Trial Condition(s):

Type 2 Diabetes Mellitus, Chronic Kidney Disease

A study to learn how well the treatment combination of finerenone and empagliflozin works and how safe it is compared to each treatment alone in adult participants with long-term kidney disease (chronic kidney disease) and type 2 diabetes (CONFIDENCE)

Bayer Identifier:

21839

ClinicalTrials.gov Identifier:

NCT05254002

EudraCT Number:

2021-003037-11

EU CT Number:

2023-506981-30-00

Recruitment Complete

Trial Purpose

Finerenone works by blocking a group of proteins, called mineralocorticoid receptor. An increased stimulation of mineralocorticoid receptor is known to trigger injury and inflammation in the kidney and is therefore thought to play a role in CKD.
Empagliflozin lowers blood sugar levels by increasing the excretion of glucose from the blood into the urine.
In this study, the researchers want to learn how well the combination of finerenone and empagliflozin helps to slow down the worsening of the participants’ kidney function compared to either treatment alone. For this, the level of protein in the urine will be measured. The investigators also want to know how safe the combination is compared to either treatment alone.
Depending on the treatment group, the participants will either take the combination of finerenone and empagliflozin, or finerenone together with a placebo, or empagliflozin together with a placebo, once a day as tablets by mouth. A placebo looks like a treatment but does not have any medicine in it. Importantly, the participants will also continue to take their other current medicine for CKD and T2D.

The participants will be in the study for up to 7.5 months and will take the study treatments for 6 months. During the study, participants will visit the study site 7 times.
The study team will:
•    collect blood and urine samples
•    check the participants’ vital signs
•    do a physical examination including height and weight
•    check the participants’ heart health by using an electrocardiogram (ECG)
•    monitor the participants’ blood pressure
•    ask the participants questions about how they are feeling and what adverse events they may be having
An adverse event is any problem that happens during the trial. Doctors keep track of all events that happen in trials, even if they do not think the events might be related to the study treatments.

Inclusion Criteria
- Participant with a clinical diagnosis of chronic kidney disease (CKD) and the following:
  -- In Part A: eGFR 40-90 ml/min/1.73m^2 (with no more than 20% having an eGFR >75 ml/min/1.73m^2) using Chronic Kidney Disease Epidemiology Collaboration (CKD EPI) formula at screening visit and at least one historical value of eGFR <60 mL/min/1.73 m^2 within 3 months or have a registered diagnosis of CKD.
  -- In Part B: eGFR 30-90 ml/min/1.73m^2 (with no more than 20% having an eGFR >75 ml/min/1.73m^2) using CKD-EPI formula at screening visit and at least one historical value of eGFR <60 mL/min/1.73 m^2 within 3 months or have a registered diagnostic of CKD. 
  -- 100 ≤UACR <5000 mg/g at screening visit (mean value from 3 morning void samples) and documentation of albuminuria/proteinuria (quantitative or semi-quantitative measurement) in the participant’s medical records at least 3 months prior to screening
- Participant with type 2 diabetes (T2D) as defined by the American Diabetes Association (ADA 2021), with glycated hemoglobin (HbA1c) at screening <11%.
- Participant treated with the clinically maximum tolerated dose, as per investigator judgment, of angiotensin-converting enzyme inhibitor (ACEi) or angiotensin receptor blocker (ARB), but not both, for more than 1 month at screening visit.
Exclusion Criteria
- Participants with type 1 diabetes (T1D).
  - Participant with hepatic insufficiency classified as Child-Pugh C.
  - Participant with blood pressure at Day 1 visit  (Visit 2) higher than 160 systolic blood pressure (SBP) or 100  diastolic blood pressure (DBP)  or SBP lower than 90 mmHg.
  - Participant currently treated with a sodium/glucose cotransporter-2 inhibitor (SGLT2i) or SGLT-1/2i or who received a SGLT2i or SGLT-1/2i which cannot be discontinued at least 8 weeks prior to the screening visit and during study intervention treatment. 
  - Participant treated with another mineralocorticoid receptor antagonist (MRA) (e.g., eplerenone, esaxerenone, spironolactone, canrenone), a renin inhibitor, potassium supplements, a potassium sparing diuretic (e.g., amiloride, triamterene), a potassium binder agent, or angiotensin receptor-neprilysin inhibitor (ARNI) which cannot be discontinued at least 8 weeks prior to the screening visit and during study intervention treatment. 
  - Participants currently treated or who were treated with Finerenone (Kerendia©) within 8 weeks prior to the screening visit.
  - Participant with serum/plasma potassium (K+) above 4.8 mmol/L at screening visit (central laboratory value).

Trial Summary

Enrollment Goal
1664
Trial Dates
black-arrow
Phase
2
Could I receive a placebo?
Yes
Products
Kerendia (Finerenone, BAY94-8862)
Accepts Healthy Volunteers
No

Where to Participate

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Locations
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Many Locations

Many Locations, Italy

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Many Locations

Many Locations, Taiwan, China

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Velocity Clinical Research - Savannah

Savannah, United States, 31406

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Many Locations

Many Locations, Japan

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Many Locations

Many Locations, France

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Many Locations

Many Locations, Spain

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Diabetologische Schwerpunkt Praxis Dortmund

Dortmund, Germany, 44137

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Zentrum für Diabetologie und Ernährungsmedizin

Ludwigshafen, Germany, 67059

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St. Josefskrankenhaus

Heidelberg, Germany, 69115

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Diabetes Zentrum Wandsbek

Hamburg, Germany, 22041

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Cardiologicum Pirna / Dresden-Seidnitz

Pirna, Germany, 1796

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Charité Campus Benjamin Franklin (CBF)

Berlin, Germany, 12203

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ClinPhenomics GmbH&Co. KG

Frankfurt, Germany, 60596

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Hopital Carémeau - Nîmes

Nîmes, France, 30029

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Center Hospitalier Michallon - Grenoble

GRENOBLE CEDEX 9, France, 38043

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Hôpital François Mitterrand - Dijon

Dijon, France, 21000

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Hôpital Edouard Herriot - Lyon Cedex

LYON CEDEX, France, 69003

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Hôpital Saint Joseph

PARIS, France, 75014

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Saiseikai Matsuyama Hospital

Matsuyama, Japan, 791-8026

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Osaka General Medical Center

Osaka, Japan, 558-8558

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Medical Corporation Taifukukai, Osaka Nishiumeda Clinic

Osaka, Japan, 530-0001

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Fukuoka University Chikushi Hospital

Chikushino, Japan, 818-8502

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Japanese Red Cross Kumamoto Hospital

Kumamoto, Japan, 861-8520

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Naka Kinen Clinic

Naka-shi, Japan, 311-0113

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Kokura Memorial Hospital

Kitakyushu, Japan, 802-8555

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Hirohata Naika Clinic

Kitakyushu, Japan, 807-0857

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Fukui-ken Saiseikai Hospital

Fukui, Japan, 918-8503

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Social Medical Corporation the Chiyukai foundation Fukuoka Wajiro Hospital

Fukuoka, Japan, 811-0213

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Ospedale San Raffaele s.r.l. - Medicina Generale Indirizzo Diabetologico ed Endocrino-Metabolico

Milano, Italy, 20132

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Azienda Socio Sanitaria Locale N 2 Della Gallura - Diabetologia

Olbia, Italy, 07026

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Azienda Socio Sanitaria Territoriale Papa Giovanni XXIII - Malattie Endocrine e Diabetologia

Bergamo, Italy, 24127

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Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo_Ospedale S. Paolo - Gestione integrata della malattia Diabetica

Milano, Italy, 20142

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Azienda Ospedaliera Universitaria Integrata Verona_Borgo Roma - Endocrinologia, Diabetologia e Malattie del Metabolismo

Verona, Italy, 37134

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ASL 4 Chiavarese

Chiavari, Italy, 16043

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Azienda Ospedaliero-Universitaria San Luigi Gonzaga - Malattie Metaboliche Diabetologia

Orbassano, Italy, 10043

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Azienda Socio Sanitaria Territoriale Rhodense

Rho, Italy, 20017

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Azienda Ospedaliero Universitaria Parma - SC Nefrologia

Parma, Italy, 43126

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Hospital Quironsalud Barcelona | Internal Medicine Department

Barcelona, Spain, 8023

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Gerencia de Gestion Integrada A Coruna | Department of Endocrinology and Nutrition

A Coruna, Spain, 15006

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Hospital Universitario Virgen de las Nieves | Servicio de Endocrinologia y Nutricion

Granada, Spain, 18014

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Hospital Principe de Asturias

Alcalá de Henares, Spain, 28805

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Hospital Clínico Universitario de Valencia

Valencia, Spain, 46010

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Complejo Hospitalario Universitario de Ferrol | Hospital Naval - Unidad de Hipertensión Arterial

Ferrol, Spain, 15405

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UZ Gent

GENT, Belgium, 9000

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UZ Leuven Gasthuisberg

LEUVEN, Belgium, 3000

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Regionaal ZH Jan Yperman Campus Mariaziekenhuis

IEPER, Belgium, 8900

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AZ Groeninge Campus Kennedylaan

Kortrijk, Belgium, 8500

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AZ Delta

ROESELARE, Belgium, 8800

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CHU de Charleroi Hôpital civil

Lodelinsart, Belgium, 6042

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AZ St-Lucas Campus St-Lucas

gent, Belgium, 9000

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Albert Schweitzer Ziekenhuis | Dordwijk - Cardiology Department

DORDRECHT, Netherlands, 3318 AT

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Gelre Ziekenhuizen

APELDOORN, Netherlands, 7334 DZ

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Meander Medisch Centrum

AMERSFOORT, Netherlands, 3818 TZ

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Onze Lieve Vrouwe Gasthuis

AMSTERDAM, Netherlands, 1091 AC

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Region Midtjylland | Regionshospitalet Godstrup - Nephrology Department

Herning, Denmark, DK-7400

Locations

Steno Diabetes Center Copenhagen | Herlev - Clinical and Translational Research Department

Herlev, Denmark, 2730

Locations

Bispebjerg Hospital - Hjerteafdeling

København, Denmark, DK-2400

Locations

Hospital of South West Jutland | Department of Endocrinology Research

Esbjerg, Denmark, 6700

Locations

Health Corporation of the Ziv Medical Center (R.A.)

Zefat, Israel, 1311001

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Barzilai Medical Center | Department of Nephrology and Hypertension

Ashkelon, Israel, 7830604

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Health Corporation of Galilee Medical Center

Nahariya, Israel, 2210001

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HaEmek Medical Center | Internal Medicine C Department - Research Unit

Afula, Israel, 1834111

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Rabin Medical Center | Beilinson Hospital - Internal Medicine C Department

Petach Tikva, Israel, 4941492

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Edith Wolfson Medical Center | Internal Medicine Department

Holon, Israel, 58100

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Far Eastern Memorial Hospital | Nephrology Department

New Taipei City, Taiwan, China, 220

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Changhua Christian Hospital

Changhua, Taiwan, China, 50006

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Chang Gung Memorial Hospital Kaohsiung

Kaohsiung, Taiwan, China, 833

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Taipei Medical University - Shuang Ho Hospital

New Taipei City, Taiwan, China, 23561

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Taipei Veterans General Hospital

Taipei, Taiwan, China, 11217

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Taichung Veterans General Hospital

Taichung, Taiwan, China, 40705

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China Medical University Hospital

Taichung, Taiwan, China, 404327

Locations

Friedrich-Schiller-Uni. Jena

Jena, Germany, 07747

Locations

Clinical Research Consultants

Kansas City, United States, 64111

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Office of Osvaldo A. Brusco, MD

Corpus Christi, United States, 78414-4173

Locations

Academic Medical Research Institute

Los Angeles, United States, 90022

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Kansas City VA Medical Center

Kansas City, United States, 64128

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Meridian Clinical Research- Norfolk

Norfolk, United States, 68701

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DaVita Clinical Research- El Paso

El Paso, United States, 79925

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Circuit Clinical/Crystal Run

Middletown, United States, 10941

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Salem VA Medical Center - Endocrinology

Salem, United States, 24153

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University of Tennessee Health Science Center

Memphis, United States, 38163

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Randolph Medical Associates

Asheboro, United States, 27203

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Clinical Advancement Center, PLLC

San Antonio, United States, 78212

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Velocity Clinical Research, Cincinnati

Cincinnati, United States, 45242

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St. Louis Heart & Vascular, PC

Saint Louis, United States, 63136

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Eastern Nephrology Associates - Greenville West

Greenville, United States, 27834

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Washington University School of Medicine in St. Louis

Saint Louis, United States, 63110-1010

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Chase Medical Research, LLC

Waterbury, United States, 06708

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Somnos Clinical Research

Lincoln, United States, 68510

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Omega Clinical Research Center

Metairie, United States, 70006

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Grady Memorial Hospital - Endocrinology

Atlanta, United States, 30303

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Olympus Family Medicine

Salt Lake City, United States, 84117

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Eastern Nephrology Associates - Kinston

Kinston, United States, 28504

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Healor Primary Care / CCT Research

Las Vegas, United States, 89102

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Versailles Family Medicine

Versailles, United States, 40383

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University of North Carolina Kidney Center

Chapel Hill, United States, 27599-7155

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Casa Sollievo della Sofferenza - Endocrinologia

San Giovanni Rotondo, Italy, 71013

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Azienda Ospedaliero Universitaria Pisana_Cisanello - Malattie Metaboliche e Diabetologia

Pisa, Italy, 56124

Locations

Hamilton Medical Research Group

Hamilton, Canada, L8M 1K7

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Sameh Fikry Professional Corporation

Waterloo, Canada, N2J 1C4

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Recherche GCP Research

Montreal, Canada, H2R 1V6

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LMC Manna Research - Calgary

Calgary, Canada, T2H 2G4

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Centre Hospitalier de l’Université de Montréal (CHUM)

Montreal, Canada, H2X 3E4

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Bluewater Clinical Research Group

Sarnia, Canada, N7T 4X3

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LMC Clinical Research Inc. Montreal

Ville Saint-Laurent, Canada, H4T 1Z9

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Severance Hospital, Yonsei University Health System

Seoul, Unmapped, 03722

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Asan Medical Center

Seoul, Unmapped, 05505

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Yonsei University Wonju Christian Hospital

Wonju, Unmapped, 26426

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Hallym University Sacred Heart Hospital

Anyang-si, Unmapped, 14068

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Chung Nam National University Hospital

Daejeon, Unmapped, 35015

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Seoul National University Hospital

Seoul, Unmapped, 3080

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MultiCare Rockwood Clinic Diabetes & Endocrinology Center

Spokane, United States, 99202

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Santa Rosa Medical Centers of Nevada / CCT Research

Las Vegas, United States, 89119

Locations

Biopharma Informatic - McAllen, TX

McAllen, United States, 78503

Locations

Hospital Universitario Dr. Peset

Valencia, Spain, 46017

Locations

Ciutat Sanitaria i Universitaria de la Vall d'Hebron

Barcelona, Spain, 08035

Locations

Clinical Research Solutions, Inc.

Waterloo, Canada, N2T 0C1

Locations

Blue Sky, MD/ Lamond Family Medicine

Hendersonville, United States, 28792

Locations

Hospital Universitario Puerta de Hierro Majadahonda | Clinical Pharmacology Department

Majadahonda, Spain, 28222

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Hospital Vithas Sevilla | Endocrinology Department

Castilleja de la Cuesta, Spain, 41950

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Hospital Universitario Virgen de la Victoria | Unidad de Investigacion Clinica - Endocrinology Department

Malaga, Spain, 29010

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Universidad Autonoma de Madrid (UAM) - Facultad de Medicina - Hospital Universitario Fundacion Jimenez Diaz (UAM-FJD)

Madrid, Spain, 28040

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H. Costa del Sol (Marbella)

Marbella, Spain, 29603

Locations

Hospital Clinico San Carlos

Madrid, Spain, 28040

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Eternal Heart Care Centre (EHCC) and Research Institute

Jaipur, India, 302020

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Government Medical College

Kozhikode, India, 673008

Locations

Vinaya Hospital and Research Centre (A Unit of KIMS)

Mangalore, India, 575003

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Sawami Man Singh (SMS) Medical College & Attached Hospitals

Jaipur, India, 302017

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Krishna Institute Of Medical Science

Secunderabad, India, 500003

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Manipal Hospital

Mysore, India, 5570 015

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K.L.E.S. Dr. Prabhakar Kore Hospital & Medical Research Centre

Belgaum, India, 590010

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Institute of Post-Graduate Medical Education and Research

Kolkata, India, 700020

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Lifepoint Multispecialty Hospital

Pune, India, 411057

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Seth Gordhandas Sunderdas Medical College (GSMC) - King Edward Memorial (KEM) Hospital

Mumbai, India, 400 012

Locations

G.S.V.M. Medical College

Kanpur, India, 208002

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Dr. Bantwal's Clinic

Bengaluru, India, 560076

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Bangalore Medical College & Research Institute

Bengaluru, India, NA

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Mavani Dialysis & Kidney Center

Ahmedabad, India, NA

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Sriram Chandra Bhanj Medical College & Hospital

Cuttack, India, NA

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Vedanta Kidney Care

Vadodara, India, NA

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Government Kilpauk Medical College Hospital

Chennai, India, NA

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Indraprastha Apollo Hospital

New Delhi, India, 110076

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Osmania General Hospital

Telangana, India, 500012

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Government Medical College and Hospital (GMCH) Nagpur

Nagpur, India, 440009

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Grant Medical Foundation - Ruby Hall Clinic (RHC)

Pune, India, 411001

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King George Hospital

Visakhapatnam, India, NA

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Asian Kidney Hospital and Medical Centre

Nagapur, India, 440010

Locations

Nizam's Institute of Medical Sciences (NIMS)

Hyderabad, India, 500082

Locations

Dunes Clinical Research LLC

Dakota Dunes, United States, 57049

Locations

DarSalud Care / LifeDOC Research

Memphis, United States, 38119

Locations

West Orange Endocrinology & Clinical Research

Ocoee, United States, 34761-4547

Locations

Innovative Research Institute

Port Charlotte, United States, 33952

Locations

Victorium Clinical Research

Houston, United States, 77024-2593

Locations

South Shore Nephrology

Plymouth, United States, 02360

Locations

Global Kidney Center

Houston, United States, 77008

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Oakland Medical Center

Dakota Dunes, United States, 48085

Locations

Nola Care Clinical Research

Metairie, United States, 70006

Locations

Thyroid, Endocrinology, and Diabetes (TED) PA

Dallas, United States, 75208-2362

Locations

Lake Michigan Nephrology

Saint Joseph, United States, 49085

Locations

North Texas Kidney Disease Associates, PLLC

Lewisville, United States, 75057

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Florida Kidney Physicians - Delray Beach Nephrology

Delray Beach, United States, 33445

Locations

Southeast Kidney Associates

East Point, United States, 30344

Locations

Touro University California

Vallejo, United States, 94592

Locations

Northridge Hospital

Northridge, United States, 91325

Locations

Olive View - UCLA Medical Center

Sylmar, United States, 91342-1437

Locations

Southwest Kidney Institute, PLC

Surprise, United States, 85374

Locations

Metabolic Research Institute, Inc.

West Palm Beach, United States, 33401-3430

Locations

University of Texas Health Science Center

San Antonio, United States, 78249

Locations

Jiyugaoka Yamada Internal Medicine Clinic

Obihiro, Japan, 080-0848

Locations

Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico - Endocrinologia

Milano, Italy, 20122

Locations

Università degli Studi "G. D'Annunzio" di Chieti - Endocrinologia

Chieti, Italy, 66100

Locations

William Osler Health centre, Sakuara Medical

Mississauga, Canada, L5H4K9

Locations

Onze-Lieve-Vrouwziekenhuis (OLVZ) - Campus Aalst

Aalst, Belgium, 9300

Locations

Clalit Health | Soroka Medical Center - Internal Medicine Department

Beer Sheva, Israel, 8410101

Locations

Kyung Hee University Hospital at Gangdong

Seoul, Unmapped, 5278

Locations

Seoul National University Bundang Hospital

Seongnam-si, Unmapped, 13620

Locations

Hanyang University Guri Hospital

Guri-si, Unmapped, 471-701

Locations

Hallym University Kangnam Sacred Heart Hospital

Seoul, Unmapped, 7442

Locations

Korea University Ansan Hospital

Gyeonggi-do, Unmapped, 425-707

Locations

The Catholic University of Korea, Incheon St.Mary's Hospital

Incheon, Unmapped, 21431

Locations

Public Central Hospital of Matto Ishikawa | Clinical Trial Management Office

Hakusan, Japan, 924-8588

Locations

Soon Chun Hyang University Cheonan Hospital

Cheonan, Unmapped, 31151

Locations

Hadassah University Medical Center (HUMC)

Jerusalem, Israel, 911200

Locations

Max Super Speciality Hospital (MSSH) - Saket

New Delhi, India, 110017

Locations

All India Institute of Medical Sciences

Bhubaneswar, India, 751019

Trial Design