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Statins use in ckd

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https://www.readbyqxmd.com/read/28635327/within-visit-blood-pressure-variability-and-cardiovascular-risk-factors-in-hypertensive-patients-with-non-dialysis-chronic-kidney-disease
#1
Kengo Azushima, Hiromichi Wakui, Kazushi Uneda, Sona Haku, Ryu Kobayashi, Kohji Ohki, Sho Kinguchi, Kotaro Haruhara, Tetsuya Fujikawa, Yoshiyuki Toya, Satoshi Umemura, Kouichi Tamura
As there may be an association between within-visit blood pressure (BP) variability and cardiovascular disease (CVD), we investigated the clinical significance of this BP variability in non-dialysis chronic kidney disease (CKD) patients. MATERIALS AND METHODS: According to the median of coefficient of variation (CV) of three systolic BP (SBP) readings within a single visit, we divided hypertensive patients with stage G1-4 CKD already treated with antihypertensive therapy into the high SBP-CV group and the low SBP-CV group...
June 21, 2017: Clinical and Experimental Hypertension: CHE
https://www.readbyqxmd.com/read/28623740/detection-of-atherosclerotic-cardiovascular-disease-influences-the-perceived-need-for-aggressive-lipid-management
#2
G B John Mancini, Milan Gupta, Michelle Tsigoulis, Christopher P Cannon, Jacques Genest, Kausik K Ray, Raul D Santos, Gerald F Watts, Paolo Raggi
BACKGROUND AND AIMS: Overt atherosclerotic cardiovascular disease (ASCVD) warrants aggressive lipid lowering. Imaging for ambiguous symptoms suggesting ischemia or for clarification of CV risk in asymptomatic individuals often uncovers previously unknown ASCVD. Guidelines do not provide clear recommendations for aggressive lipid lowering in such cases. We explored physicians' perception, as influenced by tests that detect ASCVD, regarding appropriateness of getting to lipid goals and for theoretically accessing proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i)...
June 3, 2017: Atherosclerosis
https://www.readbyqxmd.com/read/28616249/quality-of-care-for-patients-with-chronic-kidney-disease-in-the-primary-care-setting-a-retrospective-cohort-study-from-ontario-canada
#3
Danielle M Nash, Scott Brimble, Maureen Markle-Reid, Eric McArthur, Karen Tu, Gihad E Nesrallah, Allan Grill, Amit X Garg
BACKGROUND: Patients with chronic kidney disease may not be receiving recommended primary renal care. OBJECTIVE: To use recently established primary care quality indicators for chronic kidney disease to determine the proportion of patients receiving recommended renal care. DESIGN: Retrospective cohort study using administrative data with linked laboratory information. SETTING: The study was conducted in Ontario, Canada, from 2006 to 2012...
2017: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/28614117/role-of-amp-activated-protein-kinase-in-kidney-tubular-transport-metabolism-and-disease
#4
Roshan Rajani, Nuria M Pastor-Soler, Kenneth R Hallows
PURPOSE OF REVIEW: AMP-activated protein kinase (AMPK) is a metabolic sensor that regulates cellular energy balance, transport, growth, inflammation, and survival functions. This review explores recent work in defining the effects of AMPK on various renal tubular epithelial ion transport proteins as well as its role in kidney injury and repair in normal and disease states. RECENT FINDINGS: Recently, several groups have uncovered additional functions of AMPK in the regulation of kidney and transport proteins...
June 12, 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/28607686/improving-care-for-patients-with-or-at-risk-for-chronic-kidney-disease-using-electronic-medical-record-interventions-a-pragmatic-cluster-randomized-trial-protocol
#5
Danielle M Nash, Noah M Ivers, Jacqueline Young, R Liisa Jaakkimainen, Amit X Garg, Karen Tu
BACKGROUND: Many patients with or at risk for chronic kidney disease (CKD) in the primary care setting are not receiving recommended care. OBJECTIVE: The objective of this study is to determine whether a multifaceted, low-cost intervention compared with usual care improves the care of patients with or at risk for CKD in the primary care setting. DESIGN: A pragmatic cluster-randomized trial, with an embedded qualitative process evaluation, will be conducted...
2017: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/28553032/stroke-in-patients-with-chronic-kidney-disease%C3%A2-how-do-we-approach-and-manage-it
#6
REVIEW
S Nayak-Rao, M P Shenoy
Renal failure is a potent risk factor for stroke, which is a leading cause of morbidity and mortality worldwide. The risk of stroke is 5-30 times higher in patients with chronic kidney disease (CKD), especially on dialysis. Case fatality rates are also higher reaching almost 90%. It is therefore important to understand the factors that predispose to stroke in this vulnerable population to better apply preventive strategies. The heightened risk of stroke in CKD represents the interplay of the vascular co-morbidities that occur with renal impairment and factors specific to renal failure such as malnutrition-inflammation-atherosclerosis complex, the effect of uremic toxins, dialysis techniques, vascular access, and the use of anticoagulants to maintain flow in the extracorporeal circuit...
May 2017: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/28536104/development-and-validation-of-qrisk3-risk-prediction-algorithms-to-estimate-future-risk-of-cardiovascular-disease-prospective-cohort-study
#7
Julia Hippisley-Cox, Carol Coupland, Peter Brindle
Objectives To develop and validate updated QRISK3 prediction algorithms to estimate the 10 year risk of cardiovascular disease in women and men accounting for potential new risk factors.Design Prospective open cohort study.Setting General practices in England providing data for the QResearch database.Participants 1309 QResearch general practices in England: 981 practices were used to develop the scores and a separate set of 328 practices were used to validate the scores. 7.89 million patients aged 25-84 years were in the derivation cohort and 2...
May 23, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28506476/adherence-to-lipid-management-guidelines-is-associated-with-lower-mortality-and-major-adverse-limb-events-in-patients-undergoing-revascularization-for-chronic-limb-threatening-ischemia
#8
Thomas F X O'Donnell, Sarah E Deery, Jeremy D Darling, Katie E Shean, Murray A Mittleman, Gabrielle N Yee, Matthew R Dernbach, Marc L Schermerhorn
OBJECTIVE: The 2013 American College of Cardiology/American Heart Association lipid management guidelines recommend high-intensity statins for all patients ≤75 years old with chronic limb-threatening ischemia (CLTI) and moderate-intensity statins for CLTI patients >75 years old without contraindications or on dialysis, but these recommendations are based primarily on coronary and stroke data. We aimed to validate these guidelines in patients with CLTI and to assess current adherence to these recommendations...
May 12, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28502499/effects-of-statin-therapy-on-cerebrovascular-and-renal-outcomes-in-patients-with-predialysis-advanced-chronic-kidney-disease-and-dyslipidemia
#9
Chang-Min Chung, Ming-Shyan Lin, Jen-Te Hsu, Ju-Feng Hsiao, Shih-Tai Chang, Kuo-Li Pan, Chun-Liang Lin, Yu-Sheng Lin
BACKGROUND: Treatment with statin may be beneficial for patients with chronic kidney disease (CKD). However, the debate over the clinical importance of statin in patients with predialysis advanced CKD remains unresolved. OBJECTIVES: The objective of the article was to evaluate the effect of statin on mortality, cerebrovascular, and renal outcomes in patients with predialysis advanced CKD and dyslipidemia. METHODS: Data on predialysis advanced CKD patients were retrieved from the National Health Insurance Research Database based on the guidelines for prescribing regular erythropoietin-stimulating agent in CKD patients...
March 2017: Journal of Clinical Lipidology
https://www.readbyqxmd.com/read/28499030/moderator-s-view-predictive-models-a-prelude-to-precision-nephrology
#10
Carmine Zoccali
Appropriate diagnosis is fundamental in medicine because it sets the basis for the prediction of disease outcome at the single patient level (prognosis) and decisions regarding the most appropriate therapy. However, given the large series of social, clinical and biological factors that determine the likelihood of an individual's future outcome, prognosis only partly depends on diagnosis and aetiology and treatment is not decided solely on the basis of the underlying diagnosis. This issue is crucial in multifactorial diseases like atherosclerosis, where the use of statins has now shifted from 'treating hypercholesterolaemia' to 'treating the risk of adverse cardiovascular events'...
May 1, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28437620/american-association-of-clinical-endocrinologists-and-american-college-of-endocrinology-guidelines-for-management-of-dyslipidemia-and-prevention-of-cardiovascular-disease
#11
Paul S Jellinger, Yehuda Handelsman, Paul D Rosenblit, Zachary T Bloomgarden, Vivian A Fonseca, Alan J Garber, George Grunberger, Chris K Guerin, David S H Bell, Jeffrey I Mechanick, Rachel Pessah-Pollack, Kathleen Wyne, Donald Smith, Eliot A Brinton, Sergio Fazio, Michael Davidson
OBJECTIVE: The development of these guidelines is mandated by the American Association of Clinical Endocrinologists (AACE) Board of Directors and American College of Endocrinology (ACE) Board of Trustees and adheres with published AACE protocols for the standardized production of clinical practice guidelines (CPGs). METHODS: Recommendations are based on diligent reviews of the clinical evidence with transparent incorporation of subjective factors, according to established AACE/ACE guidelines for guidelines protocols...
April 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28431865/statin-use-and-other-factors-associated-with-mortality-after-major-lower-extremity-amputation
#12
Charles DeCarlo, Larry Scher, Saadat Shariff, John Phair, Evan Lipsitz, Karan Garg
OBJECTIVE: Above-knee amputations (AKAs) and below-knee amputations (BKAs) are associated with high postoperative mortality rates. In this study, we examined factors associated with 30-day, 90-day, and 1-year mortality in patients who underwent a major lower extremity amputation. METHODS: We queried a prospectively collected institutional database for all patients who underwent AKA or BKA with primary or secondary closure, during a 5-year period, between November 2009 and November 2014...
July 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28389293/smoking-cessation-counseling-improves-quality-of-care-and-surgical-outcomes-with-financial-gain-for-a-vascular-practice
#13
D A Moses, J H Mehaffey, D V Strider, M C Tracci, J A Kern, G R Upchurch
BACKGROUND: Cigarette smoking is strongly associated with atherosclerotic disease. It is incumbent on vascular surgeons to provide smoking cessation counseling (SCC) to their patients. The objective of this study was to determine the association of SCC and improvement in quality of care. METHODS: As a quality project using retrospective data, the study received institutional review board exemption status. A retrospective review of prospectively maintained database from April 2014 through March 2015 of outpatient encounters in a vascular surgery clinic was performed of current smokers...
April 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28382626/use-of-radiocontrast-agents-in-ckd-and-esrd
#14
Jehan Z Bahrainwala, Amanda K Leonberg-Yoo, Michael R Rudnick
Contrast exposure in a population with chronic kidney disease (CKD) requires additional consideration given the risk of contrast-induced nephropathy (CIN) after exposure to iodinated contrast as well as systemic injury with exposure to gadolinium-based contrast agents (GBCA). Strategies to avoid CIN, and manage patients after exposure, including extracorporeal removal of contrast media, may differ among an advanced CKD population as compared to a general population. There is strong evidence to support the use of isotonic volume expansion and the lowest dose of low-osmolar or iso-osmolar contrast media possible to decrease CIN...
April 5, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28377473/a-population-based-analysis-of-quality-indicators-in-ckd
#15
Liam Manns, Nairne Scott-Douglas, Marcello Tonelli, Robert Weaver, Helen Tam-Tham, Christy Chong, Brenda Hemmelgarn
BACKGROUND AND OBJECTIVES: Awareness of CKD remains low in comparison with other chronic diseases, such as diabetes, leading to low use of preventive medications and appropriate testing. The objective of this study was to evaluate the quality of care provided to people with and at risk of CKD. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We conducted a population-based analysis of all Albertans with eGFR=15-59 ml/min per 1.73 m(2) between April 1, 2011 and March 31, 2012 as well as patients with diabetes (as of March 31, 2012)...
May 8, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28302902/risk-of-febuxostat-associated-myopathy-in-patients-with-ckd
#16
Chung-Te Liu, Chun-You Chen, Chien-Yi Hsu, Po-Hsun Huang, Feng-Yen Lin, Jaw-Wen Chen, Shing-Jong Lin
BACKGROUND AND OBJECTIVES: Febuxostat, a nonpurine xanthine oxidase inhibitor, is widely used to treat hyperuricemia. Although febuxostat-associated rhabdomyolysis was reported in some patients with CKD, the association between CKD and febuxostat-associated myopathy remains uncertain. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Our retrospective cohort study included 1332 patients using febuxostat in Taipei Medical University-Wanfang Hospital from February of 2014 to January of 2016...
May 8, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28223836/dyslipidemia-in-patients-with-chronic-kidney-disease-etiology-and-management
#17
REVIEW
Ivana Mikolasevic, Marta Žutelija, Vojko Mavrinac, Lidija Orlic
Patients with chronic kidney disease (CKD), including those with end-stage renal disease, treated with dialysis, or renal transplant recipients have an increased risk for cardiovascular disease (CVD) morbidity and mortality. Dyslipidemia, often present in this patient population, is an important risk factor for CVD development. Specific quantitative and qualitative changes are seen at different stages of renal impairment and are associated with the degree of glomerular filtration rate declining. Patients with non-dialysis-dependent CKD have low high-density lipoproteins (HDL), normal or low total cholesterol (TC) and low-density lipoprotein (LDL) cholesterol, increased triglycerides as well as increased apolipoprotein B (apoB), lipoprotein(a) (Lp (a)), intermediate- and very-low-density lipoprotein (IDL, VLDL; "remnant particles"), and small dense LDL particles...
2017: International Journal of Nephrology and Renovascular Disease
https://www.readbyqxmd.com/read/28205311/management-of-cardiovascular-risk-factors-in-patients-with-anca-associated-vasculitis
#18
Carsten Paul Bramlage, Juliane Kröplin, Manuel Wallbach, Joan Minguet, Katherine Helen Smith, Stephan Lüders, Joachim Schrader, Susan Patschan, Oliver Gross, Cornelia Deutsch, Peter Bramlage, Gerhard Anton Müller, Michael Koziolek
OBJECTIVES: Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is accompanied by increased cardiovascular (CV) risk. Treatment of AAV patients includes the management of conventional CV risk factors, primarily hypertension and hypercholesterolemia, while lipoprotein(a) (LP(a)) is an emerging potential target. METHODS: We performed a multicenter, retrospective study in Germany. Patients were considered if they were between 18 and 90 years old and presented with AAV...
February 16, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28182761/kidney-function-and-specific-mortality-in-60-80-years-old-post-myocardial-infarction-patients-a-10-year-follow-up-study
#19
Ellen K Hoogeveen, Johanna M Geleijnse, Erik J Giltay, Sabita S Soedamah-Muthu, Janette de Goede, Linda M Oude Griep, Theo Stijnen, Daan Kromhout
Chronic kidney disease (CKD) is highly prevalent among older post-myocardial infarction (MI) patients. It is not known whether CKD is an independent risk factor for mortality in older post-MI patients with optimal cardiovascular drug-treatment. Therefore, we studied the relation between kidney function and all-cause and specific mortality among older post-MI patients, without severe heart failure, who are treated with state-of-the-art pharmacotherapy. From 2002-2006, 4,561 Dutch post-MI patients were enrolled and followed until death or January 2012...
2017: PloS One
https://www.readbyqxmd.com/read/28114129/lipid-lowering-therapy-in-ckd-should-we-use-it-and-in-which-patients
#20
George A Kaysen
BACKGROUND: Chronic kidney disease is associated with a 15-fold increase in the risk of death and a 30-fold increase in the risk of cardiovascular events even prior to dialysis initiation, and this situation remains unchanged following the initiation of the dialysis procedure. Lipoprotein structure and function, especially the anti-oxidative properties of high-density lipoprotein, are altered. In this study, the effectiveness of lipid-lowering therapy on mortality and cardiovascular outcomes is explored...
2017: Blood Purification
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