Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · Jun 2020
[Antidiabetic SGLT-2 inhibitors prevent progression of chronic kidney disease].
Several interventional trials that studied cardiovascular safety of antidiabetic drugs in patients with diabetes mellitus and elevated risk of cardiovascular disease suggested potential nephroprotective effects of SGLT-2 inhibitors. Subsequently, the CREDENCE study confirmed reduced progression of chronic kidney disease (CKD) towards dialysis-dependency in diabetic patients with mildly or moderately impaired glomerular filtration rate and high albuminuria. ⋯ The final publication of DAPA-CKD is expected in late 2020. Parallelly, new treatment guidelines from the Kidney-Disease:-Improving-Global-Outcomes (KDIGO)-Initiative will recommend SGLT-2 inhibitors as standard treatment for CKD patients with diabetes mellitus, even though these drugs are not yet licensed for patients with moderately-to-severely reduced renal function.
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Dtsch. Med. Wochenschr. · May 2020
Review[Legal Issues of Resource Allocation in the COVID-19 Pandemic - Between Utilitarianism and Life Value Indifference].
The COVID-19 pandemic poses unprecedented challenges for the German health care system. What is already the case in some other countries, may occur in Germany in the near future also: Faced with limited ICU resources, doctors will be forced to decide which patients to treat and which to let die. This paper examines the legal implications of such decisions. ⋯ The implications of this normative standard for the prioritizing in an exceptional situation as the COVID 19 pandemic have not been sufficiently clarified. This uncertainty leads to emotional and moral burdens for doctors. The authors conclude that the German law grants a limited freedom of choice that allows physicians to apply utilitarian criteria in addition to purely medical decision algorithms.