# Maximizing The Benefit of Therapy in CKD

> **NIH NIH R01** · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · 2024 · $670,156

## Abstract

ABSTRACT
 The first phase of this grant aimed to generate evidence to promote appropriate, safe, and effective use of
medications across the range of kidney function. We established a dedicated pharmacoepidemiology group
and investigated medication use across the spectrum of glomerular filtration rate (GFR) in >5 million patients in
5 international health systems. We evaluated the risks and benefits of many common medications and
medication classes: metformin, angiotensin converting enzyme (ACE)-inhibitors, angiotensin receptor blockers
(ARBs), spironolactone, and rosuvastatin, among others. We identified large gaps in guideline-recommended
monitoring and medical management, such as the pervasive undertesting of albuminuria among patients with
diabetes and hypertension.
 In this renewal application, we expand the prior study population to include additional large health systems
covering approximately 25 million patients with measures of kidney function. We incorporate current data to
enable investigation of newer classes of medications, such as sodium glucose co-transporter-2 inhibitors
(SGLT2-Is). We extend expertise of the investigative team to include leaders in implementation science and
clinical decision support, allowing translation of findings back into local electronic health systems.
 The overall premise of the application is that, by using post-marketing real-world data, we can provide
essential evidence to inform optimal care practices for patients with or at risk for chronic kidney disease (CKD).
Using SGLT2-Is as the primary example, we propose first to identify gaps in care, quantifying the number of
patients not receiving SGLT2-Is who are recommended to do so under clinical practice guidelines. Next, we
identify subgroups of patients most likely to benefit from SGLT2-I therapy through a careful assessment of
risks and benefits across individual patient characteristics. Finally, we develop and refine clinical decision
support tools that identify high-risk patients in real time who are lacking SGLT2-I therapy. In summary, with the
overall goal of simplifying provider decision-making and optimizing medical treatment for patients with or at risk
for CKD, this renewal application proposes to identify gaps in care, refine target populations for beneficial
medical therapies, and translate knowledge to the point of patient care.
 .

## Key facts

- **NIH application ID:** 10851037
- **Project number:** 5R01DK115534-07
- **Recipient organization:** NEW YORK UNIVERSITY SCHOOL OF MEDICINE
- **Principal Investigator:** Alexander R Chang
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $670,156
- **Award type:** 5
- **Project period:** 2018-08-01 → 2027-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10851037

## Citation

> US National Institutes of Health, RePORTER application 10851037, Maximizing The Benefit of Therapy in CKD (5R01DK115534-07). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/10851037. Licensed CC0.

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