Table 5 List of the clinical studies among the top 100 most cited articles
From: The evolution and future of diabetic kidney disease research: a bibliometric analysis
Information | Topic | Patients | Main results |
|---|---|---|---|
Article number 1: Effects of losartan on renal and cardiovascular outcomes in patients with type 2 diabetes and nephropathy ACT: 234.95 | RAAS | T2DM patients with nephropathy | Losartan reduced the incidence of a doubling of the serum creatinine concentration, the incidence of end-stage renal disease, and the level of proteinuria by 25, 28, and 35%, respectively. In addition, losartan did not significantly alter the morbidity and mortality from cardiovascular causes. |
Article number 2: The effect of irbesartan on the development of diabetic nephropathy in patients with type 2 diabetes ACT: 111.45 | RAAS | Hypertensive patients with T2DM and microalbuminuria | Irbesartan reduced the incidence of nephropathy and the level of urinary albumin excretion independently of its antihypertensive effect. In addition, irbesartan also reduced the incidence of serious adverse events. |
Article number 3: Aliskiren combined with losartan in type 2 diabetes and nephropathy ACT: 59.15 | RAAS | Hypertensive patients with T2DM and nephropathy | Aliskiren reduced the mean UACR by 20% without significant change in the total numbers of adverse and serious adverse events. |
Article number 7: Proteinuria, a target for renoprotection in patients with type 2 diabetic nephropathy: lessons from RENAAL ACT: 39.76 | RAAS | T2DM patients with nephropathy | Baseline albuminuria was the predominant renal risk parameter. The residual albuminuria after 6 months of losartan treatment was another strong renal risk parameter. Losartan reduced the level of albuminuria, which was the major explanation of its renoprotective function. |
Article number 8: Effects of aggressive blood pressure control in normotensive type 2 diabetic patients on albuminuria, retinopathy and strokes ACT: 30.05 | BP | Normotensive T2DM patients | Over a 5-year follow-up period, intensive BP control (approximately 128/75 mmHg) reduced the percentage of normoalbuminuria-to-microalbuminuria and microalbuminuria-to-overt albuminuria, the progression of diabetic retinopathy and the incidence of stroke compared to the moderate BP control group (approximately 137/81 mmHg). In addition, intensive BP control had no significant influence on creatinine clearance. |
Article number 9: Combined angiotensin inhibition for the treatment of diabetic nephropathy ACT: 69.00 | RAAS | T2DM veterans with overt nephropathy | Over a 2-year follow-up period, the combination of ACEi and ARB induced hyperkalemia and acute kidney injury. For safety concerns, the study was stopped. |
Article number 10: Albuminuria, a therapeutic target for cardiovascular protection in type 2 diabetic patients with nephropathy ACT: 32.00 | RAAS | T2DM patients with nephropathy | Baseline albuminuria was the predominant risk predictor of cardiovascular outcome. Reducing albuminuria in the first 6 months was renoprotective. |
Article number 14: Regression of microalbuminuria in type 1 diabetes ACT: 27.61 | T1DM | T1DM patients with microalbuminuria | Over a 6-year follow-up period, the incidence of regression of microalbuminuria was 58%. The regression of microalbuminuria did not indicate inexorable progression of nephropathy, and ACEi treatment was not associated with the regression of microalbuminuria. |
Article number 15: Olmesartan for the delay or prevention of microalbuminuria in type 2 diabetes ACT: 49.40 | RAAS | T2DM patients | Over a 3-year follow-up period, olmesartan delayed the onset of microalbuminuria by 23%. Notably, olmesartan increased the risk of fatal cardiovascular events among T2DM patients with preexisting coronary heart disease. |
Article number 17: Selective vitamin D receptor activation with paricalcitol for reduction of albuminuria in patients with type 2 diabetes (VITAL study): a randomised controlled trial ACT: 43.82 | RAAS | T2DM patients with albuminuria and ACEi or ARB treatment | Addition of 2 μg/day paricalcitol to RAAS inhibition safely reduced UACR by 18 to 28% compared with placebo. |
Article number 18: Bardoxolone methyl in type 2 diabetes and stage 4 chronic kidney disease ACT: 59.50 | OS | T2DM patients with stage 4 chronic kidney disease | Over a 9-month follow-up period, bardoxolone methyl did not reduce the risk of end-stage renal disease or death from cardiovascular causes but induced cardiovascular events. For safety concerns, the study was stopped. |
Article number 27: The risk of developing end-stage renal disease in patients with type 2 diabetes and nephropathy: The RENAAL Study ACT: 19.17 | RAAS | T2DM patients with nephropathy | A multivariate model showed that proteinuria, serum creatinine, serum albumin and haemoglobin level were independent risk predictors of renal outcomes after control of BP. Moreover, the level of proteinuria was the most important risk parameter for progressive kidney injury. |
Article number 32: Liraglutide and renal outcomes in type 2 diabetes ACT: 84.00 | GLP-1 | T2DM patients with high risk for cardiovascular disease | Over a 3-year follow-up period, liraglutide reduced the new onset of persistent macroalbuminuria by 26% and the risk of the development and progression of DKD. |
Article number 35: Effectiveness of aldosterone blockade in patients with diabetic nephropathy ACT: 18.11 | RAAS | T2DM patients with early nephropathy and ACEi treatment | Aldosterone escape appeared in 40% of patients and led to less effective antiproteinuric effects of ACEi treatment. Over a 6-month follow-up period, addition of spironolactone to ACEi reduced UACR and left ventricular mass index while it did not significantly influence BP. |
Article number 36: Efficacy and safety of canagliflozin in subjects with type 2 diabetes and chronic kidney disease ACT: 40.38 | SGLT-2 | T2DM patients with stage 3 chronic kidney disease | Canagliflozin reduced HbA1c and fasting plasma glucose and was generally well tolerated. |
Article number 41: Cardiovascular outcomes in the Irbesartan Diabetic Nephropathy Trial of patients with type 2 diabetes and overt nephropathy ACT: 17.00 | RAAS | T2DM patients with overt nephropathy | Irbesartan or amlodipine in addition to conventional antihypertensive therapy did not significantly influence the risk of composite cardiovascular events compared to placebo in addition to conventional antihypertensive therapy. |
Article number 44: Randomized trial of an inhibitor of formation of advanced glycation end products in diabetic nephropathy ACT: 17.76 | AGEs/RAGE | T1DM patients with nephropathy and retinopathy | Pimagedine did not significantly influence the progression of overt nephropathy. |
Article number 50: Avosentan for overt diabetic nephropathy ACT: 25.18 | OS | T2DM patients with ACEi or ARB treatment | Over a 4-month follow-up period, addition of avosentan to RAAS inhibitor reduced albuminuria but induced significant fluid overload and congestive heart failure. For safety concerns, the study was stopped. |
Article number 52: Effects of blood pressure level on progression of diabetic nephropathy - results from the RENAAL study ACT: 15.22 | RAAS | T2DM patients with nephropathy and hypertension | Baseline systolic blood pressure was a stronger risk predictor than diastolic blood pressure of renal outcomes. Patients with the highest baseline pulse pressure had the highest renal risk and benefited most after losartan-reduced systolic blood pressure. |
Article number 62: Proteinuria reduction and progression to renal failure in patients with type 2 diabetes mellitus and overt nephropathy ACT: 15.75 | RAAS | T2DM patients with overt nephropathy | Each doubling of baseline proteinuria level doubled the risk for renal failure. Each halving of proteinuria level between baseline and 12 months with treatment reduced the risk for renal failure by 56%. With the same reduction in proteinuria, irbesartan reduced more risk of renal failure compared to amlodipine. |
Article number 64: Independent and additive impact of blood pressure control and angiotensin II receptor blockade on renal outcomes in the Irbesartan Diabetic Nephropathy Trial: clinical implications and limitations ACT: 15.50 | RAAS | Hypertensive T2DM patients with overt nephropathy | Systolic blood pressure was the strong risk predictor of baseline serum creatinine doubling or end-stage renal disease. Systolic blood pressure target between 120 and 130 mmHg combined with irbesartan was recommended. There was no correlation between diastolic blood pressure and renal outcomes. |
Article number 66: Microalbuminuria and the risk for early progressive renal function decline in type 1 diabetes ACT: 17.64 | T1DM | T1DM patients | Early renal function decline occurred in 9% of the normoalbuminuria group and 31% of the microalbuminuria group. In multivariate analysis, the risk of early renal function decline increased after 35 years old or HbA1c exceeding 9% but was not influenced by diabetes duration, smoking, BP or ACEi treatment. Cystatin C together with microalbuminuria was recommended to diagnose early renal function decline. |
Article number 75: Albuminuria is a target for renoprotective therapy independent from blood pressure in patients with type 2 diabetic nephropathy: post hoc analysis from the reduction of endpoints in NIDDM with the angiotensin II antagonist losartan (RENAAL) trial ACT: 16.86 | RAAS | T2DM patients with hypertension | Systolic blood pressure reduction, albuminuria regression and low level of residual albuminuria were associated with a lower risk of end-stage renal disease. Systolic blood pressure reduction together with albuminuria regression was recommended to be the target of antihypertensive treatment to improve renal outcome. |
Article number 80: Addition of angiotensin receptor blockade or mineralocorticoid antagonism to maximal angiotensin-converting enzyme inhibition in diabetic nephropathy ACT: 19.33 | RAAS | Hypertensive T2DM patients with albuminuria | Compared to lisinopril alone, addition of spironolactone to lisinopril reduced UACR by 36% and addition of losartan to lisinopril reduced UACR by 16.8%. Spironolactone was recommended to be combined with lisinopril for a greater renoprotective function in addition to BP control. |
Article number 86: Impact of achieved blood pressure on cardiovascular outcomes in the irbesartan diabetic nephropathy trial ACT: 14.25 | RAAS | T2DM patients with overt nephropathy | Progressively lower achieved BP 120/85 mmHg was associated with the best protection against cardiovascular events. Increased pulse pressure, systolic blood pressure below 120 mmHg or diastolic blood pressure below 85 mmHg was associated with increased cardiovascular events. |
Article number 93: Effect of finerenone on albuminuria in patients with diabetic nephropathy: a randomized clinical trial ACT: 36.83 | RAAS | Diabetic patients with high or very high albuminuria and ACEi or ARB treatment | Addition of finerenone to ACEi or ARB dose-dependently reduced UACR and was well tolerated. |