Repurposing Therapies for Cardiorenal Protection in Kidney Disease - UBC and BCR PWR 04.19.2024

Vikas Sridhar presents his talk, “Repurposing Therapies for Cardiorenal Protection in Kidney Disease,” as part of BC Renal and UBC’s province-wide rounds.
0:08:00 - Introduction
Sridhar starts by noting that SGLT2 inhibitors can be beneficial for kidney patients, regardless of their diabetes status. He provides a brief overview of its inhibitory physiology in type 1 diabetes.
0:14:00 - Clinical evidence of SGLT2 inhibition
He highlights results from the InTandem Trials in type 1 diabetes, and points to data that his team uncovered identifying markers associated with cardio-renal protection. Sridhar then talks about the safety regarding SGLT2 inhibitors, with a special focus on increased risk of diabetic ketoacidosis, noting that this risk is slightly lower in kidney patients compared to other cohorts studied.
0:21:00 - Preserving kidney function
Sridhar explains how the SUGARNSALT trial will explore the effectiveness and safety of sotaglifozin in slowing kidney function decline in persons with type 1 diabetes and moderate to severe diabetic kidney disease, discussing primary and secondary outcomes they will explore.
0:25:00 - Residual urine volume
Sridhar highlights the importance of residual urine volume, but notes there are limited therapies available to preserve it. Small studies hint that RAS blockade may be helpful, but Sridhar suggests there’s strong rationale that SGLT2 inhibitors could offer protection. He then discusses the CANARY study, which aims to demonstrate the mechanisms of SGLT2 inhibitors that protect kidney function.
0:30:00 - Kidney transplant recipients
He emphasizes the need for new cardio-renal strategies in kidney transplant recipients, describing why SGLT2 inhibitors may be particularly useful for this population. As part of his PhD study, he has been leading the INFINITI study, which is close to completion.
0:35:00 - Post-transplant diabetes
Sridhar then talks about the pathology of post-transplant diabetes (PTDM) and how his team plans to explore whether GLP1-RA could prevent it in, including whether the effect is sustained even after patients are taken off the medication.
0:40:00 - Challenges in cardio-renal studies
He notes that large enough samples sizes are important in these studies, and discusses how much GFR decline is enough in kidney transplant recipients.
0:44:00 - RENAISSANCE trial
Lastly, Sridhar provides an overview of the RENAISSANCE trial.
0:48:00 - Future Directions and Q&A
Sridhar highlights future directions of his work and takes questions from the audience.
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