Saidu Medical College

Post-transplant hypertension is common in kidney transplant recipients and contributes to cardiovascular risk and allograft dysfunction. Most available data come from studies where the primary indication for SGLT2 inhibitor use was post-transplant diabetes mellitus or cardiorenal protection, with blood pressure assessed as a secondary outcome. To systematically evaluate the impact of SGLT2 inhibitors on blood pressure, metabolic and renal outcomes, and safety in kidney transplant recipients. PubMed, Embase, and Scopus clinical trial registries were systematically searched from inception to October 20, 2025. Randomized controlled trials and observational studies were included. Primary outcomes were changes in systolic and diastolic blood pressure at 3, 6, and 12 months. Secondary outcomes included body weight, glycated hemoglobin (HbA1c), renal function, and adverse events. Twelve studies comprising 1,292 participants were included. In controlled difference-in-differences analyses (5 studies), SGLT2 inhibitors showed no significant blood pressure reductions versus control at any time point. Exploratory single-arm analyses suggested within-group systolic blood pressure reductions at 3 and 6 months; however, these estimates are at high risk of bias and cannot establish treatment effect. Exploratory single-arm analyses suggested modest short-term reductions in systolic blood pressure and suggested metabolic effects with an acceptable safety profile. However, controlled difference-in-differences analyses showed no significant blood pressure reductions versus control. Most available evidence derives from studies in which SGLT2 inhibitors were not initiated specifically for blood pressure control. Dedicated randomized controlled trials are required to determine their role in the management of post-transplant hypertension.

Growth hormone deficiency (GHD) requires long-term hormone replacement therapy, most commonly through daily injections of recombinant human growth hormone (rhGH). Although effective, this daily regimen may lead to poor adherence, particularly in children. Somapacitan, a long-acting growth hormone analog administered once weekly, has emerged as a potential alternative. This systematic review and meta-analysis compares the efficacy, safety, and biochemical outcomes of once-weekly somapacitan with daily Norditropin in patients with GHD. Following PRISMA guidelines (PROSPERO: CRD420251118208), PubMed and CENTRAL were systematically searched up to August 2025. Randomized controlled trials comparing somapacitan with Norditropin in patients with GHD were included. Data were pooled using a random-effects meta-analysis in Review Manager 5.4, and risk of bias was assessed using the Cochrane RoB 2 tool. Ten randomized controlled trials involving 920 participants were included. Somapacitan and Norditropin demonstrated comparable outcomes in height velocity (MD = 0.12; 95

Despite advancements in treatment, chronic kidney disease (CKD) remains a major cause of morbidity and mortality in systemic lupus erythematosus (SLE). However, a comprehensive analysis of mortality trends and demographic disparities remains limited. This study aims to evaluate mortality related to CKD among patients diagnosed with SLE, acknowledging that the specific cause of CKD (e.g., lupus nephritis vs. other etiologies) cannot be determined from available data. The CDC WONDER database was used to obtain mortality data for U.S. adults (≥ 25 years) due to chronic renal failure in SLE from 1999 to 2020. Crude and age-adjusted mortality rates (AAMRs) per 100,000 individuals were calculated and stratified by gender, race, year, state, census region, urbanization, and place of death. Trends in AAMRs were evaluated using Joinpoint regression to estimate annual percent change (APC) and average annual percent change (AAPC). Between 1999 and 2020, a total of 5204 deaths were attributed to chronic renal failure in patients with SLE. The overall AAMR for CKD in SLE patients increased from 0.076 to 0.104 during this period, with a pronounced rise from 2018 to 2020 (APC: 15.06). Females exhibited higher AAMR than males (0.116 vs. 0.013). Additionally, AAMRs were highest among non-Hispanic (NH) African Americans and lowest among NH Whites (0.265 vs. 0.036). Regionally, the highest AAMRs were recorded in the West, South Carolina, and Metropolitan areas. The highest crude death rate (CDR) was observed in the 55–85 + age group. Mortality from CKD among patients with SLE has risen over the past two decades, especially from 2018 to 2020. These discrepancies underscore the need for targeted healthcare strategies and legislative measures to reduce the growing mortality burden.

To review the mechanistic rationale and recent Phase 3 clinical trial data for baxdrostat, a selective aldosterone synthase inhibitor, in the management of treatment-resistant hypertension. We evaluated efficacy and safety data from the Phase 3 BaxHTN (N = 794) and Bax24 (N = 217) trials, along with a recent systematic review and meta-analysis of aldosterone synthase inhibitors. In BaxHTN, baxdrostat 2 mg reduced seated systolic blood pressure by -15.7 mmHg (placebo-adjusted − 9.8 mmHg; P < 0.001). In Bax24, 24-hour ambulatory systolic blood pressure decreased by -16.6 mmHg (placebo-adjusted − 14.0 mmHg; P < 0.001). Hyperkalemia (> 5.5 mmol/L) occurred in approximately 12