephrol"},{"key":"2025053005064673500_bib31","doi-asserted-by":"publisher","first-page":"1379","DOI":"10.1038\/ki.1996.194","article-title":"Impact of hypertension on cardiomyopathy, morbidity and mortality in end-stage renal disease","volume":"49","author":"Foley","year":"1996","journal-title":"Kidney Int"},{"key":"2025053005064673500_bib32","doi-asserted-by":"publisher","first-page":"1088","DOI":"10.1053\/j.ajkd.2009.12.033","article-title":"Association of left atrial volume with mortality among ESRD patients with left ventricular hypertrophy referred for kidney transplantation","volume":"55","author":"Patel","year":"2010","journal-title":"Am J Kidney Dis"},{"key":"2025053005064673500_bib33","doi-asserted-by":"publisher","first-page":"1725","DOI":"10.1681\/ASN.2012020145","article-title":"Associations between kidney function and subclinical cardiac abnormalities in CKD","volume":"23","author":"Park","year":"2012","journal-title":"J Am Soc Nephrol"},{"key":"2025053005064673500_bib34","doi-asserted-by":"publisher","first-page":"1720","DOI":"10.1046\/j.1523-1755.1998.00154.x","article-title":"Long-term evolution of cardiomyopathy in dialysis patients","volume":"54","author":"Foley","year":"1998","journal-title":"Kidney Int"},{"key":"2025053005064673500_bib35","doi-asserted-by":"publisher","first-page":"186","DOI":"10.1038\/ki.1995.22","article-title":"Clinical and echocardiographic disease in patients starting end-stage renal-disease therapy","volume":"47","author":"Foley","year":"1995","journal-title":"Kidney Int"},{"key":"2025053005064673500_bib36","doi-asserted-by":"publisher","first-page":"2181","DOI":"10.1016\/S0140-6736(11)60739-3","article-title":"The effects of lowering LDL cholesterol with simvastatin plus ezetimibe in patients with chronic kidney disease (Study of Heart and Renal Protection): a randomised placebo-controlled trial","volume":"377","author":"Baigent","year":"2011","journal-title":"Lancet"},{"key":"2025053005064673500_bib37","doi-asserted-by":"crossref","first-page":"2103","DOI":"10.1056\/NEJMoa1511939","article-title":"A randomized trial of intensive versus standard blood-pressure control","volume":"373","author":"Sprint Research Group","year":"2015","journal-title":"N Engl J Med"},{"key":"2025053005064673500_bib38","doi-asserted-by":"publisher","first-page":"1789","DOI":"10.1161\/CIRCULATIONAHA.124.069568","article-title":"Sodium-glucose cotransporter-2 inhibitors and major adverse cardiovascular outcomes: a SMART-C collaborative meta-analysis","volume":"149","author":"Patel","year":"2024","journal-title":"Circulation"},{"key":"2025053005064673500_bib39","doi-asserted-by":"publisher","first-page":"757","DOI":"10.1016\/S0140-6736(22)01429-5","article-title":"SGLT-2 inhibitors in patients with heart failure: a comprehensive meta-analysis of five randomised controlled trials","volume":"400","author":"Vaduganathan","year":"2022","journal-title":"Lancet"},{"key":"2025053005064673500_bib40","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1056\/NEJMoa2403347","article-title":"Effects of semaglutide on chronic kidney disease in patients with type 2 diabetes","volume":"391","author":"Perkovic","year":"2024","journal-title":"N Engl J Med"},{"key":"2025053005064673500_bib41","doi-asserted-by":"publisher","first-page":"474","DOI":"10.1093\/eurheartj\/ehab777","article-title":"Cardiovascular and kidney outcomes with finerenone in patients with type 2 diabetes and chronic kidney disease: the FIDELITY pooled analysis","volume":"43","author":"Agarwal","year":"2022","journal-title":"Eur Heart J"},{"key":"2025053005064673500_bib42","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-024-03264-4","article-title":"Finerenone in heart failure and chronic kidney disease with type 2 diabetes: the FINE-HEART pooled analysis of cardiovascular, kidney, and mortality outcomes","volume":"30","author":"Vaduganathan","year":"2024","journal-title":"Nat Med"},{"key":"2025053005064673500_bib43","first-page":"S236","article-title":"The role of intraglomerular pressure in the initiation and progression of renal disease","volume":"4","author":"Anderson","year":"1986","journal-title":"J Hypertens Suppl"},{"key":"2025053005064673500_bib44","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2006040356","article-title":"Renin-angiotensin-aldosterone system and progression of renal disease","volume":"17","author":"R\u00fcster","year":"2006","journal-title":"J Am Soc Nephrol"},{"key":"2025053005064673500_bib45","doi-asserted-by":"publisher","first-page":"1892","DOI":"10.1056\/NEJMoa1303154","article-title":"Combined angiotensin inhibition for the treatment of diabetic nephropathy","volume":"369","author":"Fried","year":"2013","journal-title":"N Engl J Med"},{"key":"2025053005064673500_bib46","doi-asserted-by":"crossref","first-page":"1547","DOI":"10.1056\/NEJMoa0801317","article-title":"Telmisartan, ramipril, or both in patients at high risk for vascular events","volume":"358","author":"Yusuf","year":"2008","journal-title":"N Engl J Med"},{"key":"2025053005064673500_bib47","doi-asserted-by":"publisher","first-page":"2252","DOI":"10.1056\/NEJMoa2110956","article-title":"Cardiovascular events with finerenone in kidney disease and type 2 diabetes","volume":"385","author":"Pitt","year":"2021","journal-title":"N Engl J Med"},{"key":"2025053005064673500_bib48","doi-asserted-by":"publisher","first-page":"2219","DOI":"10.1056\/NEJMoa2025845","article-title":"Effect of finerenone on chronic kidney disease outcomes in type 2 diabetes","volume":"383","author":"Bakris","year":"2020","journal-title":"N Engl J Med"},{"key":"2025053005064673500_bib49","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2407107","article-title":"Finerenone in heart failure with mildly reduced or preserved ejection fraction","volume":"391","author":"Solomon Scott","journal-title":"N Engl J Med"},{"key":"2025053005064673500_bib50","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1093\/cvr\/cvac027","article-title":"Aldosterone and cardiovascular diseases","volume":"119","author":"Parksook","year":"2022","journal-title":"Cardiovasc Res"},{"key":"2025053005064673500_bib51","doi-asserted-by":"publisher","first-page":"658","DOI":"10.1053\/j.ajkd.2022.04.016","article-title":"Aldosterone, mineralocorticoid receptor activation, and CKD: a review of evolving treatment paradigms","volume-title":"Am J Kidney Dis","author":"Epstein","year":"2022"},{"key":"2025053005064673500_bib52","doi-asserted-by":"publisher","first-page":"1459","DOI":"10.1681\/ASN.2007101079","article-title":"The aggravating mechanisms of aldosterone on kidney fibrosis","volume":"19","author":"Remuzzi","year":"2008","journal-title":"J Am Soc Nephrol"},{"key":"2025053005064673500_bib53","doi-asserted-by":"publisher","first-page":"462","DOI":"10.1161\/HYPERTENSIONAHA.108.117044","article-title":"Effects of aldosterone on the heart","volume":"52","author":"D\u00edez","year":"2008","journal-title":"Hypertension"},{"key":"2025053005064673500_bib54","doi-asserted-by":"publisher","first-page":"4409","DOI":"10.1002\/cphy.c190043","article-title":"Aldosterone: renal action and physiological effects","volume":"13","author":"Johnston","year":"2023","journal-title":"Compr Physiol"},{"key":"2025053005064673500_bib55","doi-asserted-by":"publisher","first-page":"770375","DOI":"10.3389\/fphys.2022.770375","article-title":"Aldosterone-regulated sodium transport and blood pressure","volume":"13","author":"Tsilosani","year":"2022","journal-title":"Front Physiol"},{"key":"2025053005064673500_bib56","doi-asserted-by":"publisher","first-page":"2453","DOI":"10.1093\/eurheartj\/eht187","article-title":"Safety and tolerability of the novel non-steroidal mineralocorticoid receptor antagonist BAY 94-8862 in patients with chronic heart failure and mild or moderate chronic kidney disease: a randomized, double-blind trial","volume":"34","author":"Pitt","year":"2013","journal-title":"Eur Heart J"},{"key":"2025053005064673500_bib57","doi-asserted-by":"publisher","first-page":"3152","DOI":"10.1111\/bph.15734","article-title":"The mineralocorticoid receptor in chronic kidney disease","volume":"179","author":"Barrera-Chimal","year":"2022","journal-title":"Br J Pharmacol"},{"key":"2025053005064673500_bib58","doi-asserted-by":"publisher","first-page":"709","DOI":"10.1056\/NEJM199909023411001","article-title":"The effect of spironolactone on morbidity and mortality in patients with severe heart failure","volume":"341","author":"Pitt","year":"1999","journal-title":"N Engl J Med"},{"key":"2025053005064673500_bib59","doi-asserted-by":"publisher","first-page":"1309","DOI":"10.1056\/NEJMoa030207","article-title":"Eplerenone, a selective aldosterone blocker, in patients with left ventricular dysfunction after myocardial infarction","volume":"348","author":"Pitt","year":"2003","journal-title":"N Engl J Med"},{"key":"2025053005064673500_bib60","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(24)01733-1","article-title":"Mineralocorticoid receptor antagonists in heart failure: an individual patient level meta-analysis","volume":"404","author":"Jhund","journal-title":"Lancet North Am Ed"},{"key":"2025053005064673500_bib61","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1186\/s12882-016-0337-0","article-title":"Effect of mineralocorticoid receptor antagonists on proteinuria and progression of chronic kidney disease: a systematic review and meta-analysis","volume":"17","author":"Currie","year":"2016","journal-title":"BMC Nephrol"},{"key":"2025053005064673500_bib62","article-title":"A trial to learn how well Finerenone works and how safe it is in adult participants with non-diabetic chronic kidney disease (FIND-CKD) 2021"},{"key":"2025053005064673500_bib63","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfae132","article-title":"Design and baseline characteristics of the Finerenone, in addition to standard of care, on the progression of kidney disease in patients with Non-Diabetic Chronic Kidney Disease (FIND-CKD) randomized trial","author":"Heerspink","year":"2024","journal-title":"Nephrol Dial Transplant"},{"key":"2025053005064673500_bib64","doi-asserted-by":"publisher","first-page":"2295","DOI":"10.1056\/NEJMoa1811744","article-title":"Canagliflozin and renal outcomes in type 2 diabetes and nephropathy","volume":"380","author":"Perkovic","year":"2019","journal-title":"N Engl J Med"},{"key":"2025053005064673500_bib65","doi-asserted-by":"publisher","first-page":"436","DOI":"10.1016\/j.ekir.2021.12.013","article-title":"The kidney protective effects of the sodium-glucose cotransporter-2 inhibitor, dapagliflozin, are present in patients with CKD treated with mineralocorticoid receptor antagonists","volume":"7","author":"Provenzano","year":"2022","journal-title":"Kidney Int Rep"},{"key":"2025053005064673500_bib66","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1056\/NEJMoa2030183","article-title":"Sotagliflozin in patients with diabetes and recent worsening heart failure","volume":"384","author":"Bhatt","year":"2021","journal-title":"N Engl J Med"},{"key":"2025053005064673500_bib67","doi-asserted-by":"publisher","first-page":"1425","DOI":"10.1056\/NEJMoa2004967","article-title":"Cardiovascular outcomes with ertugliflozin in type 2 diabetes","volume":"383","author":"Cannon","year":"2020","journal-title":"N Engl J Med"},{"key":"2025053005064673500_bib68","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1056\/NEJMoa2030186","article-title":"Sotagliflozin in patients with diabetes and chronic kidney disease","volume":"384","author":"Bhatt","year":"2021","journal-title":"N Engl J Med"},{"key":"2025053005064673500_bib69","doi-asserted-by":"publisher","first-page":"2379","DOI":"10.1093\/eurheartj\/ehaa183","article-title":"Effects of dapagliflozin in DAPA-HF according to background heart failure therapy","volume":"41","author":"Docherty","year":"2020","journal-title":"Eur Heart J"},{"key":"2025053005064673500_bib70","doi-asserted-by":"publisher","first-page":"1397","DOI":"10.1016\/j.jacc.2021.01.044","article-title":"Interplay of mineralocorticoid receptor antagonists and empagliflozin in heart failure: EMPEROR-reduced","volume":"77","author":"Ferreira","year":"2021","journal-title":"J Am Coll Cardiol"},{"key":"2025053005064673500_bib71","doi-asserted-by":"publisher","first-page":"254","DOI":"10.1016\/j.jchf.2020.11.009","article-title":"Dapagliflozin in HFrEF patients treated with mineralocorticoid receptor antagonists: an analysis of DAPA-HF","volume":"9","author":"Shen","year":"2021","journal-title":"JACC Heart Fail"},{"key":"2025053005064673500_bib72","doi-asserted-by":"publisher","first-page":"1129","DOI":"10.1016\/j.jacc.2022.01.029","article-title":"Mineralocorticoid receptor antagonists and empagliflozin in patients with heart failure and preserved ejection fraction","volume":"79","author":"Ferreira","year":"2022","journal-title":"J Am Coll Cardiol"},{"key":"2025053005064673500_bib73","doi-asserted-by":"publisher","first-page":"757","DOI":"10.1016\/S0140-6736(22)01429-5","article-title":"SGLT-2 inhibitors in patients with heart failure: a comprehensive meta-analysis of five randomised controlled trials","volume":"400","author":"Vaduganathan","year":"2022","journal-title":"Lancet North Am Ed"},{"key":"2025053005064673500_bib74","doi-asserted-by":"publisher","first-page":"894","DOI":"10.1093\/ndt\/gfac198","article-title":"Design of the COmbinatioN effect of FInerenone anD EmpaglifloziN in participants with chronic kidney disease and type 2 diabetes using a UACR Endpoint study (CONFIDENCE)","volume":"38","author":"Green","year":"2022","journal-title":"Nephrol Dial Transplant"},{"key":"2025053005064673500_bib75","doi-asserted-by":"publisher","first-page":"105859","DOI":"10.1016\/j.phrs.2021.105859","article-title":"Nonsteroidal mineralocorticoid receptor antagonism for cardiovascular and renal disorders\u2014new perspectives for combination therapy","volume":"172","author":"Kolkhof","year":"2021","journal-title":"Pharmacol Res"},{"key":"2025053005064673500_bib76","doi-asserted-by":"publisher","first-page":"1470320317717883","DOI":"10.1177\/1470320317717883","article-title":"LY3045697: results from two randomized clinical trials of a novel inhibitor of aldosterone synthase","volume":"18","author":"Sloan-Lancaster","year":"2017","journal-title":"J Renin Angiotensin Aldosterone Syst"},{"key":"2025053005064673500_bib77","doi-asserted-by":"publisher","first-page":"1303","DOI":"10.2147\/DDDT.S315359","article-title":"Clinical utility of osilodrostat in Cushing's disease: review of currently available literature","volume":"17","author":"Perosevic","year":"2023","journal-title":"Drug Des Dev Ther"},{"key":"2025053005064673500_bib78","doi-asserted-by":"publisher","first-page":"1945","DOI":"10.1161\/CIRCULATIONAHA.111.029892","article-title":"Effects of a novel aldosterone synthase inhibitor for treatment of primary hypertension: results of a randomized, double-blind, placebo- and active-controlled phase 2 trial","volume":"124","author":"Calhoun","year":"2011","journal-title":"Circulation"},{"key":"2025053005064673500_bib79","doi-asserted-by":"publisher","first-page":"1140","DOI":"10.1001\/jama.2023.16029","article-title":"Aldosterone synthase inhibition with lorundrostat for uncontrolled hypertension: the target-HTN randomized clinical trial","volume":"330","author":"Laffin","year":"2023","journal-title":"JAMA"},{"key":"2025053005064673500_bib80","doi-asserted-by":"publisher","first-page":"395","DOI":"10.1056\/NEJMoa2213169","article-title":"Phase 2 trial of baxdrostat for treatment-resistant hypertension","volume":"388","author":"Freeman","year":"2023","journal-title":"N Engl J Med"},{"key":"2025053005064673500_bib81","doi-asserted-by":"publisher","first-page":"379","DOI":"10.1016\/S0140-6736(23)02408-X","article-title":"Efficacy and safety of aldosterone synthase inhibition with and without empagliflozin for chronic kidney disease: a randomised, controlled, phase 2 trial","volume":"403","author":"Tuttle","year":"2024","journal-title":"Lancet"},{"key":"2025053005064673500_bib82","doi-asserted-by":"publisher","DOI":"10.1159\/000534808","article-title":"Study design and baseline characteristics for aldosterone synthase inhibition in CKD","volume":"55","author":"Tuttle","year":"2024","journal-title":"Am J Nephrol"},{"key":"2025053005064673500_bib83","doi-asserted-by":"crossref","first-page":"1460","DOI":"10.1161\/CIRCULATIONAHA.121.057736","article-title":"Sodium-glucose cotransporter 2 inhibitors and risk of hyperkalemia in people with type 2 diabetes: a meta-analysis of individual participant data from randomized controlled trials","volume":"145","author":"Neuen","year":"2022","journal-title":"Circulation"},{"key":"2025053005064673500_bib84","doi-asserted-by":"publisher","first-page":"1445","DOI":"10.2337\/dc21-2034","article-title":"Safety of empagliflozin in patients with type 2 diabetes and chronic kidney disease: pooled analysis of placebo-controlled clinical trials","volume":"45","author":"Tuttle","year":"2022","journal-title":"Diabetes Care"},{"key":"2025053005064673500_bib85","doi-asserted-by":"publisher","first-page":"1965","DOI":"10.1681\/ASN.0000000000000248","article-title":"Effect of SGLT2 inhibitors on discontinuation of renin-angiotensin system blockade: a joint analysis of the CREDENCE and DAPA-CKD trials","volume":"34","author":"Fletcher","year":"2023","journal-title":"J Am Soc Nephrol"},{"key":"2025053005064673500_bib86","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1016\/S2213-8587(23)00321-2","article-title":"Effects of empagliflozin on progression of chronic kidney disease: a prespecified secondary analysis from the EMPA-KIDNEY trial","volume":"12","author":"EMPA-KIDNEY Collaborative Group","year":"2024","journal-title":"Lancet Diabetes Endocrinol"},{"key":"2025053005064673500_bib87","doi-asserted-by":"publisher","first-page":"1119","DOI":"10.2215\/CJN.0000000000000498","article-title":"Frailty, multimorbidity and polypharmacy: exploratory analyses of the effects of empagliflozin from the EMPA-KIDNEY trial","volume":"19","author":"Mayne","year":"2024","journal-title":"Clin J Am Soc Nephrol"},{"key":"2025053005064673500_bib88","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfae203","article-title":"Empagliflozin lowers serum uric acid in chronic kidney disease: exploratory analyses from the EMPA-KIDNEY trial","author":"Mayne","year":"2024","journal-title":"Nephrol Dial Transplant"},{"key":"2025053005064673500_bib89","doi-asserted-by":"publisher","first-page":"202","DOI":"10.1681\/ASN.0000000000000271","article-title":"Effects of empagliflozin on fluid overload, weight, and blood pressure in CKD","volume":"35","author":"Mayne","year":"2024","journal-title":"J Am Soc Nephrol"},{"key":"2025053005064673500_bib90","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2409183","article-title":"Long-term effects of empagliflozin in patients with chronic kidney disease","volume-title":"N Engl J Med","author":"EMPA-KIDNEY Collaborative Group","year":"2024"},{"key":"2025053005064673500_bib91","doi-asserted-by":"publisher","first-page":"297","DOI":"10.1016\/j.kint.2017.04.019","article-title":"Challenges in conducting clinical trials in nephrology: conclusions from a Kidney Disease-Improving Global Outcomes (KDIGO) controversies conference","volume":"92","author":"Baigent","year":"2017","journal-title":"Kidney Int"},{"key":"2025053005064673500_bib92","article-title":"Design considerations for future renoprotection trials in the era of multiple therapies for chronic kidney disease. Nephrol Dial Transplant","author":"Zhu","year":"2024"},{"key":"2025053005064673500_bib93","article-title":"A phase III study to investigate the efficacy and safety of baxdrostat in combination with dapagliflozin on CKD progression in participants with CKD and high blood pressure"}],"container-title":["Nephrology Dialysis Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ndt\/advance-article-pdf\/doi\/10.1093\/ndt\/gfae263\/60630619\/gfae263.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ndt\/article-pdf\/40\/6\/1175\/60630619\/gfae263.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ndt\/article-pdf\/40\/6\/1175\/60630619\/gfae263.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T05:06:56Z","timestamp":1748581616000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ndt\/article\/40\/6\/1175\/7896419"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,12]]},"references-count":93,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2024,11,12]]},"published-print":{"date-parts":[[2025,5,30]]}},"URL":"https:\/\/doi.org\/10.1093\/ndt\/gfae263","relation":{},"ISSN":["0931-0509","1460-2385"],"issn-type":[{"value":"0931-0509","type":"print"},{"value":"1460-2385","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,6]]},"published":{"date-parts":[[2024,11,12]]}}}