Bruce Carter

Member since 2 years ago

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• Newbie

4 ideas posted

42 comments 1 vote

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Years in Research or Practice?:

0-5

What is your primary focus?:

CKD

Degree:

Master of Science

Affilliation:

None

Do you do research?:

No

Do you see patients?:

No

Are you a lay person?:

Yes

Work Zip Code:

85710

Bruce Carter is a member of:

• KIDNEY RESEARCH NATIONAL DIALOGUE-PHASE I

Activity Stream

Owned Ideas

Ideas contributed by Bruce Carter

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  CKD »

  Direct renin inhibitors vs. ACEI/ARB for CKD

  Theoretical grounds suggest that direct renin inhibitors (Aliskiren) may be superior at slowing CKD progression compared to ACE-inhibitors or ARB, and is supported by some animal studies. Renoprotective effect in humans has been demonstrated, but whether this represents "superiority" remains an unanswered question. Larger trials, including head-to-head comparisons are needed to determine whether direct renin inhibition ...more »

  Theoretical grounds suggest that direct renin inhibitors (Aliskiren) may be superior at slowing CKD progression compared to ACE-inhibitors or ARB, and is supported by some animal studies. Renoprotective effect in humans has been demonstrated, but whether this represents "superiority" remains an unanswered question.

  Larger trials, including head-to-head comparisons are needed to determine whether direct renin inhibition provides superior protection against CKD progression, or might replace or supplant ACE/ARB as the standard of care.

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  1 comment for Idea: Direct renin inhibitors vs. ACEI/ARB for CKD

  Submitted by Bruce Carter 2 years ago

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  CKD »

  Intensive vs. Standard Therapy for slowing CKD

  Researchers affiliated with the Mario Negri Institute and other institutions in Italy have developed a "Remission Clinic" intervention protocol and have reported achieving substantial (on the order of 90%) reductions in GFR decline, observed ESRD, and projected ESRD, with delays ranging from 12 (all subjects) to 21 years (nondiabetics). http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2396935/ http://clinicalweb.marionegri.it/remission/letteratura.php ...more »

  Researchers affiliated with the Mario Negri Institute and other institutions in Italy have developed a "Remission Clinic" intervention protocol and have reported achieving substantial (on the order of 90%) reductions in GFR decline, observed ESRD, and projected ESRD, with delays ranging from 12 (all subjects) to 21 years (nondiabetics).

  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2396935/

  http://clinicalweb.marionegri.it/remission/letteratura.php

  A more recent randomized trial again found substantial slowing (greater than 50%) of CKD progression:

  http://www.ncbi.nlm.nih.gov/pubmed/20097461

  Such findings warrant validation through larger multi-center trials, as such remarkable results would represent a significant improvement in prognosis.

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  1 comment for Idea: Intensive vs. Standard Therapy for slowing CKD

  Submitted by Bruce Carter 2 years ago

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  CKD »

  Optimal statin therapy to slow or halt CKD progression

  CKD sub-analysis from the large TNT and more recent JUPITER trials suggest that more intensive statin therapy, can help slow and even reverse CKD progression. It remains to be determined which statins and at what doses will be most effective, and how statin therapy should be adjusted over the course of CKD. Targeted head-to-head trials and varying-dose trials are needed to answer these questions. http://www.renalandurologynews.com/high-dose-statin-therapy-has-expanded-benefits/article/175689/ ...more »

  CKD sub-analysis from the large TNT and more recent JUPITER trials suggest that more intensive statin therapy, can help slow and even reverse CKD progression.

  It remains to be determined which statins and at what doses will be most effective, and how statin therapy should be adjusted over the course of CKD. Targeted head-to-head trials and varying-dose trials are needed to answer these questions.

  http://www.renalandurologynews.com/high-dose-statin-therapy-has-expanded-benefits/article/175689/

  http://www.ncbi.nlm.nih.gov/pubmed/20097461

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  3 comments for Idea: Optimal statin therapy to slow or halt CKD progression

  Submitted by Bruce Carter 2 years ago

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  CKD »

  Reducing uric acid levels to slow CKD progression.

  Recent single-center randomized trials suggest reducing uric acid levels to be simultaneously renoprotective and cardioprotective, even without the presence of gout. Risk reductions on the order of 50% have been reported.

  These results need validation in larger, multi-center trials, as well as determining optimal targets and treatment guidelines.

  3 comments for Idea: Reducing uric acid levels to slow CKD progression.

  Submitted by Bruce Carter 2 years ago

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