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Research Letter
January 2016

Representation of Patients With Kidney Disease in Trials of Cardiovascular InterventionsAn Updated Systematic Review

Author Affiliations
  • 1Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
  • 2Division of Nephrology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
  • 3Department of Public Health, Icahn School of Medicine at Mount Sinai, New York, New York
  • 4Department of Medicine, St Luke’s Roosevelt Hospital Center at Mount Sinai, New York, New York
  • 5Section of Nephrology, Department of Medicine, Yale School of Medicine, New Haven, Connecticut
JAMA Intern Med. 2016;176(1):121-124. doi:10.1001/jamainternmed.2015.6102

The prevalence of kidney disease (KD) among the general population and in patients with cardiovascular disease (CVD) is high and growing.1 Also, standard therapeutic strategies may act differently in patients with KD, making extrapolation of trial data from patients without KD unreliable.2 In addition, trials in nephrology are more likely to be smaller and unblinded, leading to poorer-quality evidence.3 Despite the need for high-quality evidence for CVD interventions, 2 systematic reviews using data from 1985-2005 and 1998-2005 showed that patients with KD are underrepresented in randomized clinical trials of CVD interventions.4,5 We aimed to update the estimates of the representation of patients with KD in major randomized clinical trials of CVD interventions.

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