NP40 Nephrology

Landmark Nephrology Trials/References

Essential Med Notes 2015

Trial

Reference

Results

ROAD

JASN 2007; 18:1889-98

Uptitration of either ACEI benazepril or ARB losartan to optimal anti-proteinuria doses conferred benefit on renal outcome in
patients without DM who had proteinuria and renal insufficiency

ROADMAP

NEJM 2011; 364:907-17

The use of the ARB olmesartan was more effective than placebo in delaying the onset of microalbuminuria in patients with
type 2 DM, normoalbuminuria, and good blood pressure control; however, a higher rate of fatal cardiovascular events was
found amongst patients with preexisting coronary heart disease in the olmesartan group

SHARP

Lancet 2011; 377:2181-92

Randomized placebo-controlled trial in patients with CKD and no history of MI or coronary revascularization took
simvastatin 20 mg plus ezetimibe 10 mg daily vs. matching placebo; simvastatin 20 mg plus ezetimibe 10 mg daily resulted
in reduction of LDL cholesterol with associated reduction of major atherosclerotic events in patients with CKD

TREAT

NEJM 2009; 361:2019-32

Patients with type 2 DM, CKD, and anemia were randomized to darbepoetin targeting a hemoglobin of 13 g/dL or placebo;
darbepoetin did not reduce the risk of death, a cardiovascular event, or a renal event, and was associated with an
increased risk of stroke

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Barnett AH, Bain SC, Bouter P, et al. Angiotensin-receptor blockade vs. converting-enzyme inhibition in type 2 diabetes and nephropathy. NEJM 2004;351:1952-1961.
Brenner BM, Cooper ME, de Zeeuw D, et al. Effects of losartan on renal cardiovascular outcomes in patients with type 2 diabetes and nephropathy. NEJM 2001;345:861-869.
Churchill DN, Blacke PG, Jindal KK, et al. Clinical practice guidelines for initiation of dialysis. Canadian Society of Nephrology. J Am Soc Nephrol 1999;10(Suppl 13):S238-291.
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