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Chronic kidney disease cardiovascular

L Regard, H Lafoeste, C Martin, G Chassagnon, P-R Burgel
Cystic fibrosis (CF) is a genetic disease with pulmonary involvement being predominant and often leading to respiratory failure and premature death. Non-pulmonary complications related to CF transmembrane conductance regulator (CFTR) defect are numerous and account for significant morbidity (exocrine pancreatic insufficiency, diabetes, CF-related liver disease, chronic sinusitis, osteoporosis). Improvement in patients' care led to a continuous increase in life expectancy, with a subsequent increase in the number of adult CF patients worldwide...
October 10, 2018: Revue de Pneumologie Clinique
Allan K Grill, Scott Brimble
OBJECTIVE: To help primary care providers, both family physicians and nurse practitioners, identify, detect, and manage patients with and at risk of chronic kidney disease (CKD), as well as outline criteria for appropriate referral to nephrology. SOURCES OF INFORMATION: Published guidelines on the topic of CKD and its comorbidities were reviewed. A MEDLINE search was conducted using the MeSH terms chronic renal insufficiency, family practice, and primary health care ...
October 2018: Canadian Family Physician Médecin de Famille Canadien
Christoph Wanner, Hiddo J L Heerspink, Bernard Zinman, Silvio E Inzucchi, Audrey Koitka-Weber, Michaela Mattheus, Stefan Hantel, Hans-Juergen Woerle, Uli C Broedl, Maximilian von Eynatten, Per-Henrik Groop
BACKGROUND: Empagliflozin slowed the progression of CKD in patients with type 2 diabetes and cardiovascular disease in the EMPA-REG OUTCOME Trial. In a prespecified statistical approach, we assessed treatment differences in kidney function by analyzing slopes of eGFR changes. METHODS: Participants ( n =7020) were randomized (1:1:1) to empagliflozin 10 mg/d, empagliflozin 25 mg/d, or placebo added to standard of care. We calculated eGFR slopes using random-intercept/random-coefficient models for prespecified study periods: treatment initiation (baseline to week 4), chronic maintenance treatment (week 4 to last value on treatment), and post-treatment (last value on treatment to follow-up)...
October 12, 2018: Journal of the American Society of Nephrology: JASN
Faisal Nuhu, Sunil Bhandari
Patients with chronic kidney disease (CKD) have significant cardiovascular morbidity and mortality as a result of risk factors such as left ventricular hypertrophy (LVH), oxidative stress, and inflammation. The presence of anaemia in CKD further increases the risk of LVH and oxidative stress, thereby magnifying the deleterious consequence in uraemic cardiomyopathy (UCM), and aggravating progression to failure and increasing the risk of sudden cardiac death. This short review highlights the specific cardio-renal oxidative stress in CKD and provides an understanding of the pathophysiology and impact of uraemic toxins, inflammation, and anaemia on oxidative stress...
October 11, 2018: Pharmaceuticals
Erzsébet Horváth-Puhó, Marit M Suttorp, Henrik Frederiksen, Tiny Hoekstra, Olaf M Dekkers, Lars Pedersen, Suzanne C Cannegieter, Friedo W Dekker, Henrik Toft Sørensen
Introduction: Erythropoiesis-stimulating agent (ESA) treatment has been associated with an increased risk of venous thromboembolism (VTE) in patients with solid tumors and with an increased risk of cardiovascular events in patients with chronic kidney disease. The ESA-related risk in patients with hematological neoplasms remains unclear. We, therefore, aimed to assess the ESA-related risk of VTE, myocardial infarction (MI), and stroke in patients with multiple myeloma (MM) and myelodysplastic syndrome (MDS)...
2018: Clinical Epidemiology
Chandrika Chitturi, James E Novak
The leading cause of death worldwide is cardiovascular disease. The heart and the kidneys are functionally interdependent, such that dysfunction in one organ may cause dysfunction in the other. By one estimate, more than 60% of patients with congestive heart failure develop chronic kidney disease. Volume overload and congestion are hallmarks of heart failure, and these findings are associated with severe symptoms and poor outcomes. Given the importance of congestion, diuretics remain a cornerstone of heart failure management...
September 2018: Advances in Chronic Kidney Disease
Yunan Zhou, Matthias Hellberg, Evangelia Kouidi, Asterios Deligiannis, Peter Höglund, Naomi Clyne
BACKGROUND: Abdominal aortic calcification (AAC) is an established risk factor for cardiovascular events in patients with chronic kidney disease (CKD). We hypothesized that AAC is associated with a decline in glomerular filtration rate (GFR) as well as with some other cardiovascular risk factors. MATERIALS AND METHODS: This is a cross-sectional analysis of baseline data from a randomized controlled clinical trial (RENEXC). A total of 151 patients (aged 66 ± 14 years) with an average measured GFR (mGFR) of 22...
October 12, 2018: Clinical Nephrology
Fabrizio Fabrizi, Piergiorgio Messa
Introduction Hepatitis C virus (HCV) infection leads to important morbidity and mortality through liver disease and extra-hepatic manifestations. Recent evidence suggests the role of HCV in developing chronic kidney disease (CKD); also, HCV adversely impacts on cardiovascular (CV) disease both in the general population and in patients with CKD. Areas covered All-oral, interferon-free direct-acting antiviral agents are currently available; anti-HCV regimens based on direct-acting antiviral agents (DAAs) are provided with high efficacy and safety and short treatment duration...
October 12, 2018: Expert Review of Clinical Pharmacology
Ying Zheng, Li Tang, Weiguang Zhang, Delong Zhao, Dong Zhang, Li Zhang, Guangyan Cai, Xiangmei Chen
Background: The 2017 high blood pressure (BP) clinical practice guideline reported by the American College of Cardiology/American Heart Association put forward new categories of BP. This study aimed to assess the applicability of the new guideline in a nondialysis chronic kidney disease (CKD) population. Methods: This is a nationwide, multicenter, cross-sectional study with a large sample. A total of 8927 nondialysis CKD patients in 61 tertiary hospitals in all 31 provinces, municipalities and autonomous regions of China (except Hong Kong, Macao and Taiwan) were analyzed...
October 9, 2018: Nephrology, Dialysis, Transplantation
Zachary Bouck, Graham C Mecredy, Noah M Ivers, Moumita Barua, Danielle Martin, Peter C Austin, Joshua Tepper, R Sacha Bhatia
Importance: International nephrology societies advise against nonsteroidal anti-inflammatory drug (NSAID) use in patients with hypertension, heart failure, or chronic kidney disease (CKD); however, recent studies have not investigated the frequency or associations of use in these patients. Objectives: To estimate the frequency of and variation in prescription NSAID use among high-risk patients, to identify characteristics associated with prescription NSAID use, and to investigate whether use is associated with short-term, safety-related outcomes...
October 8, 2018: JAMA Internal Medicine
Yazhou He, Xue Li, Danijela Gasevic, Eleanor Brunt, Fiona McLachlan, Marisa Millenson, Maria Timofeeva, John P A Ioannidis, Harry Campbell, Evropi Theodoratou
Background: Many effects of statins on non-cardiovascular disease (non-CVD) outcomes have been reported. Purpose: To evaluate the quantity, validity, and credibility of evidence regarding associations between statins and non-CVD outcomes and the effects of statins on these outcomes. Data Sources: MEDLINE and EMBASE (English terms only, inception to 28 May 2018). Study Selection: Meta-analyses (published in English) of observational studies and of randomized controlled trials (RCTs) that examined non-CVD outcomes of statin intake...
October 9, 2018: Annals of Internal Medicine
Eun Hee Cho, Sang Wook Kim
BACKGROUND: Dipeptidyl peptidase-4 (DPP-4) is strongly expressed in the kidney, and soluble levels of this protein are used as a marker in various chronic inflammatory diseases, including diabetes, coronary artery disease, and cancer. This study examined the association between the serum soluble DPP-4 levels and renal function or cardiovascular risk in patients with type 2 diabetes mellitus. METHODS: In this retrospective analysis, soluble DPP-4 levels were measured in preserved sera from 140 patients with type 2 diabetes mellitus who had participated in our previous coronary artery calcium (CAC) score study...
October 8, 2018: Diabetes & Metabolism Journal
J Aleksova, K W Ng, C Jung, H Zeimer, K M Dwyer, F Milat, R J MacIsaac
The metabolic abnormalities affecting bone in the setting of chronic kidney disease (CKD) are complex with over-lapping and inter-acting aetiologies and have challenging diagnostic and management strategies. Disturbances in calcium, phosphate, fibroblast growth factor 23, parathyroid hormone (PTH) concentrations and vitamin D deficiency are commonly encountered and contribute to the clinical syndromes of bone disorders in CKD including hyperparathyroidism, osteomalacia, osteoporosis and adynamic bone disease...
October 9, 2018: Internal Medicine Journal
Oh Yoen Kim, Su Mi Lee, Won Suk An
Fatty acids (FAs) are essential nutrients and main constituents of cell membranes that are involved in the signaling pathway and associated with health conditions. We investigated if blood or erythrocyte membrane FAs can predict the risk of cardiovascular disease (CVD), chronic kidney disease (CKD), and related complications. Omega-3 ( n -3) FAs are important predictors for metabolic syndrome, diabetes, CVD, and CKD risks, and the n -3 index is also a good biomarker for sudden cardiac death in coronary artery disease...
October 7, 2018: Nutrients
Rayana A P Maciel, Regiane S Cunha, Valentina Busato, Célia R C Franco, Paulo C Gregório, Carla J R Dolenga, Lia S Nakao, Ziad A Massy, Agnès Boullier, Roberto Pecoits-Filho, Andréa E M Stinghen
Endothelial dysfunction in uremia can result in cell-to-cell junction loss and increased permeability, contributing to cardiovascular diseases (CVD) development. This study evaluated the impact of the uremic milieu on endothelial morphology and cell junction's proteins. We evaluated (i) serum levels of inflammatory biomarkers in a cohort of chronic kidney disease (CKD) patients and the expression of VE-cadherin and Zonula Occludens-1 (ZO-1) junction proteins on endothelial cells (ECs) of arteries removed from CKD patients during renal transplant; (ii) ECs morphology in vitro under different uremic conditions, and (iii) the impact of uremic toxins p-cresyl sulfate (PCS), indoxyl sulfate (IS), and inorganic phosphate (Pi) as well as of total uremic serum on VE-cadherin and ZO-1 gene and protein expression in cultured ECs...
October 7, 2018: Toxins
Qi Yue, Fei-Ting Yin, Qian Zhang, Chao Yuan, Mei-Yan Ye, Xiao-Ling Wang, Ji-Jun Li, Ye-Hua Gan
OBJECTIVE: The aim of this study was to evaluate the carious status and the microbial profiles of supragingival plaque in patients with chronic kidney disease undergoing hemodialysis. METHODS: This study included 30 patients with chronic kidney disease undergoing hemodialysis as well as 30 control subjects. Dental examination was performed and the decayed-missing-filled-teeth was recorded. Supragingival plaque was taken and analyzed using 16S rRNA gene amplicon by Illumina MiSeq sequencing to detect microbial composition and community diversity and structure...
2018: PloS One
Jingru Lin, Rui Xu, Lin Yun, Yamin Hou, Chan Li, Ying Lian, Fei Zheng
Backgroud: While numerous risk factors for renal damage in the hypertensive population have been reported, there is no single prediction model. The purpose of this study was to develop a model to comprehensively evaluate renal damage risk among hypertensive patients. Methods: We analyzed the data of 582 Chinese hypertensive patients from 1 January 2013 to 30 June 2016. Basic patient information was collected along with laboratory test results. According to the albumin-to-creatinine ratio, the subjects were divided into a hypertension with renal damage group and a hypertension without renal damage group...
October 9, 2018: Clinical and Experimental Hypertension: CHE
Jwa-Kyung Kim, Mi Jin Park, Hoi Woul Lee, Hyung Seok Lee, Sun Ryoung Choi, Young Rim Song, Hyung Jik Kim, Hyeong-Cheon Park, Sung Gyun Kim
In chronic kidney disease (CKD), the number of circulating neutrophils are increased, and this is usually accompanied by an increased basal activation state. However, the possible association between neutrophil extracellular traps (NETs) with vascular complications has not been evaluated. We assessed the relationship between NETs, autophagy and endothelial dysfunction in maintenance hemodialysis (MHD) patients. NET formation, neutrophil elastase (NE) activities, and serum nucleosome levels were measured in MHD (n = 60) and controls (n = 20)...
October 5, 2018: Clinical Immunology: the Official Journal of the Clinical Immunology Society
Dimitrie Siriopol, Adrian Covic, Radu Iliescu, Mehmet Kanbay, Oana Tautu, Luminita Radulescu, Ovidiu Mitu, Delia Salaru, Maria Dorobantu
Accumulating evidence indicates that higher levels of salt intake are associated with higher blood pressure levels. The aim of our analysis was to test the hypothesis that the effect of urinary sodium excretion (UNaV) on systolic blood pressure (SBP) is mediated through estimated glomerular filtration rate (eGFR) and arterial stiffness and also to test the direction of the relationship between eGFR and arterial stiffness, in both hypertensive and normotensive patients. We assessed the potential for connection between UNaV and SBP and mediators (eGFR and pulse wave velocity [PWV]) of this relationship using structural equation models of data from 1599 adults ≥18 years of age and without chronic kidney disease who participated in the Third Epidemiologic Study concerning the Prevalence of Arterial Hypertension and Cardiovascular Risk in Romania (SEPHAR III)...
October 7, 2018: Journal of Clinical Hypertension
Terumasa Hayashi, Yukari Uemura, Michiko Kumagai, Masashi Kimpara, Hiroyuki Kanno, Yasuo Ohashi
BACKGROUND: Previous randomized-controlled trials have shown that targeting higher hemoglobin (Hb) levels using high dose of ESA in non-dialysis chronic kidney disease (NDCKD) patients resulted in poorer cardiovascular outcome; however, it remains unknown how high Hb levels achieved by ESA in clinical practice dose could affect renal outcome. METHODS: In a multicenter prospective observational study, Japanese NDCKD patients with an estimated glomerular filtration rate (eGFR) of ≥ 6 mL/min/1...
October 5, 2018: Clinical and Experimental Nephrology
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