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Dapagliflozin in patients with Chronic Kidney Disease
Dapagliflozin is a sodium-glucose cotransporter-2 (SGLT-2) inhibitor that has shown promise in the management of Chronic Kidney Disease (CKD) in patients with type 2 diabetes. Dapagliflozin has demonstrated efficacy in reducing the progression of CKD in individuals with type 2 diabetes by inhibiting the reabsorption of glucose and sodium in the proximal renal tubules. Clinical trials have indicated that dapagliflozin reduces albuminuria, a key marker of kidney damage, thereby potentially slowing the decline in renal function. The use of dapagliflozin has been associated with improvements in glomerular filtration rate (GFR), suggesting a positive impact on overall kidney function. Dapagliflozin's mechanism of action involves promoting glycosuria and natriuresis, leading to a reduction in intraglomerular pressure and ultimately protecting the kidneys. Studies have highlighted the cardiovascular benefits of dapagliflozin in CKD patients, including a reduction in major adverse cardiovascular events and heart failure hospitalizations. Dapagliflozin's renal protective effects extend beyond glycemic control, making it a valuable therapeutic option for patients with both diabetes and CKD. The safety profile of dapagliflozin in CKD patients appears favorable, with few adverse effects reported in clinical trials. Dapagliflozin's impact on renal outcomes has prompted its inclusion in treatment guidelines for individuals with type 2 diabetes and CKD.
About the Speaker
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Dr Satyanarayana Garre
Consultant Nephrologist, Apollo Hospitals, Hyderabad
Upcoming Case Discussions
Clinician’s Approach to Hypertensive Nephropathy
Many processes influence the management of chronic kidney disease (CKD) and lead to the development of hypertension in the disease. Increased sympathetic tone in patients with chronic kidney disease (CKD) is a result of afferent signals produced by functionally failing kidneys. The great majority of CKD patients suffer from hypertension, which can both cause and result from the disease. In people with CKD, controlling hypertension is crucial since it lowers the risk of CVD and slows the disease's course. There is no agreement on the ideal blood pressure (BP) targets provided by current guidelines. Consequently, when deciding how to care specific patients.
Anaphylaxis In Emergency Department
A dangerous systemic hypersensitivity reaction with a typically quick onset that can be fatal is anaphylaxis. Rapid onset of breathing, circulation,and/or airway issues are its defining characteristics. The most crucial treatment is intramuscular adrenaline, although many patients do not receive it even in medical facilities, despite recommendations to the contrary. The significance of positioning during the management of anaphylaxis and the necessity of avoiding activities that could postpone the timely and proper delivery of adrenaline. Antihistamines should only be used as a last resort when ABC characteristics have been successfully treated in order to lessen skin involvement.
Circulatory Shock In Trauma
The inability of the circulatory system to supply tissue oxygenation and organ perfusion necessary to meet cellular metabolic demands is known as shock. Although non-haemorrhagic shock, such as cardiogenic or neurogenic shock, can occur after trauma, hemorrhage is more frequently linked to trauma-related shock. Evidence gathered over the past ten years has shown that trauma patients suffer from acute traumatic coagulopathy (ATC), which is brought on by the actual process of injury. Damage control resuscitation (DCR), the current method for managing acute shock, was developed with this as a key component. Haemostatic resuscitation, which uses blood products as the main resuscitative fluid, permissive hypotension, and damage control surgery are the three main resuscitative techniques included in DCR.
Fertilization & Early Development
Fertilization occurs when a sperm cell merges with an egg cell, creating a zygote, which is the first stage of a new life. This process takes place in the fallopian tube. The zygote then undergoes rapid cell division, known as cleavage, forming a multi-cellular structure called a blastocyst. As the blastocyst moves toward the uterus, it continues to divide and develop. Approximately 5-7 days after fertilization, the blastocyst implants itself into the uterine lining, initiating pregnancy. Early development involves the formation of the foundational structures and systems that will shape the embryo.
Metabolic Syndrome and Heart Health
Metabolic syndrome is a cluster of conditions that increase the risk of heart disease, stroke, and type 2 diabetes. These conditions include high blood pressure, elevated blood sugar, excess body fat around the waist, and abnormal cholesterol or triglyceride levels. When these risk factors occur together, they amplify the risk of developing cardiovascular issues. Metabolic syndrome is closely linked to insulin resistance, where the body struggles to use insulin effectively. Lifestyle changes, such as adopting a healthy diet, regular exercise, and weight management, are crucial in managing the syndrome. Early intervention is essential to prevent the progression to heart disease and other complications.