{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T00:38:18Z","timestamp":1784248698172,"version":"3.55.0"},"reference-count":34,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2016,1,13]],"date-time":"2016-01-13T00:00:00Z","timestamp":1452643200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100008272","name":"Novartis Pharmaceuticals Corporation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2016,2]]},"abstract":"<jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>\n                      To investigate whether the degree of albuminuria reduction observed in the\n                      <jats:styled-content style=\"fixed-case\">ALTITUDE<\/jats:styled-content>\n                      trial is associated with renal and cardiovascular protection, and secondly, whether the reduction in albuminuria was too small to afford clinical benefit.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In a\n                      <jats:italic>post hoc<\/jats:italic>\n                      analysis of the\n                      <jats:styled-content style=\"fixed-case\">ALTITUDE<\/jats:styled-content>\n                      trial in 8561 patients with type 2 diabetes and chronic kidney disease or cardiovascular disease we examined the effect of albuminuria changes at 6 months on renal and cardiovascular outcomes using\n                      <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>\n                      ox proportional hazard regression.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The median change in albuminuria in the first 6 months in the aliskiren arm of the trial was \u221212% (25th to 75th percentile: \u221248.7_to_ +41.9%) and 0.0% (25th to 75th percentile: \u221240.2_to_55%) in the placebo arm. Changes in albuminuria in the first 6 months were linearly associated with renal and cardiovascular endpoints: a &gt;30% reduction in albuminuria in the first 6 months was associated with a 62% reduction in renal risk and a 25% reduction in cardiovascular risk compared with an increase in albuminuria. The association between changes at 6 months in albuminuria and renal or cardiovascular endpoints was similar in the two treatment groups (p for interaction &gt;0.1 for both endpoints).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The addition of aliskiren to angiotensin\u2010converting enzyme inhibitor\/angiotensin receptor blocker therapy resulted in albuminuria changes that were associated with renal and cardiovascular risk changes. This did not translate into renal or cardiovascular protection because the overall reduction in albuminuria in the aliskiren arm was too small and nearly similar to that in the placebo arm.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.12600","type":"journal-article","created":{"date-parts":[[2015,10,29]],"date-time":"2015-10-29T03:51:40Z","timestamp":1446090700000},"page":"169-177","source":"Crossref","is-referenced-by-count":54,"title":["Is a reduction in albuminuria associated with renal and cardiovascular protection? A\n                    <i>post hoc<\/i>\n                    analysis of the\n                    <scp>ALTITUDE<\/scp>\n                    trial"],"prefix":"10.1111","volume":"18","author":[{"given":"H. J. L.","family":"Heerspink","sequence":"first","affiliation":[{"name":"Department of Clinical Pharmacy and Pharmacology University Medical Center Groningen, University of Groningen  Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Ninomiya","sequence":"additional","affiliation":[{"name":"Division of Research Management Center for Cohort Studies Graduate School of Medical Sciences, Kyushu University  Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"Persson","sequence":"additional","affiliation":[{"name":"Steno Diabetes Centre  Gentofte Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B. M.","family":"Brenner","sequence":"additional","affiliation":[{"name":"Renal Division Brigham and Women's Hospital, Harvard Medical School  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Brunel","sequence":"additional","affiliation":[{"name":"Novartis Pharma AB, Global Medical Affairs  Basel Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Chaturvedi","sequence":"additional","affiliation":[{"name":"Institute of Cardiovascular Sciences, University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. S.","family":"Desai","sequence":"additional","affiliation":[{"name":"Cardiovascular Division Brigham and Women's Hospital and Harvard Medical School  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. M.","family":"Haffner","sequence":"additional","affiliation":[{"name":"Department of Medicine and Clinical Epidemiology University of Texas Health Science Center  San Antonio TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. J. V.","family":"Mcmurray","sequence":"additional","affiliation":[{"name":"British Heart Foundation Cardiovascular Research Centre, University of Glasgow  Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. D.","family":"Solomon","sequence":"additional","affiliation":[{"name":"Cardiovascular Division Brigham and Women's Hospital and Harvard Medical School  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. A.","family":"Pfeffer","sequence":"additional","affiliation":[{"name":"Cardiovascular Division Brigham and Women's Hospital and Harvard Medical School  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.\u2010H.","family":"Parving","sequence":"additional","affiliation":[{"name":"Department of Medical Endocrinology Rigshospitalet, University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"de Zeeuw","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy and Pharmacology University Medical Center Groningen, University of Groningen  Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,1,13]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc13-2036"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc14-S014"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2008121270"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-139-11-200312020-00008"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000031732.78052.81"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1523-1755.2004.00653.x"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-012-2755-2"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.165.8.947"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1523-1755.2003.00033.x"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehr017"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/ki.2014.321"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc08-s248"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1208799"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1303154"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-159-11-201312030-00009"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.f360"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa011161"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa011303"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfn721"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2006050445"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000139860.33974.28"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gft249"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2008070730"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2008060655"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2012.06.017"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)60674-5"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2004.10.019"},{"key":"e_1_2_7_29_1","unstructured":"European Medicine Agency.European public assessment report Rasilez. EMA 2012. Available from URL:http:\/\/www.ema.europa.eu\/ema\/index.jsp?curl=pages\/medicines\/human\/medicines\/000780\/human_med_001013.jsp&#x00026;mid=WC0b01ac058001d124. Accessed 1 April 2015."},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/0272-6386(95)90058-6"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1523-1755.1998.00905.x"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajprenal.00069.2006"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajprenal.2001.280.4.F562"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00285287"},{"key":"e_1_2_7_35_1","doi-asserted-by":"publisher","DOI":"10.2337\/diabetes.51.4.1157"}],"container-title":["Diabetes, Obesity and Metabolism"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fdom.12600","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/dom-pubs.pericles-prod.literatumonline.com\/doi\/pdf\/10.1111\/dom.12600","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T05:04:17Z","timestamp":1761887057000},"score":1,"resource":{"primary":{"URL":"https:\/\/dom-pubs.pericles-prod.literatumonline.com\/doi\/10.1111\/dom.12600"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,1,13]]},"references-count":34,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2016,2]]}},"alternative-id":["10.1111\/dom.12600"],"URL":"https:\/\/doi.org\/10.1111\/dom.12600","archive":["Portico"],"relation":{},"ISSN":["1462-8902","1463-1326"],"issn-type":[{"value":"1462-8902","type":"print"},{"value":"1463-1326","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,1,13]]}}}