{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T04:38:47Z","timestamp":1792471127152,"version":"4.5.0"},"reference-count":41,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T00:00:00Z","timestamp":1785369600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T00:00:00Z","timestamp":1785369600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100001003","name":"Boehringer Ingelheim","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100001003","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2026,10]]},"abstract":"ABSTRACT<\/jats:title>\n \n Aims<\/jats:title>\n To assess the feasibility of a decentralised response\u2010guided trial and to characterise urinary albumin\u2010to\u2010creatinine ratio (UACR) responses to empagliflozin and finerenone in type 2 diabetes and chronic kidney disease (CKD).<\/jats:p>\n <\/jats:sec>\n \n Materials and Methods<\/jats:title>\n \n Adults with type 2 diabetes, estimated glomerular filtration rate (eGFR) \u2265\u200925\u2009mL\/min\/1.73\u2009m\n 2<\/jats:sup>\n , and UACR >\u20094.5\u2009mg\/mmol (>\u200940\u2009mg\/g) were enrolled in a decentralised response\u2010guided trial. Participants completed study procedures remotely and received empagliflozin 10\u2009mg once daily for 3\u2009weeks. Based on predefined UACR response thresholds during empagliflozin treatment, participants entered a 4\u2010week\u2009second treatment phase with continuation of empagliflozin, add\u2010on finerenone or substitution with finerenone. Primary outcomes were feasibility measures, including participant\u2010reported acceptability, sample delivery and completion of home measurements. Exploratory outcomes included changes in UACR.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Eleven participants completed the study (mean [SD] age 69.6 [6.1] years; mean eGFR 61.1 [24.8] mL\/min\/1.73\u2009m\n 2<\/jats:sup>\n ; median [IQR] UACR 246.9\u2009mg\/g [102.8\u2013457.7]). All predefined feasibility criteria were met: urine and capillary blood sample delivery rates were 100% and 98.8%, respectively; home blood pressure and body weight completion rates were 91.3% and 98.6%. During empagliflozin monotherapy, UACR changed by \u221218.7% overall, after which nine participants (81.8%) initiated empagliflozin\u2013finerenone combination therapy and 2 (18.2%) switched to finerenone monotherapy. UACR was further reduced by 40.1% after finerenone addition and by 34.0% after finerenone substitution, relative to the end of empagliflozin monotherapy. No serious adverse events or hyperkalaemia events were observed during treatment with empagliflozin, finerenone, or their combination.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n A decentralised response\u2010guided trial was feasible and safe, supporting further evaluation of this approach for individualised optimisation of kidney\u2010protective therapy in type 2 diabetes and CKD.<\/jats:p>\n \n Trial Registration:<\/jats:bold>\n ClinicalTrials.gov<\/jats:ext-link>\n Identifier: NCT06094920.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/dom.71147","type":"journal-article","created":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T13:29:07Z","timestamp":1785418147000},"page":"9412-9422","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Feasibility of Decentralised Response\u2010Guided Albuminuria Monitoring to Optimise Empagliflozin and Finerenone Therapy in Type 2 Diabetes and Chronic Kidney Disease"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4615-9012","authenticated-orcid":false,"given":"Jelle M.","family":"Beernink","sequence":"first","affiliation":[{"name":"Department of Internal Medicine\/Nephrology Ziekenhuisgroep Twente Almelo the Netherlands"},{"name":"Department of Clinical Pharmacy and Pharmacology University of Groningen, University Medical Center Groningen Groningen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gozewijn D.","family":"Laverman","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine\/Nephrology Ziekenhuisgroep Twente Almelo the Netherlands"},{"name":"Department of Biomedical Signals and Systems University of Twente Enschede the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3126-3730","authenticated-orcid":false,"given":"Hiddo J. L.","family":"Heerspink","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy and Pharmacology University of Groningen, University Medical Center Groningen Groningen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,30]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(12)61350\u20106"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2022.06.008"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010019\u201049525\u2010y"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2025845"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2110956"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.2337\/dci22\u20100027"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2022.06.013"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehad192"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213\u20108587(21)00243\u20106"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.10081"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2020050723"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2019.06.009"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2014070688"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc26\u2010S011"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.0000000000000550"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/dom.16359"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2410659"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13300\u2010025\u201001796\u20107"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ekir.2023.12.012"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.34067\/KID.0000001227"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pdig.0001191"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cct.2020.106219"},{"issue":"4","key":"e_1_2_10_24_1","first-page":"249","article-title":"PeeSpot; urine home collection device Innovatieve methode voor verzamelen van portie urine","volume":"36","author":"Hessels J.","year":"2011","journal-title":"Nederlands Tijdschrift Voor Klinische Chemie En Laboratoriumgeneeskunde"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cca.2016.04.030"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.15420\/ecr.2015.10.2.95"},{"issue":"1","key":"e_1_2_10_27_1","first-page":"31","article-title":"How to Measure Home Blood Pressure: Recommendations for Healthcare Professionals and Patients","volume":"45","author":"Sharman J. 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