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2. Outcomes with Finerenone in Participants with Stage 4 CKD and Type 2 Diabetes: A FIDELITY Subgroup Analysis

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Sarafidis, Pantelis, Agarwal, Rajiv, Pitt, Bertram, Wanner, Christoph, Filippatos, Gerasimos, Boletis, John, Tuttle, Katherine R., Ruilope, Luis M., Rossing, Peter, Toto, Robert, Anker, Stefan D., Liu, Zhi-Hong, Joseph, Amer, Ahlers, Christiane, Brinker, Meike, Lawatscheck, Robert, Bakris, George, Aizenberg, Diego, Bartolacci, Inés, Besada, Diego, Bittar, Julio, Chahin, Mariano, Elbert, Alicia, Gelersztein, Elizabeth, Liberman, Alberto, Maffei, Laura, Manghi, Federico Pérez, Sanabria, Hugo, Vallejos, Augusto, Viñes, Gloria, Wassermann, Alfredo, Abhayaratna, Walter, Acharya, Shamasunder, Ekinci, Elif, Lee, Darren, MacIsaac, Richard, Mah, Peak Mann, Nelson, Craig, Packham, David, Pape, Alexia, Roger, Simon, Stephenson, Hugo, Suranyi, Michael, Wittert, Gary, Vale, Elizabeth, Colman, Peter, Colquhoun, David, Ellis, Chris, Joshua, Kim, Pedagogos, Eugenia, Regal, Paul, Topliss, Duncan, Vandeleur, James, Verjans, Johan, Wittert, Gary, Wynne, Katie-Jane, Clodi, Martin, Ebenbichler, Christoph, Fliesser-Görzer, Evelyn, Hanusch, Ursula, Krebs, Michael, Lhotta, Karl, Ludvik, Bernhard, Mayer, Gert, Neudorfer, Peter, Paulweber, Bernhard, Prager, Rudolf, Preiß, Wolfgang, Prischl, Friedrich, Schernthaner, Gerit-Holger, Sourij, Harald, Wiesholzer, Martin, Drexel, Heinz, Oberbauer, Rainer, Schönherr, Hans-Robert, Doubel, Peter, Engelen, Wendy, Gillard, Pieter, Hougardy, Jean-Michel, Krzesinski, Jean-Marie, Maes, Bart, Speeckaert, Marijn, Stas, Koen, van Gaal, Luc, Vanbelleghem, Hilde, Duyck, Francis, Scheen, André, Antunes, Daniela, Botelho, Roberto, Brito, Claudia, Canani, Luis, Canziani, Maria Eugenia, Cerqueira, Maria, de Paula, Rogerio, Eliaschewitz, Freddy, Figueiredo, Carlos Eduardo, Forti, Adriana, Hissa, Miguel, Leite, Emerson Lima Maurilo, Jr, Noronha, Irene, Paolino, Bruno, Paschoalin, Nathalia, Paschoalin, Raphael, Filho, Roberto Pecoits, Pereira, Marcio, Portes, Evandro, Precoma, Dalton, Rea, Rosangela, Riella, Miguel, Salles, Joao Eduardo, Vasconcellos, Eduardo, Vencio, Sergio, Bacci, Marcelo, Maia, Lilia, Villacorta, Aline, Apostolova, Emiliya, Boshnyashka, Radostina, Farah, Ghassan, Georgiev, Dimitar, Gushterova, Valentina, Klyuchkova, Neli, Lucheva, Mariya, Manova, Petya, Minkova, Dotska, Nonchev, Boyan, Pichmanova, Mariyana, Prakova, Zhulieta, Rangelov, Rangel, Rashkov, Rosen, Stanchev, Pavel, Stoyanovska-Elencheva, Bilyana, Tagarev, Zhivko, Temelkova-Kurktschieva, Theodora, Vasileva, Svetla, Yoncheva-Mihaylova, Mariana, Marinchev, Angel, Miteva, Mariya, Barre, Paul, Carlson, Brian, Conway, James, Cournoyer, Serge, Dumas, Richard, Fikry, Sameh, Goluch, Richard, Hamet, Pavel, Hart, Randolph, Henein, Sam, Liutkus, Joanne, Madore, Francois, Martinho, Valdemar, Mazza, Giuseppe, McFarlane, Philip, Keefe, Dennis O′, Peterson, Sean, Schwartz, Daniel, Shu, Daniel, Steele, Andrew, Tellier, Guy, Tennankore, Karthik, Tobe, Sheldon, Tsoukas, George, Tytus, Richard, Vitou, Louise, Walsh, Michael, Weisnagel, Stanley, Wilderman, Igor, Yale, Jean-Francois, El Boreky, Fadia, Kelly, Alan, Leiter, Lawrence, Teitelbaum, Ivor, Cobos, Jorge, Godoy, Juan, González, Fernando, Lobos, Sergio, Palma, Juan Carlos, Prieto Dominguez, Juan Carlos, Reyes, Eliana, Romero, Carmen, Saavedra, Victor, Vega, Mario, Medina, Marcelo, Varleta, Paola, Bu, Ruifang, Cai, Hanqing, Chen, Nan, Chen, Qinkai, Chen, Dejun, Cheng, Jinluo, Dong, Youping, Dong, Junwu, Guan, Tianjun, Hao, Chuanming, Huang, Wen, Jiang, Fangfang, Lei, Minxiang, Li, Ling, Li, Zhonghe, Li, Xuemei, Li, Jingmei, Li, Yan, Liang, Xinling, Liang, Bo, Liu, Fang, Liu, Yinghong, Liu, Yuantao, Liu, Zhihong, Long, Gang, Lu, Guoyuan, Lu, Weiping, Lu, Yibing, Luo, Ping, Ma, Jianhua, Mo, Zhaohui, Niu, Jianying, Peng, Ai, Shen, Jiansong, Shen, Feixia, Shi, Bingyin, Su, Qing, Sun, Zhuxing, Tang, Shuifu, Tong, Nanwei, Wang, Hao, Wang, Xinjun, Wang, Guixia, Wang, Jianqin, Wang, Yangang, Wang, Li, Wei, Jiali, Wu, Tianfeng, Wu, Chaoqing, Xing, Changying, Xiong, Fei, Xu, Xudong, Xu, Ning, Yan, Tiekun, Yang, Jinkui, Yin, Aiping, Zeng, Longyi, Zhang, Hao, Zhang, Yanlin, Zhang, Ying, Zhao, Wenjing, Zhao, Zhiquan, Zheng, Hongguang, Zhong, Ling, Zhu, Dalong, Zhuang, Yongze, Du, Yuming, Fang, Yi, Guo, Weiying, Jiang, Sheng, Kuang, Jian, Li, Dongmei, Li, Hongmei, Li, Yinan, Li, Yuxiu, Liu, Jian, Liu, Yu, Miao, Heng, Peng, Wen, Wang, Lihua, Xu, Mingtong, Zhong, Liyong, Zhu, Jun, Arango, Clara, Barrera, Sandra, López, Nelly Beltrán, Benitez, Diego, Blanco, Guillermo, Cadena, Andrés, Coronel, Julian, Cure, Carlos, Durán, Carlos, González, Alexander, Guzmán, Gustavo, Hernández, Eric, Ibarra, Jaime, Jaramillo, Carlos, Jaramillo, Nicolás, Kattah, William, Molina, Dora, Sánchez, Gregorio, Terront, Mónica, Trujillo, Freddy, Urina, Miguel, Vargas, Ruben, Villegas, Iván, Yupanqui, Hernán, Arcos, Edgar, Aroca, Gustavo, Barreto, Germán, Bermudez, Andres, Botero, Rodrigo, Cárdenas, Tatiana, Figueroa, Wilmer, Jaramillo, Mónica, Liévano, Manuel, López, Mónica, Molina, Dora, Rosero, Ricardo, Trillos, Pedro, Dino Alferi, Brada, Michal, Brezina, Jiri, Bucek, Petr, Edelsberger, Tomas, Gulakova, Drahomira, Zapletalova, Jitka Hasalova, Hola, Olga, Hornova, Lucie, Houdova, Jana, Hrmova, Helena, Karasek, David, Kopecka, Sarka, Kovar, Richard, Krcova, Eva, Kuchar, Jiri, Kutejova, Vlasta, Lubanda, Hana, Matyasek, Ivo, Mokrejsova, Magdalena, Okenka, Libor, Prazny, Martin, Pumprla, Jiri, Tomanek, Pavel, Andersen, Ulla, Andries, Alin, Bech, Jesper, Faber, Jens, Gislason, Gunnar, Hangaard, Jørgen, Pacyk, Grzegorz Jaroslaw, Juhl, Claus, Krarup, Thure, Lindhardt, Morten, Madsbad, Sten, Nielsen, Joan, Pedersen-Bjergaard, Ulrik, Poulsen, Per, Rasmussen, Ole, Rossing, Peter, Schousboe, Karoline, Gram, Jeppe, Lauridsen, Thomas, Pedersen, Erling, Thorsteinsson, Birger, Flöjt, Päivi, Honkasalo, Mikko, Honkasalo, Mikko, Humaloja, Kari, Kananen, Kristiina, Kantola, Ilkka, Koistinen, Arvo, Korsoff, Pirkko, Lahtela, Jorma, Nieminen, Sakari, Nieminen, Tuomo, Sadeharju, Karita, Strand, Jorma, Sulosaari, Sakari, Cariou, Bertrand, Chantrel, François, Clavel, Sylvaine, Combe, Christian, Fauvel, Jean-Pierre, Gallouj, Karim, Gouet, Didier, Guerci, Bruno, Guerrot, Dominique, Hourmant, Maryvonne, Klein, Alexandre, Mariat, Christophe, Marre, Michel, Mesbah, Rafik, Le Meur, Yannick, Monier, Arnaud, Moranne, Olivier, Roussel, Ronan, Serusclat, Pierre, Vendrely, Benoit, Verges, Bruno, Zaoui, Philippe, Axthelm, Christoph, Bergmann, Andreas, Birkenfeld, Andreas L., Braun, Hermann, Busch, Klaus, Contzen, Christel, Degenhardt, Stefan, Derwahl, Karl, Giebel, Thomas, Hagenow, Andreas, Haller, Hermann, Hasslacher, Christoph, Horacek, Thomas, Jungmair, Wolfgang, Kloos, Christof, Koch, Thorsten, Krüger, Thilo, Mühlfeld, Anja, Müller, Joachim, Pfützner, Andreas, Pistrosch, Frank, Rinke, Andrea, Rose, Ludger, Rump, Lars, Schettler, Volker, Schiefke, Ingolf, Schlichthaar, Heike, Schröppel, Bernd, Schöll, Norbert, Schubert, Kristin, Schürholz, Thomas, Sigal, Helena, Stemler, Lutz, Strack, Georg, Täschner, Heidrun, Toursarkissian, Nicole, Tschöpe, Diethelm, Ulmer, Achim, van der Giet, Markus, Wanner, Christoph, Winkelmann, Bernhard R., Boletis, Ioannis, Dimitriadis, George, Hatziagelaki, Erifili, Iatrou, Christos, Ioannidis, Ioannis, Kounadi, Theodora, Makriniotou, Ioanna, Papadopoulou, Dorothea, Papagianni, Aikaterini, Passadakis, Ploumis, Piaditis, George, Stefanidis, Ioannis, Tai Pang Ip, Lee, Paul, Andrea Luk, On Yan, Ma, Ronald, Chow, Wing Sun, Wang, Angela, Yeung, Vincent, Bajcsi, Dora, Danos, Peter, Harcsa, Eleonora, Kalina, Akos, Kazup, Szilvia, Keltai, Katalin, Kirschner, Robert, Kiss, Julianna, Kovacs, Laszlo, Lamboy, Beata, Literati-Nagy, Botond, Mileder, Margit, Nagy, Laszlo, Noori, Ebrahim, Nyirati, Gabor, Petro, Gizella, Schneider, Karoly, Simon, Judit, Szocs, Albert, Vasas, Szilard, Wudi, Krisztina, Zilahi, Zsolt, Zsom, Marianna, Eustace, Joe, Holian, John, Reddan, Donal, Meara, Yvonne O′, Abramof Ness, Rosane, Adawi, Faiad, Armaly, Zaher, Atar, Shaul, Bashkin, Amir, Ben Chetrit, Sydney, Yanay, Noa Berar, Chernin, Gil, Darawsha, Mahmud, Efrati, Shai, Elias, Mazen, Farber, Evgeny, Glandt, Mariela, Grossman, Ehud, Halabi, Majdi, Harman-Boehm, Ilana, Khazim, Khaled, Liberty, Idit, Minuchin, Oscar, Mosenzon, Ofri, Nakhoul, Farid, Nimer, Assy, Schwartz, Doron, Wainstein, Julio, Yagil, Yoram, Zukermann, Robert, Avogaro, Angelo, Battaglia, Giovanni Giorgio, Bevilacqua, Maurizio Tiziano, Bonora, Enzo, Bossi, Carlo Antonio, Calabrò, Paolo, Cavalot, Franco Luigi, Cimino, Roberto, Cozzolino, Mario Gennaro, David, Salvatore, Emdin, Michele, Fiaccadori, Enrico, Fiorina, Paolo, Giorda, Carlo Bruno, Gregorini, Maria Cristina, La Manna, Gaetano, Maggi, Davide Carlo, Manti, Roberta, Meregalli, Giancarla, Pani, Antonello, Parvanova, Aneliy Ilieva, Perico, Norberto, Piatti, PierMarco, Pisani, Antonio, Pontiroli, Antonio Ettore, Ponzani, Paola, Santorelli, Gennaro, Santoro, Domenico, Scanziani, Renzo, Teatini, Ugo, Tonolo, Giancarlo, Trevisan, Roberto, Veronelli, Anna Maria, Viviani, Giorgio Luciano, Araki, Hideo, Bando, Yukihiro, Ebisui, Osamu, Fujita, Naruhiro, Fukasawa, Hirotaka, Furuya, Ryuichi, Hamamoto, Yoshiyuki, Hamasaki, Akihiro, Hasegawa, Kotaro, Hatazaki, Masahiro, Hayashi, Terumasa, Higashi, Takayuki, Hirohata, Yoshihide, Horinouchi, Shuji, Hoshi, Ayumu, Imoto, Hirofumi, Inagaki, Akemi, Inagaki, Masayuki, Inaguma, Daijo, Inoue, Toshihiko, Ishii, Masao, Ishiko, Tamayo, Isono, Motohide, Jinnouchi, Hideaki, Kanai, Hidetoshi, Kanda, Daisuke, Kanehara, Hideo, Kashima, Masayuki, Kataoka, Yuko, Katayama, Shigehiro, Kato, Kiyoe, Katsuki, Takeshi, Kawamitsu, Katsunori, Kawasaki, Satsuki, Kikuchi, Fumi, Kikuchi, Hidetoshi, Kishimoto, Rui, Kobayashi, Kunihisa, Koide, Junko, Komi, Rieko, Kubota, Miyuki, Kuriya, Genpei, Kurose, Takeshi, Kusano, Yoshiro, Hajime, Maeda, Matsubayashi, Sunao, Matsumoto, Kazunari, Matsumura, Naoya, Matsuo, Yasuto, Matsuoka, Naoki, Miyaoka, Hiroaki, Miyata, Satoshi, Morita, Takeshi, Murakami, Isao, Murao, Satoshi, Nakamura, Udai, Nakayama, Mikihiro, Nakazawa, Jun, Nohara, Sakae, Nomiyama, Takashi, Noritake, Masayuki, Oda, Yoshiaki, Ogiwara, Takayuki, Ohashi, Hiroshi, Okamoto, Hideki, Okino, Shinichi, Osonoi, Takeshi, Sasaki, Nobuhiro, Sayo, Yoshitaka, Sekigami, Taiji, Shibasaki, Taro, Shibata, Hirotaka, Shimoyama, Tatsushi, Shinoda, Junji, Sobajima, Hiroshi, Sugitatsu, Kazuya, Sugiura, Toshiyuki, Sugiyama, Toru, Suzuki, Daisuke, Suzuki, Hiroyuki, Suzuki, Masaaki, Takeda, Asami, Tanaka, Asami, Tanaka, Seiichi, Tsunematsu, Izumi, Ueda, Yasuo, Uekihara, Soichi, Ujihara, Makoto, Yajima, Ken, Yamada, Daishiro, Yamada, Masayo, Yamagata, Kazuo, Yamakawa, Ken, Yamakawa, Fumiko, Yamasaki, Yoshimitsu, Yambe, Yuko, Yanagida, Taihei, Yanai, Hidekatsu, Yanase, Toshihiko, Yasuda, Tetsuyuki, Kriauciuniene, Dovile, Lasiene, Jurate, Navickas, Antanas, Radzeviciene, Lina, Urbanaviciene, Egle, Urbonas, Gediminas, Velaviciene, Audrone, Abd Ghani, Rohana, Aziz, Nor Azizah, Lee, Li Yuan, Loh, Chek Loong, Ali, Norhaliza Mohd, Noor, Nurain Mohd, Fatnoon Nik Ahmad, Nik Nur, Ratnasingam, Jeyakantha, Halimi Bin Wan Hasan, Wan Hasnul, Izani Wan Mohamed, Wan Mohd, Khir, Rizmy Najme, Mohamad, Masni, Alexander Tan, Tong Boon, Avila Pardo, Sandro, Adrian, Miriam Bastidas, Wong, Alfredo Chew, Escobedo de la Peña, Jorge, Salmón, Guillermo Fanghänel, Gálvez, Guillermo González, Ochoa, Ramiro Gutiérrez, Santana, Saúl Irizar, Rovalo, Magdalena Madero, Machado, Gustavo Méndez, Ruiz, Luis Nevarez, Ibarra, Denisse Ramos, López, Gabriel Ramos, Reyna, Leobardo Sauque, Ortiz, Gustavo Solache, Ortiz, Rafael Valdez, Mesa, Juan Villagordoa, Salazar, Melchor Alpizar, Hernández, Pedro García, González, José, Soto, José Lazcano, Mendoza, Arturo Saldaña, Santana, Sergio Irizar, Vilchis, Elvira González, Bakker, R.C., Barendregt, J.N.M., Boonstra, A.H., Bos, Willem, Brouwer, C.B., Buren, M. van, Gansevoort, Ron, Kooy, Adriaan, Krekels, Marielle, Leendert, Ruud J.M. van, Lieverse, Louis A.G., Luik, P.T., Penne, E. Lars, Gregoor, Peter Smak, Vogt, Liffert, Born, Bert-Jan van den, John Baker, Crawford, Veronica, Cutfield, Rick, Dunn, Peter, Krebs, Jeremy, Nirmalaraj, Kingsley, Scott, Russell, Smuts, Nine, Titchener, Janet, Eriksen, Erik, Finnes, Trine, Høivik, Hans, Karlsson, Thomas, Munk, Peter Scott, Radtke, Maria, Risberg, Knut, Rocke, Jan, Solnør, Leidulv, Stenehjem, Aud-Eldrid, Tafjord, Anne-Beathe, Asprusten, Emil, Hagemeier, Robert, Høye, Kjetil, Selsås, Hilde, Thorup, Frode, Wium, Cecilie, Pamugas, Glenda, Panelo, Araceli, Perez, Ronald, Tanque, Maribel, Tirador, Louie, Villa, Michael, Bautista, Albert, Catindig, Elizabeth, Manalo, Carlo, Mirasol, Roberto, Butrymowicz, Patrycja, Ciechanowski, Kazimierz, Cieslik, Grazyna, Franek, Edward, Gumprecht, Janusz, Hoffmann, Michal, Krzykowska, Jolanta, Kurnatowska, Ilona, Landa, Katarzyna, Madrzejewski, Adam, Madziarska, Katarzyna, Mazur, Stanislaw, Napora, Piotr, Nowicki, Michal, Ocicka-Kozakiewicz, Anna, Rewerska, Barbara, Rusicka, Teresa, Ruxer, Jan, Skokowska, Ewa, Stankiewicz, Andrzej, Stompor, Tomasz, Tiuryn-Petrulewicz, Agnieszka, Wasilewska, Katarzyna, Wierusz-Wysocka, Bogna, Wnetrzak-Michalska, Renata, Jedynasty, Krystyna, Anand, Izabela Sein, Almeida, Edgar, Ballesteros, Rosa, Barreto, Carlos, Beirao, Idalina, Birne, Rita, Esteves, Cesar, Guia, Jose, Heitor, Susana, Marques, Olinda, Melo, Pedro, Nolasco, Fernando, Pereira, Amalia, Roque, Cristina, Rosario, Francisco, Silva, Gil, Silva, Ana, Teixeira e Costa, Fernando, Lobos, Ana Vila, Alves, Ana Rita, Brandao, Ilidio, Carvalho, Rui, Coelho, Joao, Lourenco, Ana, Matos, Pedro, Rosario, Vanisa, Neves, Joao Sergio, Cortes-Maisonet, Gregorio, Roman-Miranda, Amaury, Brito-Peguero, Yudit, Colon-Vega, Gildred, Albota, Adrian, Bala, Cornelia, Barbonta, Hortensia, Caceaune, Elena, Catrinoui, Doina, Constantin, Ciprian, Dumitrescu, Adriana, Mindrescu, Nicoleta, Mistode, Cristina, Negrisanu, Gabriela, Onaca, Adriana, Paveliu, Silvia, Pintilei, Ella, Pop, Lavinia, Popa, Amorin, Popescu, Alexandrina, Radulian, Gabriela, Szilagyi, Iosif, Turcu, Liana, Vacaru, Georgeta, Vlad, Adrian, Filimon, Adriana, Veresiu, Ioan, Antsiferov, Mikhail, Arkhipov, Mikhail, Babkin, Andrey, Barbarash, Olga, Baranov, Vitaliy, Chernyavskaya, Elena, Demko, Arkadiy, Dreval, Alexander, Edin, Anton, Ermakova, Polina, Fadeev, Valentin, Galyavich, Albert, Gaysina, Leyla, Gordeev, Ivan, Ipatko, Irina, Kalashnikova, Marina, Khalimov, Yuriy, Klimontov, Vadim, Kobalava, Zhanna, Kosmacheva, Elena, Koziolova, Natalya, Sergey Levashov, Lyudmila Kvitkova, Libis, Roman, Marasaev, Vyacheslav, Malykh, Natalia, Martynenko, Vladimir, Malyutina, Sofya, Merai, Imad, Mkrtumyan, Ashot, Nechaeva, Galina, Petunina, Nina, Palyutin, Shamil, Pimenov, Leonid, Rechkova, Elena, Rodionova, Tatyana, Rymar, Oksana, Sardinov, Ruslan, Semenova, Olga, Sherenkov, Alexander, Solovev, Oleg, Smolyarchuk, Elena, Strongin, Leonid, Ukhanova, Olga, Verlan, Nadezhda, Vorokhobina, Natalya, Yakhontov, Davyd, Yakushin, Sergey, Zakharova, Elena, Zalevskaya, Alsu, Zanozina, Olga, Zhdanova, Elena, Zhukova, Larisa, Zykova, Tatyana, Argunova, Yulia, Nikolaev, Konstantin, Villevalde, Svetlana, Fang Sum, Chee, Suhail, Sufi Muhummad, San Tan, Ru, Vathsala, Anantharaman, Wong, Edmund, Bee, Yong Mong, Babikova, Jana, Buganova, Ingrid, Dzupina, Andrej, Ochodnicka, Zuzana, Sosovec, Dalibor, Spodniakova, Denisa, Minarik, Peter, Fayzal Ahmed, Amod, Aslam, Bhana, Sindeep, Distiller, Larry, Jansen van Rensburg, Dirkie, Joshi, Mukesh, Joshi, Shaifali, Lakha, Deepak, Mitha, Essack, Podgorski, Gracjan, Ranjith, Naresh, Rayner, Brian, Rheeder, Paul, Sarvan, Mohamed, Seeber, Mary, Siebert, Heidi, Tayob, Mohammed, Trokis, Julien, Urbach, Dorothea, van Zyl, Louis, Jansen van Rensburg, Dirkie, Bum-Soon Choi, Choi, Moon Gi, Chung, ChoonHee, Hwang, YouCheol, Kim, ChongHwa, Kim, InJoo, Kim, JaeHyeon, Kim, SinGon, Kim, SungGyun, Kim, Tae Hee, Lee, WooJe, Lee, ByungWan, Lee, Kang Wook, Oh, Kook-Hwan, Oh, Ji Eun, Oh, Yun Kyu, Oh, Dong-Jin, Park, Junbeom, Shin, Seok Joon, Sung, Su-Ah, Yu, Jae Myung, Chung, HyeSoo, Huh, Ji Hye, Kang, JunGoo, Kim, ChulSik, Kim, HyeSoon, Kim, NamHoon, Lim, Soo, Cho, Young Min, Park, Cheol Young, Agraz, Irene, Ampudia, Francisco Javier, Bouarich, Hanane, Calero, Francesca, Castro, Cristina, Guldris, Secundino Cigarrán, Garrit, Josep Cruzado, de Álvaro, Fernando, Galcerán, Josep, Albarrán, Olga González, Jaras, Julio Hernández, Ibernón, Meritxell, Deben, Francisco Martínez, Ma, Esteban, Dolores Martínez, Pascual Izuel, José María, Martins, Judith, Mediavilla, Juan, Michán, Alfredo, Santos, Julio Pascual, Poch, Esteban, Rusillo, Manuel Polaina, Juan, Carlos Sánchez, Olmo, Rafael Santamaría, Segura de la Morena, José Julián, Soto, Alfonso, Troya, Maribel, Castro, Fernando Cereto, Fernández, Pablo Gómez, Sánchez, Laura Fuentes, Moya, Mercedes González, Marrero, Domingo Hernández, Maroto, Gonzalo Piedrola, Redón, Josep, Seron, Daniel, Bruchfeld, Annette, Curiac, Dan, Eliasson, Ken, Frank, Malin, Guron, Gregor, Hellberg, Olof, Hellgren, Margareta, Larnefeldt, Hans, Lindholm, Carl-Johan, Löndahl, Magnus, Rein-Hedin, Erik, Soveri, Inga, Spaak, Jonas, Tengmark, Bengt-Olov, Lif-Tiberg, Cornelia, Månflod, Johan, Nguyen, Han, Ackermann, Daniel, Bilz, Stefan, Burnier, Michel, Forster, Christian, Kalbermatter, Stefan, Kistler, Andreas, Pechère-Bertschi, Antoinette, Schultes, Bernd, Laimer, Markus, Rudofsky, Gottfried, Strey, Christopher, Wuerzner, Gregoire, Chiz-Tzung Chang, Hung, Cheng-Chieh, Jiang, Ju-Ying, Lee, Chien-Te, Lin, Shuei-Liong, Tarng, Der-Cherng, Tu, Shih-Te, Wu, Mai-Szu, Wu, Ming-Ju, Chuang, Lee-Ming, Deerochanawong, Chaicharn, Kitiyakara, Chagriya, Ophascharoensuk, Vuddhidej, Pongchaiyakul, Chatlert, Satirapoj, Bancha, Kosachunhanan, Natapong, Sritara, Piyamitr, Eren, Necmi, Gul, Ibrahim, Gulel, Okan, Kocyigit, Ismail, Kumbasar, Abdulbaki, Sahin, Idris, Sari, Ramazan, Sayin, Burak, Tavli, Talat, Ustundag, Sedat, Yenicerioglu, Yavuz, Badak, Ozer, Cayli, Murat, Oguz, Aytekin, Ozdogan, Oner, Sari, Ibrahim, Temizhan, Ahmet, Tigen, Mustafa, Turk, Ugur, Yilmaz, Huseyin, Yilmaz, Mehmet, Bondarets, Iryna, Botsyurko, Volodymyr, Chernikova, Viktoriia, Donets, Oleksandra, Fushtey, Ivan, Grachova, Mariia, Isayeva, Anna, Kogut, Dmytro, Komisarenko, Julia, Kravchun, Nonna, Malyar, Kateryna, Mankovsky, Borys, Martynyuk, Liliya, Maslyanko, Vitaliy, Myshanych, Halyna, Pererva, Larysa, Pertseva, Nataliia, Serhiyenko, Oleksandr, Smirnov, Ivan, Sokolova, Liubov, Stryzhak, Vasyl, Vlasenko, Maryna, Isayeva, Ganna, Larin, Oleksandr, Ahmad AbouSaleh, Barratt, Jonathan, Dang, Cuong, Kahal, Hassan, Kirk, Adam, Kilvert, Anne, Kon, Sui Phi, McCafferty, Kieran, Patel, Dipesh, Rice, Sam, Vijayaraman, Arutchelvam, Wong, Yuk-ki, Gibson, Martin, Wahba, Mona, Zaidi, Reza, Bilous, Rudy, Johnson, Andrew, Kalathil, Dhanya, Kilvert, Anne, Kyriakidou, Christina, Mathew, Amit, Mukhtar, Rasha, Munsoor, Imrozia, Poterajlo, Anton, Swift, Pauline, Idalia Acosta, Adams, Atoya, Adler, Sharon, Ajani, Dilawar, Ali, Slamat, Alicic, Radica, Al-Karadsheh, Amer, Alla, Sreedhara, Allison, D., Andrawis, Nabil, Arif, Ahmed, Awad, Ahmed, Azizad, Masoud, Bahrami, Michael, Bansal, Shweta, Barag, Steven, Barakzoy, Ahmad, Barney, Mark, Barzilay, Joshua, Bashir, Khalid, Bautista, Jose, Beddhu, Srinivasan, Belo, Diogo, Benjamin, Sabrina, Berenji, Ramin, Bhargava, Anuj, Birriel, Jose, Brietzke, Stephen, Brosius, Frank, Brusco, Osvaldo, Burgner, Anna, Busch, Robert, Canadas, Rafael, Caramori, Maria, Cardona, Jose, Case, Christopher, Cruz, Humberto, Dandillaya, Ramprasad, Dawoud, Dalia, Din, Zia, Dixon, Bradley, Doshi, Ankur, Drakakis, James, El Shahawy, Mahfouz, El-Meanawy, Ashraf, El-Shahawy, Mohammed, Evans, John, Fadda, George, Farooq, Umar, Fernando, Roland, Fink, Raymond, First, Brian, Fitz-Patrick, David, Flack, John, Fluck, Patrick, Fogelfeld, Leon, Fonseca, Vivian, Frias, Juan, Galphin, Claude, Garcia-Mayol, Luis, Goldstein, Gary, Gonzalez, Edgar, Gonzalez-Abreu, Francisco, Gore, Ashwini, Grant, David, Habwe, Violet, Hamilton, Maxine, Hammoud, Jamal, Handelsman, Stuart, Hartman, Israel, Heigerick, Glenn, Henry, Andrew, Hernandez, German, Hernandez-Cassis, Carlos, Herrera, Carlos, Hertel, Joachim, Huang, Wenyu, Iglesias, Rogelio, Iranmanesh, Ali, Jackson, Timothy, Jain, Mahendra, Jamerson, Kenneth, Johnson, Karen, Judd, Eric, Kaplan, Joshua, Kayali, Zeid, Khan, Bobby, Khan, Muhammad, Kharait, Sourabh, Kirkman, M. Sue, Kopyt, Nelson, Kotzker, Wayne, Kovesdy, Csaba, Kreit, Camil, Krishna, Arvind, Kronfli, Saeed, Lee, Keung, LeJeune, Derek, Lemus, Brenda, Leon-Forero, Carlos, Linfert, Douglas, Lora, Henry, Lurie, Alexander, Maddukuri, Geetha, Magno, Alexander, Maletz, Louis, Mandayam, Sreedhar, Markell, Mariana, Mayfield, Ronald, Mbogua, Caroline, McMullen, Dierdre, Meisner, Carl, Minton, Stephen, Mocherla, Bharat, Mohandas, Rajesh, Montero, Manuel, Moustafa, Moustafa, Nadkarni, Salil, Nakhle, Samer, Navarro, Jesus, Neyra, Nilda, Nica, Romanita, Nicol, Philip, Norwood, Paul, Numrungroad, Visal, Donovan, Richard O′, Odugbesan, A., Paoli-Bruno, Jorge, Parikh, Samir, Patel, Rakesh, Peixoto, Aldo, Pergola, Pablo, Perlman, Alan, Pettis, Karlton, Pisoni, Roberto, Ponduchi, Mirela, Posada, Jorge, Prabhakar, Sharma, Radhakrishnan, Jai, Rahman, Mahboob, Raina, Rupesh, Rastogi, Anjay, Reisin, Efrain, Rendell, Marc, Robertson, David, Rocco, Michael, Romeu, Hugo, Rosas, Sylvia, Rosenfeld, Jack, Ross, Dennis, Rothman, Jeffrey, Rudolph, Lance, Ruhullah, Yusuf, Ruoff, Gary, Ryu, Jeffrey, Sahani, Mandeep, Sam, Ramin, Samuels, Garfield, Sanchez, William, Santos, Vladimir, Satko, Scott, Saxena, Sanjeev, Scott, David, Seco, Gilberto, Seek, Melvin, Serota, Harvey, Shafi, Tariq, Shahid, Nauman, Shanik, Michael, Sharma, Santosh, Sinha, Arjun, Smelser, James, Smith, Mark, Soe, Kyaw, Solomon, Richard, Soroka, Eugene, Soufer, Joseph, Spinowitz, Bruce, Spry, Leslie, Suarez, Rosa, Subramanian, Bala, Szerlip, Harold, Tamirisa, Aparna, Thomson, Stephen, Tran, Tuan-Huy, Treger, Richard, Trullenque, Gretel, Turk, Thomas, Umpierrez, Guillermo, Urbach, Daniel, Valdes, Martin, Valika, Shujauddin, Vega, Damaris, Weissman, Peter, Whaley-Connell, Adam, Winston, Jonathan, Wise, Jonathan, Wynne, Alan, Zeig, Steven, Abdel-Rahman, Emaad, Abreu, Edel, Awad, Alaa, Bahri, Nader, Bertsch, John, Bleich, David, Bornfreund, Jonathan, Brar, Harjeet, Brian, Susan, Brinson, Cynthia, Bruschetta, Humberto, Carpio, Jose, Cohen, Steven, Cosby, John, Dhanireddy, Soni, Diaz, Jorge, Dunn, Fredrick, Eppanapally, Sabitha, Fayad, Joseph, Goel, Archana, Govindaraju, Kanakadurga, Halpern, Stephen, Jones, Audrey, Kaye, William, Knight, Herbert, Koch, Stanley, Kohli, Nandini, Lastra, Guido, Lerman, Sam, Loredo, Jorge, Lovre, Dragana, Mandviwala, Mustafa, Martin, Earl, Meyer, Jill, Murray, John, Oliver, David, Oparil, Suzanne, Penabad, Jesus, Pereira, Isabel, Popeil, Larry, Quesada, Gonzalo, Ramanathan, Kodangudi, Ramos-Gonez, Luis, Rastegar, Mandana, Rastogi, Padmashri, Rondon, Juan, Roy-Chaudhury, Prabir, Smith, David, Williamson, Don, Womack, Catherine, Yamout, Hala, Yuryev, Michael, Chu, Phuong, Van Hoang, Lam, Khanh, Tran, Phi Nga, Nguyen Thi, Son, Pham Nguyen, Tran, Lan Phuong, Le, Thuy Khuong, Nguyen, Boi Ngoc, Nguyen, Thao, Nui, Nguyen Minh, Nam, Tran Quang, and Tran, Kim Chi

Published
2023
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3. Assessment of a strategy combining ambulatory blood pressure, adherence monitoring and a standardised triple therapy in resistant hypertension

Author

Erietta Polychronopoulou, Michel Burnier, Georg Ehret, Renate Schoenenberger-Berzins, Maxime Berney, Belen Ponte, Paul Erne, Murielle Bochud, Antoinette Pechère-Bertschi, and Gregoire Wuerzner

Subjects
resistant hypertension, blood pressure control, fixed-dose combination therapy, electronic pill boxes, treatment adherence, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Purpose Poor adherence to drug therapy and inadequate drug regimens are two frequent factors responsible for the poor blood pressure (BP) control observed in patients with apparent resistant hypertension. We evaluated the efficacy of an antihypertensive management strategy combining a standardised therapy with three long acting drugs and electronic monitoring of drug adherence in patients with apparent resistant hypertension. Materials and Methods In this multicentric observational study, adult patients with residual hypertension on 24 h ambulatory BP monitoring (ABMP) despite the use of three or more antihypertensive drugs could be included. Olmesartan/amlodipine (40/10 mg, single pill fixed-dose combination) and chlorthalidone (25 mg) were prescribed for 3 months in two separated electronic pills boxes (EPB). The primary outcome was 24 h ambulatory systolic BP (SBP) control at 3 months, defined as mean SBP

Published
2021
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4. Accurate Location of Catheter Tip With the Free-to-Total Metanephrine Ratio During Adrenal Vein Sampling

Author

Foteini Christou, Edward Pivin, Alban Denys, Karim A. Abid, Tobias Zingg, Maurice Matter, Antoinette Pechère-Bertschi, Marc Maillard, Eric Grouzmann, and Gregoire Wuerzner

Subjects
primary aldosteronism, secondary hypertension, aldosterone, adrenal vein sampling (AVS), metanephrines (plasma), cortisol, Diseases of the endocrine glands. Clinical endocrinology, RC648-665
Abstract

BackgroundThe selectivity index (SI) of cortisol is used to document correct catheter placement during adrenal vein sampling (AVS) in patients with primary aldosteronism (PA). We aimed to determine the cutoff values of the SIs based on cortisol, free metanephrine, and the free-to-total metanephrine ratio (FTMR) using an adapted AVS protocol in combination with CT.MethodsAdults with PA and referred for AVS were recruited in two hypertension centers. The cortisol and free metanephrine-derived SIs were calculated as the concentration of the analyte in adrenal veins divided by the concentration of the analyte in the distal vena cava. The FTMR-derived SI was calculated as the concentration of free metanephrine in the adrenal vein divided by that of total metanephrine in the ipsilateral adrenal vein. The AVS was classified as an unequivocal radiological success (uAVS) if the tip of the catheter was seen in the adrenal vein. The SI cutoffs of each index marker were established using receiver operating characteristic curve analysis.ResultsOut of 125 enrolled patients, 65 patients had an uAVS. The SI cutoffs were 2.6 for cortisol, 10.0 for free metanephrine, 0.31 for the FTMR on the left side, and 2.5, 9.9, and 0.25 on the right side. Compared to free metanephrine and the FTMR, cortisol misclassified AVS as unsuccessful in 36.6% and 39.0% of the cases, respectively.ConclusionThis study is the first to calculate the SIs of cortisol, free metanephrine, and the FTMR indices for the AVS procedure. It confirms that free metanephrine-based SIs are better than those based on cortisol.

Published
2022
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5. Increased glucocorticoid metabolism in diabetic kidney disease.

Author

Daniel Ackermann, Bruno Vogt, Murielle Bochud, Michel Burnier, Pierre-Yves Martin, Fred Paccaud, Georg Ehret, Idris Guessous, Belen Ponte, Menno Pruijm, Antoinette Pechère-Bertschi, Heidi Jamin, Rahel Klossner, Bernhard Dick, Markus G Mohaupt, and Carine Gennari-Moser

Subjects
Medicine, Science
Abstract

AimsGlomerular damage indicated by proteinuria is a main symptom in diabetic nephropathy. Mineralocorticoid receptor (MR) antagonists (MRAs) are beneficial irrespective of aldosterone availability. Thus, we hypothesized an alternatively activated MR to promote glomerular damage in proteinuric diabetic nephropathy. Specifically, we aimed first to demonstrate the presence of steroid hormones serving as alternative MR targets in type II diabetic patients with proteinuric kidney disease, second whether MR selectivity was modified, third to characterize MR and glucocorticoid receptor (GR) expression and activity in glomerular cell types exposed to eu- and hyperglycemic conditions, fourth to characterize the pro-fibrotic potential of primary human renal mesangial cells (HRMC) upon stimulation with aldosterone and cortisol, and fifth to specify the involvement of the MR and/or GR in pro-fibrotic signaling.Materials and methodsUrinary steroid hormone profiles of patients with diabetic kidney disease were analyzed by gas chromatography-mass spectrometry and compared to an age and gender matched healthy control group taken out of a population study. In both cohorts, the activity of the MR pre-receptor enzyme 11β-hydroxysteroid dehydrogenase type 2 (HSD11B2), which inactivates cortisol to prevent it from binding to the MR, was assessed to define a change in MR selectivity. Expression of HSD11B2, MR and GR was quantified in HRMC and primary human renal glomerular endothelial cells (HRGEC). Activity of MR and GR was explored in HRMC by measuring the MR/GR down-stream signal SGK1 and the pro-fibrotic genes TGFB1, FN1 and COL1A1 in normal and high glucose conditions with the MR/GR agonists aldosterone/cortisol and the MR/GR antagonists spironolactone/RU486.ResultsPatients with diabetic kidney disease excreted more tetrahydroaldosterone than the control group reaching significance in men. The excretion of MR-agonistic steroid hormones was only increased for 18-hydroxytetrahydrocorticosterone in diabetic women. The excretion of most glucocorticoids was higher in the diabetic cohort. Higher apparent systemic HSD11B2 activity suggested less activation of the MR by cortisol in diabetic patients. Both cell types, HRMC and HRGEC, lacked expression of HSD11B2. Hyperglycemic conditions did not change MR and GR expression and activity. Stimulation with both aldosterone and cortisol promoted upregulation of pro-fibrotic genes in HRMC. This effect of MR and/or GR activation was more pronounced in high glucose conditions and partially inhibited by MRAs and GR antagonists.ConclusionsIn patients with diabetic kidney disease alternative MR activation is conceivable as cortisol and cortisone metabolites are increased. Systemic availability of active metabolites is counteracted via an increased HSD11B2 activity. As this cortisol deactivation is absent in HRMC and HRGEC, cortisol binding to the MR is enabled. Both, cortisol and aldosterone stimulation led to an increased expression of pro-fibrotic genes in HRMC. This mechanism was related to the MR as well as the GR and more marked in high glucose conditions linking the benefit of MRAs in diabetic kidney disease to these findings.

Published
2022
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6. Cardiovascular therapy use, modification, and in-hospital death in patients with COVID-19: A cohort study

Author

Cédric Follonier, Elena Tessitore, Sandra Handgraaf, David Carballo, Maëlle Achard, Antoinette Pechère-Bertschi, François Mach, François R. Herrmann, and François R. Girardin

Subjects
Medicine, Science
Abstract

Aims To assess the associations of exposure and modifications in exposure (i.e., discontinuation on admission, initiation during hospitalization) to eight common cardiovascular therapies with the risk of in-hospital death among inpatients with coronavirus disease 2019 (COVID-19). Methods In this observational study including 838 hospitalized unvaccinated adult patients with confirmed COVID-19, the use of cardiovascular therapies was assessed using logistic regression models adjusted for potential confounders. Results No cardiovascular therapy used before hospitalization was associated with an increased risk of in-hospital death. During hospitalization, the use of diuretics (aOR 2.59 [1.68–3.98]) was associated with an increase, and the use of agents acting on the renin-angiotensin system (aOR 0.39 [0.23–0.64]) and lipid-lowering agents (aOR 0.41 [0.24–0.68]) was associated with a reduction in the odds of in-hospital death. Exposure modifications associated with decreased survival were the discontinuation of an agent acting on the renin-angiotensin system (aOR 4.42 [2.08–9.37]), a β-blocker (aOR 5.44 [1.16–25.46]), a lipid-modifying agent (aOR 3.26 [1.42–7.50]) or an anticoagulant (aOR 5.85 [1.25–27.27]), as well as the initiation of a diuretic (aOR 5.19 [2.98–9.03]) or an antiarrhythmic (aOR 6.62 [2.07–21.15]). Exposure modification associated with improved survival was the initiation of an agent acting on the renin-angiotensin system (aOR 0.17 [0.03–0.82]). Conclusion In hospitalized and unvaccinated patients with COVID-19, there was no detrimental association of the prehospital use of any regular cardiovascular medication with in-hospital death, and these therapies should be continued as recommended.

Published
2022

7. Management of hypertensive disorders in pregnancy: a Position Statement of the European Society of Hypertension Working Group 'Hypertension in Women'.

Author

Thomopoulos, Costas, Hitij, Jana Brguljan, De Backer, Tine, Gkaliagkousi, Eugenia, Kreutz, Reinhold, Lopez-Sublet, Marilucy, Marketou, Maria, Mihailidou, Anastasia S., Olszanecka, Agnieszka, Pechère-Bertschi, Antoinette, Paula Pérez, Mariana, Persu, Alexandre, Piani, Federica, Socrates, Thenral, Stolarz-Skrzypek, Katarzyna, and Cífková, Renata

Published
2024
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10. Sex- and age-specific reference intervals for diagnostic ratios reflecting relative activity of steroidogenic enzymes and pathways in adults.

Author

Valentin Rousson, Daniel Ackermann, Belen Ponte, Menno Pruijm, Idris Guessous, Claudia H d'Uscio, Georg Ehret, Geneviève Escher, Antoinette Pechère-Bertschi, Michael Groessl, Pierre-Yves Martin, Michel Burnier, Bernhard Dick, Murielle Bochud, Bruno Vogt, and Nasser A Dhayat

Subjects
Medicine, Science
Abstract

ObjectiveDiagnostic ratios calculated from urinary steroid hormone metabolites are used as a measure for the relative activity of steroidogenic enzymes or pathways in the clinical investigation of steroid metabolism disorders. However, population-based sex- and age-specific reference intervals and day-night differences in adults are lacking.MethodsSixty-five diagnostic ratios were calculated from steroid metabolites measured by GC-MS in day- and night-time and in 24-hour urine from 1128 adults recruited within the Swiss Kidney Project on Genes in Hypertension (SKIPOGH), a population-based, multicenter cohort study. Differences related to sex, age and day- and night-time were evaluated and reference curves in function of age and sex were modelled by multivariable linear mixed regression for diagnostic ratios and were compared to values from the literature.ResultsMost ratios had sex- and age-specific relationships. For each ratio, percentiles were plotted in function of age and sex in order to create reference curves and sex- and age-specific reference intervals derived from 2.5th and 97.5th percentiles were obtained. Most ratios reflected a higher enzyme activity during the day compared to the night.ConclusionsSex- and age-specific references for 24 hours, day and night urine steroid metabolite ratios may help distinguishing between health and disease when investigating human disorders affecting steroid synthesis and metabolism. The day-night differences observed for most of the diagnostic ratios suggest a circadian rhythm for enzymes involved in human steroid hormones metabolism.

Published
2021
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11. Correction: Reference intervals for the urinary steroid metabolome: The impact of sex, age, day and night time on human adult steroidogenesis.

Author

Daniel Ackermann, Michael Groessl, Menno Pruijm, Belen Ponte, Geneviève Escher, Claudia H d'Uscio, Idris Guessous, Georg Ehret, Antoinette Pechère-Bertschi, Pierre-Yves Martin, Michel Burnier, Bernhard Dick, Bruno Vogt, Murielle Bochud, Valentin Rousson, and Nasser A Dhayat

Subjects
Medicine, Science
Abstract

[This corrects the article DOI: 10.1371/journal.pone.0214549.].

Published
2021
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12. Gender Differences in Cardiovascular Pharmacotherapy—the Example of Hypertension: A Mini Review

Author

Jacklean Kalibala, Antoinette Pechère-Bertschi, and Jules Desmeules

Subjects
hypertension, pharmacology, gender, sex, pharmacokinetics, cardiovascular drugs, Therapeutics. Pharmacology, RM1-950
Abstract

Cardiovascular disease (CVD) is the leading cause of mortality worldwide in both sexes. Despite considerable progress in better understanding the patterns of disease in women, they are still often undertreated and benefit less from evidence-based treatment. Hypertension is a key contributor to CVD and is also one of the most potent risk factors for heart failure in women. Even with the wide variety of available drugs, blood pressure control is globally suboptimal. Current guidelines do not suggest differential treatment of hypertension for women; however, a growing body of research suggests gender dimorphism in the pathophysiology of hypertension and pharmacological response to cardiovascular drugs. The clinical relevance of theses sex-divergent effects of drugs is still under investigation. Owing to the exponential relationship between blood pressure and cardiovascular mortality, even a modest decrease in blood pressure or therapeutic adhesion could be clinically \relevant. In this review, we explore the known pharmacological and pharmacokinetic sex differences with special attention to the main classes of antihypertensive treatment. Current data shows frequently higher drug exposures in women and more frequent adverse drug reactions in all antihypertensive drug groups. As far as cardiovascular prevention is concerned, sex-specific data is often lacking in clinical trials, highlighting the necessity to further study CVD and their treatment in both men and women.

Published
2020
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15. Renal Resistive Index Is Associated With Inactive Matrix Gla (γ‐Carboxyglutamate) Protein in an Adult Population‐Based Study

Author

David A. Jaques, Edward Pivin, Menno Pruijm, Daniel Ackermann, Idris Guessous, Georg Ehret, Fang‐Fei Wei, Jan A. Staessen, Antoinette Pechère‐Bertschi, Cees Vermeer, Bruno Vogt, Michel Burnier, Pierre‐Yves Martin, Murielle Bochud, and Belen Ponte

Subjects
atherosclerosis, matrix Gla (γ‐carboxyglutamate) protein, pulse pressure, pulse wave velocity, renal physiology, renal resistive index, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Background Increased renal resistive index (RRI) has been associated with target organ damage as well as renal and cardiovascular outcomes. Matrix Gla (γ‐carboxyglutamate) protein (MGP) is a strong inhibitor of soft tissue calcification. Its inactive form (dephospho‐uncarboxylated MGP [dp‐ucMGP]) has been associated with vascular stiffness, cardiovascular outcomes, and mortality. In this study, we hypothesized that high levels of dp‐ucMGP were associated with increased RRI. Methods and Results We recruited participants via a multicenter family‐based cross‐sectional study in Switzerland. Levels of dp‐ucMGP were measured in plasma by sandwich ELISA. RRI was measured by Doppler ultrasound in 3 segmental arteries in both kidneys. We used mixed regression models to assess the relationship between dp‐ucMGP and RRI. We adjusted for common determinants of RRI as well as renal function and cardiovascular risk factors. We included 1006 participants in our analyses: 526 women and 480 men. Mean values were 0.44±0.20 nmol/L for dp‐ucMGP and 64±5% for RRI. After multivariable adjustment, dp‐ucMGP was positively associated with RRI (P=0.001). In subgroup analysis by age tertiles, this association was not significant in the youngest age group (55 years; P=0.016 and P

Published
2019
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19. Reference intervals for the urinary steroid metabolome: The impact of sex, age, day and night time on human adult steroidogenesis.

Author

Daniel Ackermann, Michael Groessl, Menno Pruijm, Belen Ponte, Geneviève Escher, Claudia H d'Uscio, Idris Guessous, Georg Ehret, Antoinette Pechère-Bertschi, Pierre-Yves Martin, Michel Burnier, Bernhard Dick, Bruno Vogt, Murielle Bochud, Valentin Rousson, and Nasser A Dhayat

Subjects
Medicine, Science
Abstract

ObjectiveUrinary steroid metabolomics by GC-MS is an established method in both clinical and research settings to describe steroidogenic disorders. However, population-based reference intervals for adults do not exist.MethodsWe measured daytime and night time urinary excretion of 40 steroid metabolites by GC-MS in 1128 adult participants of European ancestry, aged 18 to 90 years, within a large population-based, multicentric, cross-sectional study. Age and sex-related patterns in adjacent daytime and night time urine collections over 24 hours were modelled for each steroid metabolite by multivariable linear mixed regression. We compared our results with those obtained through a systematic literature review on reference intervals of urinary steroid excretion.ResultsFlexible models were created for all urinary steroid metabolites thereby estimating sex- and age-related changes of the urinary steroid metabolome. Most urinary steroid metabolites showed an age-dependence with the exception of 6β-OH-cortisol, 18-OH-cortisol, and β-cortol. Reference intervals for all metabolites excreted during 24 hours were derived from the 2.5th and 97.5th percentile of modelled reference curves. The excretion rate per period of metabolites predominantly derived from the adrenals was mainly higher during the day than at night and the correlation between day and night time metabolite excretion was highly positive for most androgens and moderately positive for glucocorticoids.ConclusionsThis study gives unprecedented new insights into sex- and age-specificity of the human adult steroid metabolome and provides further information on the day/night variation of urinary steroid hormone excretion. The population-based reference ranges for 40 GC-MS-measured metabolites will facilitate the interpretation of steroid profiles in clinical practice.

Published
2019
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23. Hypertension artérielle : ce qui a changé en 2022 [Hypertension: what's new in 2022]

Author

Wuerzner, G., Ponte, B., and Pechère-Bertschi, A.

Subjects
Pregnancy, Female, Humans, Hypertension/drug therapy, Antihypertensive Agents/therapeutic use, Antihypertensive Agents/pharmacology, Blood Pressure, Sodium
Abstract

Our article summarizing the most important studies of the past year emphasizes the difficulty of controlling blood pressure (BP) in hypertensive patients. In addition, it discusses factors such as temperature and sodium that may influence BP, proposes new targets in pregnant hypertensive patients, and challenges the usefulness of taking an antihypertensive drug nightly. Finally, a strategy targeting endothelin blockade in resistant hypertension is presented.

Published
2023

28. Pression sur les médecins en formation

Author

Belén Ponte, Grégoire Wuerzner, and Antoinette Pechère-Bertschi

Subjects
General Medicine, Clinical Competence, Humans, Physicians
Published
2022

29. [Hypertension and SCUBA diving]

Author

Jenny, Duperrex-Fabrizio, Jean-Yves, Berney, Pierre, Louge, and Antoinette, Pechère-Bertschi

Subjects
Risk Factors, Diving, Hypertension, Humans, Pulmonary Edema
Abstract

Hypertension is a major cardiovascular risk factor in our population. This condition is widely recognized as an exacerbating factor for several physiopathological mechanisms, especially under an intense physical effort. In this article we focus on the link between high blood pressure and risk factors in scuba diving. In particular, we illustrate how a hypertensive diver is exposed to an increased risk of acute immersion pulmonary edema, as well as cardiac death.L’hypertension artérielle est un facteur de risque cardiovasculaire prépondérant dans notre population. Elle est reconnue comme pouvant exacerber de nombreux mécanismes physiopathologiques lors de conditions d’efforts. Dans cet article, nous nous focalisons sur le lien entre l’hypertension artérielle et le risque qu’elle pourrait représenter lors de la pratique de la plongée sous-marine. En particulier, nous illustrerons comment un plongeur hypertendu peut être exposé à un risque augmenté d’œdème pulmonaire aigu d’immersion, ainsi qu’à la mort subite d’origine cardiaque.

Published
2022

30. [Does arterial hypertension have a gender?]

Author

Sophie, Huegli and Antoinette, Pechère-Bertschi

Subjects
Male, Pregnancy, Hypertension, Humans, Female, Calcium Channel Blockers, Antihypertensive Agents
Abstract

Women are less frequently affected by arterial hypertension than men during their reproductive life, but their risk catches up and exceeds men's after the menopause. There is a knowledge gap about the specificity of arterial hypertension in women, due to an under inclusion of women in clinical trials. Hypertensive disorders of pregnancy are a recognized ulterior cardiovascular risk factor, and obstetrical history must be part of the evaluation of hypertensive women. In certain cases, we propose to lower the doses of antihypertensive medications in women, due to increased efficiency and increased risk of secondary effects, most notably for thiazide diuretics and calcium channel blockers.Les femmes sont moins touchées par l’hypertension artérielle (HTA) que les hommes durant leur vie reproductive, mais leur tension artérielle et leur risque cardiovasculaire s’élèvent et dépassent ceux des hommes après la ménopause. Il existe un déficit de connaissances sur les spécificités de l’HTA féminine en raison d’une sous-inclusion des femmes dans les études cliniques. Les pathologies hypertensives de la grossesse sont un facteur de risque cardiovasculaire ultérieur reconnu et l’anamnèse obstétricale doit faire partie de l’évaluation des femmes hypertendues. Dans certains cas, une diminution de la posologie des traitements antihypertenseurs chez les femmes est à considérer en raison d’une efficacité augmentée et d’un risque accru d’effets secondaires chez elles, notamment pour les diurétiques thiazidiques et les anticalciques.

Published
2022

36. Increased glucocorticoid metabolism in diabetic kidney disease

Author

Ackermann, Daniel, primary, Vogt, Bruno, additional, Bochud, Murielle, additional, Burnier, Michel, additional, Martin, Pierre-Yves, additional, Paccaud, Fred, additional, Ehret, Georg, additional, Guessous, Idris, additional, Ponte, Belen, additional, Pruijm, Menno, additional, Pechère-Bertschi, Antoinette, additional, Jamin, Heidi, additional, Klossner, Rahel, additional, Dick, Bernhard, additional, Mohaupt, Markus G., additional, and Gennari-Moser, Carine, additional

Published
2022
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38. [Hypertension: novelties 2021]

Author

Grégoire, Wuerzner, Belen, Ponte, and Antoinette, Pechère-Bertschi

Subjects
Pre-Eclampsia, Pregnancy, Hypertension, Pregnancy Complications, Cardiovascular, Humans, Female, Middle Aged, Aged
Abstract

The past year has been particularly rich in the field of arterial hypertension. Our annual review covers the latest epidemiological studies which show that more than 1.2 billion people have high blood pressure, half of them are unaware of it and that only a quarter of treated patients reach the recommended targets. The impact of poor adherence in young hypertensive patients on cardiovascular events and the effects of intensive treatment in patients over 60 years of age will be discussed. Finally, the adjustment of anti hypertensive treatment in pregnant women with a history of pre-eclampsia according to hemodynamic parameters measured during pregnancy and the effects of potassium supplementation in table salt on cardiovascular events will be presented.L’année écoulée a été particulièrement riche dans le domaine de l’hypertension artérielle (HTA). Notre revue annuelle couvre les dernières études épidémiologiques qui montrent que plus de 1,2 milliard de personnes sont atteintes d’HTA, que la moitié d’entre elles l’ignore et finalement qu’un quart des patient·e·s atteignent les cibles recommandées. L’impact d’une mauvaise adhésion chez des jeunes patients hypertendus sur les événements cardiovasculaires ainsi que les effets d’un traitement intensif chez des patients de plus de 60 ans seront abordés. Finalement, l’ajustement d’un traitement antihypertenseur chez des femmes enceintes avec antécédents de prééclampsie en fonction des paramètres hémodynamiques mesurés en cours de grossesse et les effets d’une supplémentation de potassium dans le sel de table sur les événements cardiovasculaires seront présentés.

Published
2022

44. Urinary Cadmium Excretion Is Associated With Increased Synthesis of Cortico- and Sex Steroids in a Population Study

Author

Max Haldimann, Murielle Bochud, Idris Guessous, Michel Burnier, Markus G. Mohaupt, Daniel Ackermann, Judith Jenny-Burri, Georg Ehret, Antoinette Pechère-Bertschi, Fred Paccaud, Belen Ponte, Geneviève Escher, Bruno Vogt, Vincent Dudler, Menno Pruijm, Pierre-Yves Martin, Bernhard Dick, and Dusan Petrovic

Subjects
0301 basic medicine, Adult, Male, medicine.medical_specialty, Endocrinology, Diabetes and Metabolism, Urinary system, medicine.medical_treatment, Clinical Biochemistry, 010501 environmental sciences, Kidney, 01 natural sciences, Biochemistry, Excretion, Cohort Studies, 03 medical and health sciences, chemistry.chemical_compound, Endocrinology, Sex hormone-binding globulin, Adrenal Cortex Hormones, Internal medicine, Mineralocorticoids, medicine, Humans, Family, Testosterone, 610 Medicine & health, Gonadal Steroid Hormones, Aldosterone, ddc:613, 0105 earth and related environmental sciences, Aged, ddc:616, biology, business.industry, Biochemistry (medical), Kidney metabolism, Middle Aged, Steroid hormone, 030104 developmental biology, chemistry, Sex steroid, Hypertension, biology.protein, Female, business, Cadmium
Abstract

Context Urinary cadmium (Cd) excretion is associated with cancer and cardiovascular morbidity. A potential mechanism could be disturbance of steroidogenesis in gonads and adrenal glands. Objective We tested whether urinary excretion of Cd is correlated with that of cortico- and sex steroid metabolites in the general adult population. Setting The Swiss Kidney Project on Genes in Hypertension is a multicentric, family-based population study. Measures Urinary excretions of steroid hormone metabolites and Cd were measured with separate day and night collections. Associations were analyzed by mixed linear models. Results Urinary Cd and testosterone excretions in men were significantly correlated (respective day and night β values [standard error (SE)], 1.378 [0.242], P < 0.0005; and 1.440 [0.333], P < 0.0005), but not in women [0.333(0.257), P = 0.2; and 0.674 (0.361), P = 0.06]. Urinary Cd and cortisol excretions were positively associated in both sexes [day: β = 0.475 (SE, 0.157), P = 0.0025, and 0.877 (SE, 0.194), P < 0.0005, respectively; night: β = 0.875 (SE, 0.253), P < 0.0005 and 1.183 (SE, 0.277), P = 0.00002, respectively]. Cd excretion was correlated with mineralocorticoid metabolites excretion, except tetrahydroaldosterone, in both sexes (P < 0.01). There was an independent effect of Cd on sex hormone and corticosteroid synthesis and an interdependent effect on gluco- and mineralcorticoid production. Conclusion Our findings provide evidence for a global stimulating effect on steroid synthesis already at low-dose Cd exposure. These findings might explain the association of Cd with diseases such as steroid-sensitive cancers or metabolic disorders.

Published
2021

45. [Hyponatremia and thiazides]

Author

Sonia, Bensabre, Sofia, Zisimopoulou, and Antoinette, Pechère-Bertschi

Subjects
Thiazides, Indapamide, Chlorthalidone, Humans, Antihypertensive Agents, Hyponatremia
Abstract

Thiazide diuretics (hydrochlorothiazide) and « thiazide-like » (chlorthalidone, indapamide) are widely prescribed due to their effectiveness in the treatment of arterial hypertension. The use of thiazides may be complicated by hyponatremia that is associated with increased morbidity and mortality. The pathophysiology of thiazide-induced hyponatremia is not yet clear. It is currently difficult to predict who will develop thiazide-induced hyponatremia. Genetic predisposition is considered, and several studies are attempting to clarify it in order to identify patients at risk of developing hyponatremia after taking a thiazide. Their reintroduction to a patient who already presented hyponatremia upon thiazide should be avoided.Les diurétiques thiazidiques (hydrochlorothiazide) et thiazidiques apparentés (chlortalidone, indapamide) sont largement prescrits du fait de leur efficacité dans le traitement de l’hypertension artérielle. La prise de thiazidiques peut se compliquer d’une hyponatrémie associée à une morbidité et une mortalité augmentées. La physiopathologie de cette hyponatrémie n’est pas encore totalement élucidée. Il est à l’heure actuelle difficile de prédire qui va présenter une hyponatrémie induite par les thiazidiques. Une susceptibilité génétique a été envisagée et plusieurs études tentent de la préciser dans le but d’identifier les patients à risque de développer une hyponatrémie après la mise sous thiazidiques. Chez un patient qui a présenté une hyponatrémie sur thiazidiques, leur réintroduction devrait être évitée.

Published
2021

46. [Effect of seasons on blood pressure]

Author

Léa, Roth and Antoinette, Pechère-Bertschi

Subjects
Hypertension, Humans, Blood Pressure, Seasons, Blood Pressure Monitoring, Ambulatory, Antihypertensive Agents, Circadian Rhythm
Abstract

Blood pressure (BP) variability appears to be a cardiovascular risk factor in its own right. Seasonal and temperature changes contribute to BP variations in the medium term with increased BP values in winter and lowered values in summer, and in the short term by influencing the circadian rhythm of BP. International societies have not issued specific recommendations on the detection of patients at risk of significant seasonal variations in BP, nor on the possible adaptation of antihypertensive treatments. This is a topical issue in the context of global warming, which will make these seasonal differences more significant in the future. Measuring BP outside the medical setting can be of great help in screening and monitoring these patients.La variabilité de la pression artérielle (PA) semble être un facteur de risque cardiovasculaire à part entière. Les changements de saison et de température participent aux variations de la PA à moyen terme avec des valeurs tensionnelles augmentées en hiver et abaissées en été et à court terme en influençant le rythme circadien de la PA. Les sociétés internationales n’ont pas émis de recommandations spécifiques sur la détection des patients à risque de présenter des variations saisonnières importantes de la PA, ni sur l’adaptation éventuelle des traitements antihypertenseurs. Le sujet est d’actualité à l’heure du réchauffement climatique qui pourrait rendre ces différences saisonnières plus importantes à l’avenir. La mesure de la PA hors du milieu médical peut être d’une grande aide au dépistage et au suivi de ces patients.

Published
2021

50. Accuracy of doctors’ anthropometric measurements in general practice

Author

Paul Sebo, Dagmar Haller, Antoinette Pechère-Bertschi, Patrick Bovier, and François Herrmann

Subjects
primary care, accuracy, anthropometric measurements, Medicine
Abstract

PURPOSE: There is increasing pressure on general practitioners (GPs) to identify patients with abdominal obesity in order to reduce the life-threatening consequences of this condition in the population. We aimed to confirm previous findings on the inaccuracy of anthropometric measurements performed by GPs in an academic primary care clinic and to assess the effect of theoretical training to improve the quality of these measurements. METHODS: This cross-sectional study involved 26 GPs from private practices in Geneva, Switzerland. They were asked to measure weight, height, waist and hip circumference on ten volunteers within their practice. Two trained research assistants repeated the measurementss after the GPs (“gold standard”). The GPs were then randomised to receive information detailing the correct method for taking measurements (intervention, 14 doctors) or simple information about obesity (control, 12 doctors). Measurements were repeated a few weeks later. Measurement error was computed by comparing the GPs’ values with the average value of two measurements taken in turn by the research assistants, and agreement was examined by Bland-Altman plots. The GPs’ skills were assessed through auto-questionnaire and direct observation. RESULTS: All measurements except height were prone to measurement error, the least affected being weight (and therefore body mass index [BMI]). Following training, measurement errors were slightly less prominent in the intervention group. GPs’ skills in measuring waist and hip circumference were frequently assessed as inadequate, but showed improvement after training. CONCLUSIONS: Without proper training, priority should be given to using classical anthropometric measurements (i.e. weight, height and BMI determination) in daily practice.

Published
2015
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