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Cardiorenal Medicine

Abhinav Goyal, Kshitij Chatterjee, Roy O Mathew, Mandeep S Sidhu, Sripal Bangalore, Peter A McCollough, Janani Rangaswami
BACKGROUND: Kidney transplantation (KT) is the treatment of choice for end-stage kidney disease. Cardiovascular disease is a major determinant of morbidity and mortality in patients with KT. Temporal trends in perioperative cardiovascular outcomes after KT are understudied, especially in light of an aging KT waitlist population. METHODS: We performed a retrospective observational cohort study using the National Inpatient Sample for the years 2004-2013. All adult patients undergoing KT were identified using the appropriate International Classification of Diseases, 9th Revision, Clinical Modification codes...
November 14, 2018: Cardiorenal Medicine
Robert Ekart, Sebastjan Bevc, Nina Hojs, Radovan Hojs
BACKGROUND: Chronic kidney disease (CKD) is a well-known mortality risk factor. The subendocardial viability ratio (SEVR) is one of the pulse wave analysis parameters that constitutes a non-invasive measure of coronary perfusion. We aimed to assess the prognostic value of the SEVR for cardiovascular outcome in non-dialysis CKD patients. METHODS: A total of 98 CKD patients (mean age 60 years) were prospectively followed up from the date of the SEVR measurement until their death or the start of dialysis/transplantation, maximally up to 7...
November 8, 2018: Cardiorenal Medicine
Jing Shi, Guofeng Wu, Xiaohua Zou, Ke Jiang
BACKGROUND/AIMS: Cardiac surgery-associated acute kidney injury (CSA-AKI) is one of the most common postoperative complications in intensive care medicine. Baicalin has been shown to have anti-inflammatory and antioxidant roles in various disorders. We aimed to test the protective effects of baicalin on CSA-AKI using a rat model. METHODS: Sprague-Dawley rats underwent 75 min of cardiopulmonary bypass (CPB) with 45 min of cardioplegic arrest (CA) to establish the AKI model...
November 7, 2018: Cardiorenal Medicine
Jiahui Li, Aili Li, Jiali Wang, Yu Zhang, Ying Zhou
PURPOSE: Cardiac valve calcification (VC) is very common in patients on hemodialysis. However, the definite effect of VC on left ventricular (LV) geometry and function in this population is unknown, especially when LV ejection fraction (LVEF) is normal. The aim of this study was to determine the effect of VC on LV geometry and function in long-term hemodialysis patients by conventional echocardiography and two-dimensional speckle tracking echocardiography (2D-STE). METHODS: A total of 47 hemodialysis patients (2-3 times weekly for 5 years or more) were enrolled in this study...
October 31, 2018: Cardiorenal Medicine
Luca Di Lullo, Claudio Ronco, Antonio Granata, Ernesto Paoletti, Vincenzo Barbera, Mario Cozzolino, Maura Ravera, Maria Fusaro, Antonio Bellasi
Chronic hyperkalemia (HK) is a serious medical condition that often manifests in patients with chronic kidney disease (CKD) and heart failure (HF) leading to poor outcomes and necessitating careful management by cardionephrologists. CKD, HF, diabetes, and renin-angiotensin-aldosterone system inhibitors use is known to induce HK. Current therapeutic options are not optimal, as pointed out by a large number of CKD and HF patients with HK. The following review will focus on the main risk factors for developing HK and also aims to provide a guide for a correct diagnosis and present new approaches to therapy...
October 25, 2018: Cardiorenal Medicine
Amir Kazory, Claudio Ronco
BACKGROUND: Accumulating evidence on the pathophysiology of hepatorenal syndrome has challenged the conventional model of liver-kidney connection. While liver cirrhosis is traditionally considered the origin of a cascade of pathophysiologic mechanisms directly affecting other organs such as the kidney, emerging data point to the heart as the potential mediator of the untoward renal effects. SUMMARY: Herein, we briefly review the often-overlooked contribution of the heart to circulatory dysfunction in hepatorenal syndrome and put forward evidence arguing for the involvement of systemic inflammation and endothelial dysfunction in this setting...
September 17, 2018: Cardiorenal Medicine
Vojko Kanic, Gregor Kompara, David Suran, Robert Ekart, Sebastjan Bevc, Radovan Hojs
BACKGROUND: There are limited data regarding the incidence and long-term impact of acute kidney injury (AKI) according to the KDIGO guidelines on the outcome in patients with myocardial infarction (MI) treated with percutaneous coronary intervention (PCI). The aim of the study was to evaluate the prevalence of AKI, as classified by the KDIGO criteria, and its association with long-term mortality. METHODS: Data from 5,859 MI patients undergoing PCI at our institution were analyzed...
2018: Cardiorenal Medicine
Grazia Maria Virzì, Andrea Breglia, Alessandra Brocca, Massimo de Cal, Chiara Bolin, Giorgio Vescovo, Claudio Ronco
BACKGROUND: Cardiorenal syndrome type 1 (CRS type 1) is characterized by a rapid worsening of cardiac function leading to acute kidney injury (AKI). Inflammation and oxidative stress seem to play a pivotal role in its pathophysiology. In this in vivo study, we examined the putative role of inflammation and humoral markers in the pathogenesis of the CRS type 1. METHODS: We enrolled 53 patients with acute heart failure (AHF); 17 of them developed AKI (CRS type 1)...
2018: Cardiorenal Medicine
Hsing-Yu Chen, Chien Chou, Chih-Hsiang Chang, Nien-Gen Lee, Pei-Chun Yu, Yu-Chi Chen, Heng-Chih Pan, Pei-Chun Fan, Chih-Wei Yang, Wen-Jin Cherng, Yung-Chang Chen
BACKGROUND: Type 1 cardiorenal syndrome (CRS) is a severe complication for acute decompensated heart failure patients. This study aimed at evaluating the feasibility of using the gold nanoparticle-based localized surface plasmon-coupled fluorescence biosensor (LSPCFB) to detect urine cofilin-1 as a biomarker for predicting CRS among patients in the coronary care unit (CCU). METHODS: A total of 44 patients were included with prospectively collected urine and blood samples...
2018: Cardiorenal Medicine
Hui-Wen Zhang, Xi Zhao, Rui-Xia Xu, Yuan-Lin Guo, Cheng-Gang Zhu, Na-Qiong Wu, Chuan-Jue Cui, Qian Dong, Jian-Jun Li
BACKGROUND: Elevated levels of proprotein convertase subtilisin/kexin type 9 (PCSK9) have been reported to be related to dyslipidemia, including patients with kidney dysfunction. However, its association with estimated glomerular filtration rate (eGFR) in individuals with normal serum creatinine (SCr) has not been determined. METHODS: A total of 2,089 subjects with normal SCr and without lipid-lowering treatment were consecutively enrolled in this study. Plasma PCSK9 levels were measured by ELISA kit and eGFR was evaluated by the Chronic Kidney Disease Epidemiology Collaboration equation...
2018: Cardiorenal Medicine
Amir Kazory, Peter A McCullough, Janani Rangaswami, Claudio Ronco
The field of cardiorenal medicine is vast, rapidly expanding, and complex. Conventional nephrology training programs provide the fellows with the necessary core knowledge to provide general care for patients with renal and cardiovascular diseases. However, there is a need for focused training of interested physicians to master the specialized aspects of these exceedingly common clinical scenarios and optimize the care of such patients. A cardionephrology-focused training can add value to the nephrology subspecialty and potentially increase its attractiveness for a significant subset of trainees...
2018: Cardiorenal Medicine
Rafia I Chaudhry, Roy O Mathew, Mandeep S Sidhu, Preety Sidhu-Adler, Radmila Lyubarova, Janani Rangaswami, Loay Salman, Arif Asif, Jerome L Fleg, Peter A McCullough, Frank Maddux, Sripal Bangalore
BACKGROUND: Atherosclerotic cardiovascular disease (ASCVD) is a leading cause of morbidity and mortality among patients with chronic kidney disease (CKD) with a glomerular filtration rate of < 60 mL/min/1.73 m2 body surface area. The availability of high-quality randomized controlled trial data to guide management for the population with CKD and ASCVD is limited. Understanding current practice patterns among providers caring for individuals with CKD and CVD is important in guiding future trial questions...
2018: Cardiorenal Medicine
Gaetano Ruocco, Frederik Hendrik Verbrugge, Ranuccio Nuti, Alberto Palazzuoli
BACKGROUND: Hyponatremia is the most common electrolyte abnormality found in hospitalized patients with acute heart failure (AHF) and is related to poor prognosis. This study sought to evaluate: (1) the different prognostic impact of dilutional versus depletional hyponatremia, evaluating short- and long-term outcome; (2) the relationship between both types of hyponatremia and intravenous furosemide dose, renal function changes, and persistent congestion at discharge. METHODS: This retrospective single-center study included 233 consecutive patients with a primary diagnosis of AHF...
2018: Cardiorenal Medicine
Fei Shi, Sheng Feng, Jing Zhu, Yanni Wu, Jianchang Chen
BACKGROUND: This study aimed to evaluate the role of two-dimensional speckle-tracking imaging (2D-STI) and myocardial layer-specific analysis in evaluating early left ventricular (LV) myocardial function and systolic dyssynchrony in young and middle-aged uremic patients undergoing peritoneal dialysis (PD). METHODS: We enrolled 31 PD patients aged ≤65 years with preserved LV ejection fraction (LVEF, ≥54%) as the PD group and 49 age-matched healthy people as the control group...
2018: Cardiorenal Medicine
Dominika Klimczak-Tomaniak, Tomasz Pilecki, Dorota Żochowska, Damian Sieńko, Maciej Janiszewski, Leszek Pączek, Marek Kuch
BACKGROUND/AIMS: Chronic kidney disease is a pro-inflammatory condition where the interplay between different regulatory pathways and immune cells mediates an unfavorable remodeling of the vascular wall and myocardial hypertrophy. These mechanisms include the action of CXCL12. The aim of this study is to evaluate the association between serum CXCL12 with left ventricular hypertrophy (LVH) and blood pressure control in chronic kidney disease (CKD) patients. METHODS: This single-center observational study involved 90 stable CKD stage 1-5 patients (including 33 renal transplant recipients) and 25 healthy age- and sex-matched control subjects...
2018: Cardiorenal Medicine
Marcin Majerczyk, Piotr Choręza, Katarzyna Mizia-Stec, Maria Bożentowicz-Wikarek, Aniceta Brzozowska, Habibullah Arabzada, Aleksander J Owczarek, Aleksandra Szybalska, Tomasz Grodzicki, Andrzej Więcek, Magdalena Olszanecka-Glinianowicz, Jerzy Chudek
BACKGROUND/AIM: Elevated plasma concentration of retinol-binding protein 4 (RBP4) has recently emerged as a potential new risk factor for cardiovascular diseases, including hypertension (HT) and coronary artery disease (CAD). Limited data suggest that RBP4 promotes inflammatory damage to cardiomyocytes and participates in the development of heart failure (HF). This study aimed to analyze the relationship between concentrations of plasma RBP4 and serum N-terminal proBNP (NT-proBNP), a powerful biomarker of left ventricle dysfunction, in the older Polish population...
2018: Cardiorenal Medicine
Ik Jun Choi, Sungmin Lim, Eun-Ho Choo, Jin-Jin Kim, Byung-Hee Hwang, Tae-Hoon Kim, Suk Min Seo, Yoon-Seok Koh, Dong Il Shin, Hun-Jun Park, Pum-Joon Kim, Doo-Soo Jeon, Seung-Hwan Lee, Jae-Hyoung Cho, Jung-Im Jung, Kiyuk Chang, Ki-Bae Seung
AIM: The aim of this study was to assess the combined effects of chronic kidney disease (CKD) and diabetes on the extent and developmental pattern of coronary artery disease (CAD). METHODS: A total of 3,017 self-referred asymptomatic individuals without known CAD who underwent 64-channel dual-source coronary computed tomography angiography between 2006 and 2010 were enrolled. The patients were divided into six groups based on their diabetes status (nondiabetic or diabetic) and estimated glomerular filtration rate (eGFR) (eGFR > 90 mL/min/1...
2018: Cardiorenal Medicine
Ali Amiri, Reza Ghanavati, Hassan Riahi Beni, Seyyed Hashem Sezavar, Mehrdad Sheykhvatan, Mahsa Arab
BACKGROUND: Finding patients at risk of developing contrast-induced acute kidney injury (CI-AKI) is important because of its associated complications. In the present study, the contribution of different variables, such as the presence of metabolic syndrome (MetS), the volume creatinine clearance (V/CrCl) ratio, the iodine-dose (I-dose)/CrCl ratio, or hypertension, to CI-AKI was evaluated. METHODS: A total of 255 patients undergoing elective coronary angiography with or without intervention were enrolled and divided into a MetS and a control group...
2018: Cardiorenal Medicine
Andrea Breglia, Grazia Maria Virzì, Silvia Pastori, Alessandra Brocca, Massimo de Cal, Chiara Bolin, Giorgio Vescovo, Claudio Ronco
BACKGROUND: Cardiorenal syndrome type 1 (CRS type 1) is characterized by a rapid worsening of cardiac function leading to acute kidney injury (AKI). Its pathophysiology is complex and not completely understood. In this study, we examined the role of apoptosis and the caspase pathways involved. MATERIAL AND METHODS: We enrolled 40 acute heart failure (AHF) patients, 11 of whom developed AKI characterizing CRS type 1. We exposed the human cell line U937 to plasma from the CRS type 1 and AHF groups and then we evaluated apoptotic activity by annexin-V evaluation, determination of caspase-3, -8 and -9 levels, and BAX, BAD, and FAS gene expression...
2018: Cardiorenal Medicine
Antonio Concistrè, Luigi Petramala, Gianmarco Scoccia, Susanna Sciomer, Valeria Bisogni, Vincenza Saracino, Gino Iannucci, Silvia Lai, Daniela Mastroluca, Gianluca Iacobellis, Claudio Letizia
INTRODUCTION: Autosomal dominant polycystic kidney disease (ADPKD) is associated with early organ damage such as left ventricular hypertrophy and higher cardiovascular risk when compared to essential hypertension (EH). Epicardial adipose tissue (EAT) is a new cardiovascular risk factor, but its role and correlation with left ventricular mass (LVM) in ADPKD is unknown. AIMS: we sought to investigate whether EAT is higher and related to LVM indexed by body surface area (LVMi) in hypertensive patients with ADPKD compared to those with EH...
2018: Cardiorenal Medicine
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