Altrincham

Researchers are evaluating the effects of tirzepatide compared with standard care in adults living with obesity who do not have diabetes. This phase 4 study aims to assess weight loss and the occurrence of type 2 diabetes over a long period in a real-world setting. Participants must have obesity and at least one weight-related health condition to join the study. Participants will receive either tirzepatide, given once weekly by injection under the skin, or continue with standard care as determined by their healthcare providers. The study is designed to reflect real-life treatment and monitoring situations to understand how tirzepatide works outside of tightly controlled clinical trials. The study lasts about 260 weeks, during which participants will be regularly monitored for changes in body weight and the development of type 2 diabetes. Measurements will be taken at the start and throughout the study to track weight changes. Researchers will also observe safety and overall health during this extended follow-up period.

Researchers are evaluating the effects of two different default dialysate sodium concentrations, 137 mmol/l and 140 mmol/l, on major cardiovascular events and death in adults receiving maintenance haemodialysis. This pragmatic, cluster-randomised, open-label study takes place in real-world dialysis sites and aims to compare the outcomes associated with these sodium levels over an extended period. The study focuses on patients with end-stage kidney disease undergoing regular haemodialysis treatment. Dialysis sites are randomly assigned to use either a default dialysate sodium concentration of 137 mmol/l or 140 mmol/l for at least 90% of dialysis sessions at that site. All other care practices continue as usual based on local standards. The study plans to recruit sites over 5 to 7 years, with individual follow-up lasting roughly 2 to 5 years. Site participation requires consent, while individual patient consent may be waived or offered an opt-out option. Participants will be monitored for major cardiovascular events and death, with the primary outcome measuring the time until the first such event occurs. Data collection methods are implemented across participating dialysis units, focusing only on in-center or satellite dialysis patients where applicable. The study's duration depends on the occurrence of endpoints, with an average follow-up of about 5 years anticipated per participant.