Project Grant R03DK145928

The National Institute of Diabetes and Digestive and Kidney Diseases awarded Tufts Medical Center Parent, Inc. (doing business as Tufts Medical Center) $133,875 on September 1, 2026, under the Diabetes, Digestive, and Kidney Diseases Extramural Research program (CFDA 93.847). The project grant funds an evaluation of how estimated glomerular filtration rate (eGFR) decline influences clinical practice patterns of medication withdrawal in heart failure patients. The research addresses a significant clinical problem: guideline-directed medical therapies including renin-angiotensin-aldosterone system inhibitors, mineralocorticoid receptor antagonists, and sodium-glucose co-transporter 2 inhibitors reduce mortality and cardiovascular risk in patients with heart failure with reduced ejection fraction, yet each class causes an acute, hemodynamic eGFR decline that clinicians often cannot distinguish from true kidney injury, leading to inappropriate discontinuation and increased cardiovascular risk. The award covers the period of performance from September 1, 2026, through June 30, 2028, with work performed at Tufts Medical Center in Boston, Massachusetts. The project examines whether early discontinuation of guideline-directed medical therapy following eGFR decline harms patients, addressing barriers to optimal heart failure treatment initiation and continuation that persist despite strong clinical trial evidence of therapeutic benefit.