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Albumin creatinine ratio cardiovascular

Svetlana Villevalde, Zhanna Kovbalava
OBJECTIVE: Microalbuminuria (MAU) and glomerular filtration rate (GFR) are the signs of subclinical kidney damage, independently predict cardiovascular morbidity and mortality. The aim of the study was to investigate the relative role of MAU, cardiac and vascular ultrasonography, carotid-femoral pulse wave velocity (PWV) for the detection of hypertensive target organ damage (TOD) and risk stratification. DESIGN AND METHOD: In 576 non-diabetic hypertensive patients without established cardiovascular or renal disease (291 male, 53...
September 2016: Journal of Hypertension
Jongha Park
Cardiovascular (CV) risk assessment is not easy in chronic kidney disease (CKD) patients. Age, male sex, race, family history of CV disease, smoking status and diabetes should be considered as CV risk factors as the general population. It is also accepted that hypertension (HTN) is associated with the greater risk of CV complications in this population. However, there are some concerns in this issue.First, supporting evidence for specific blood pressure (BP) targets in CKD is scarce. Many observational studies reported a J-shaped association between BP level and CV mortality unlike a linear association in the general population...
September 2016: Journal of Hypertension
Shokei Kim-Mitsuyama
There is accumulating evidence that RAS inhibitors not only reduce blood pressure, but also exert pleiotropic effects, including a renoprotective effect, amelioration of insulin resistance, reduction in onset of diabetes, and suppression of cardiovascular remodelling,. However, the definite benefit of RAS inhibition in treatment of hypertension with CKD or DM is not conclusive. We previously performed the OlmeSartan and Calcium Antagonists Randomized (OSCAR) study comparing the preventive effect of high-dose ARB therapy versus ARB plus CCB combination therapy on cardiovascular morbidity and mortality in 1164 Japanese elderly hypertensive patients with baseline type 2 diabetes and/or CVD (Am J Med (2012))...
September 2016: Journal of Hypertension
Yi Zhang, Yuyan Lu, Bin Bai, Shikai Yu, Jing Xiong, Dela Jia, Yawei Xu
OBJECTIVE: To compare of carotid-femoral pulse wave velocity (cf-PWV) and brachial-ankle PWV (ba-PWV) in the association with conventional cardiovascular risk factors and target organ damages (TODs). DESIGN AND METHOD: 1599 community-dwelling elderly subjects (age > 65 years old) in the northern Shanghai were recruited from June 2014 to August 2015. Cf-PWV and ba-PWV were measured by SphygmCor (AtCor, Australia) and VP1000 (Omron, Japan), respectively. Under the framework of comprehensive cardiovascular examinations, cardiovascular risk factors were assessed, and hypertensive TODs, including left ventricular mass index (LVMI), peak transmitral pulsed Doppler velocity/early diastolic tissue Doppler velocity (E/Ea), carotid intima-media thickness (CIMT), ankle-brachial index (ABI), creatinine clearance rate (CCR) and urinary albumin-creatinine ratio (UACR), were all evaluated...
September 2016: Journal of Hypertension
Mihae Seo, Ki-Chul Sung
OBJECTIVE: The urinary albumin and hypertension (HTN) is independently associated with an increased risk of all-cause mortality. The effect of albuminuria with absence or presence HTN uncertain in mortality. This study aimed to evaluated the effect of urinary albumin and hypertension on all-cause and cardiovascular disease (CVD) mortality. DESIGN AND METHOD: Mortality outcomes for 39460 Koreans enrolled in a health screening with measurements of Urine albumin creatinine ratio (UACR) at baseline and median follow-up of 5...
September 2016: Journal of Hypertension
Yi-Bang Cheng, Ting-Yan Xu, Yan Yang, Qian-Hui Guo, Chang-Sheng Sheng, Qi-Fang Huang, Jing-Jing Li, Dong-Yan Zhang, Ji-Guang Wang, Yan Li
OBJECTIVE: Central blood pressure (BP) is suggested to be more closely correlated to target organ damage and cardiovascular events than brachial BP. Outcome-based thresholds for the diagnosis of central hypertension has been recently proposed. However, little is known about central hypertension. In an untreated patient cohort, we therefore investigated the prevalence of central hypertension and its association with target organ damage. DESIGN AND METHOD: Consecutive untreated patients referred for ambulatory BP monitoring to our Hypertension Clinic were recruited...
September 2016: Journal of Hypertension
Ki Chul Sung
OBJECTIVE: Microalbuminuria is associated with cardiovascular disease (CVD) mortality but whether lower levels of urine albumin excretion similarly predict CVD is uncertain. We investigated associations between urine albumin:creatinine ratio (UACR) < 30mg/g, and incident hypertension, incident diabetes, all cause and CVD mortality, at 10 year follow-up. DESIGN AND METHOD: 39,071 individuals in a health screening program between 2002 and 2012 (N = 39,071) with baseline measurements of urine albumin creatinine ratio (UACR) were studied...
September 2016: Journal of Hypertension
Faiçal Jarraya
Hypertension remains the most important risk factor for cardiovascular disease. If antihypertensive drugs choice is well guided today, blood pressure (BP) target still a subject of controversies. Residual risk is matter of debate and the lower- the better dogma is come back again regarding to data reported from recent trials. The J curve, reason for European Society of Hypertension Guidelines reappraisal in 2009, is criticized by recent data. The one goal (<140/90 mmHg) fit 90 mmg 90 mmHg) fit all should be adapted as a personalized goal guided by evidence generated by randomized controlled trials...
October 9, 2016: Advances in Experimental Medicine and Biology
S A Paul Chubb, Wendy A Davis, Kirsten E Peters, Timothy M E Davis
BACKGROUND: Serum bicarbonate is associated with mortality, heart failure (HF) and progression of renal failure in studies of healthy people and patients with chronic kidney disease, but the significance of these observations in unselected patients with diabetes in the general population is unknown. The aim of this study was to determine whether serum bicarbonate was associated with mortality and cardiovascular disease risk in type 2 diabetes. METHODS: Baseline serum bicarbonate was available for 1283 well-characterized community-based patients (mean ± SD age 64...
October 6, 2016: Cardiovascular Diabetology
I-Chih Chen, Chao-Chin Yu, Yi-Hsuan Wu, Ting-Hsing Chao
BACKGROUND: Inflammation plays an important role in the pathogenesis of cardiovascular disease in patients with advanced chronic kidney disease (CKD). Neutrophil-to-lymphocyte ratio (NLR), an inflammatory biomarker, has not been evaluated in patients who have advanced CKD with peripheral artery disease (PAD) undergoing percutaneous transluminal angioplasty (PTA), especially in Taiwan. METHODS: We retrospectively evaluated 148 advanced CKD (creatinine clearance rate ≤ 30 mL/min/1...
September 2016: Acta Cardiol Sin
Zhen-Wei Shen, Jie Xing, Qing-Lian Wang, Ali Faheem, Xiang Ji, Jie Li, Wei-Wei Bian, Zheng Jiang, Xiu-Jun Li, Fu-Zhong Xue, Jing Liu
PURPOSE: Limited numbers of literatures have focused on the association between γ-glutamyltransferase (GGT) and chronic kidney disease (CKD), and their results were controversial. Therefore, in this study, we set up a large-scale cohort of Chinese population to discover and verify the association between serum GGT and CKD. METHODS: Our cohort study was based on 21,818 patients who visited Health Management Center of Shandong Provincial Hospital, China, to receive routine health check-up during the period of 2005-2010, and we used multivariate Cox regression model to clarify whether elevated serum GGT increased the risk of CKD or not...
October 4, 2016: International Urology and Nephrology
Toralf Melsom, Vidar Stefansson, Jørgen Schei, Marit Solbu, Trond Jenssen, Tom Wilsgaard, Bjørn O Eriksen
BACKGROUND AND OBJECTIVES: Hyperfiltration at the single-nephron level has been proposed as an early stage of kidney dysfunction of different origins. Evidence supporting this hypothesis in humans is lacking, because there is no method of measuring single-nephron GFR in humans. However, increased whole-kidney GFR in the same individual implies an increased single-nephron GFR, because the number of nephrons does not increase with age. We hypothesized that an increase in GFR would be associated with an increased albumin-to-creatinine ratio in a cohort of the general population...
September 28, 2016: Clinical Journal of the American Society of Nephrology: CJASN
Alexander R Opotowsky, Fernando R Baraona, Finnian R Mc Causland, Brittani Loukas, Elizabeth Landzberg, Michael J Landzberg, Venkata Sabbisetti, Sushrut S Waikar
OBJECTIVES: To define whether adults with a Fontan circulation, who have lifelong venous congestion and limited cardiac output, have impaired glomerular filtration rate (GFR) or elevated urinary biomarkers of kidney injury. METHODS: We measured circulating cystatin C and creatinine (n=70) and urinary creatinine, albumin, kidney injury molecule-1 (KIM-1), neutrophil gelatinase-associated lipocalin (NGAL) and N-acetyl glucosaminidase (NAG) (n=59) in ambulatory adult Fontan patients and 20 age-matched and sex-matched controls...
September 26, 2016: Heart: Official Journal of the British Cardiac Society
Kyung Hee Lee, Jang-Hee Cho, Owen Kwon, Sang-Un Kim, Ryang Hi Kim, Young Wook Cho, Hee-Yeon Jung, Ji-Young Choi, Chan-Duck Kim, Yong-Lim Kim, Sun-Hee Park
BACKGROUND: Prealbumin, a sensitive marker for protein-energy status, is also known as an independent risk factor for mortality in hemodialysis patients. We investigated the impact of prealbumin on survival in incident peritoneal dialysis (PD) patients. METHODS: In total, 136 incident PD patients (mean age, 53.0 ± 15.8 years) between 2002 and 2007 were enrolled in the study. Laboratory data, dialysis adequacy, and nutritional parameters were assessed 3 months after PD initiation...
September 2016: Kidney Research and Clinical Practice
Anandita Agarwala, Salim Virani, David Couper, Lloyd Chambless, Eric Boerwinkle, Brad C Astor, Ron C Hoogeveen, Joe Coresh, A Richey Sharrett, Aaron R Folsom, Tom Mosley, Christie M Ballantyne, Vijay Nambi
BACKGROUND AND AIMS: Biomarkers and atherosclerosis imaging have been studied individually for association with incident cardiovascular disease (CVD); however, limited data exist on whether the biomarkers are associated with events with a similar magnitude in the presence of atherosclerosis. In this study, we assessed whether the presence of atherosclerosis as measured by carotid intima media thickness (cIMT) affects the association between biomarkers known to be associated with coronary heart disease (CHD) and incident cardiovascular disease (CVD) in a primary prevention cohort...
October 2016: Atherosclerosis
Rajiv Agarwal
BACKGROUND: Masked uncontrolled hypertension (MUCH) is associated with greater target organ damage such as left ventricular hypertrophy, increased arterial stiffness and albuminuria. Whether MUCH independently associates with greater cardiovascular end-organ damage or kidney damage is unclear. The objective of this study was to assess the strength of the relationship of MUCH (awake ambulatory blood pressure ≥135/85 mmHg and clinic blood pressure <140/90 mmHg) with target organ damage...
September 20, 2016: Nephrology, Dialysis, Transplantation
Adam Shardlow, Natasha J McIntyre, Richard J Fluck, Christopher W McIntyre, Maarten W Taal
BACKGROUND: Chronic kidney disease (CKD) is commonly managed in primary care, but most guidelines have a secondary care perspective emphasizing the risk of end-stage kidney disease (ESKD) and need for renal replacement therapy. In this prospective cohort study, we sought to study in detail the natural history of CKD in primary care to better inform the appropriate emphasis for future guidance. METHODS AND FINDINGS: In this study, 1,741 people with CKD stage 3 were individually recruited from 32 primary care practices in Derbyshire, United Kingdom...
September 2016: PLoS Medicine
Salim Elyas, Angela C Shore, Hayley Kingwell, Samantha Keenan, Leigh Boxall, Jane Stewart, Martin A James, William David Strain
OBJECTIVE: Transient ischemic attacks (TIA) and minor strokes are important risk factors for recurrent strokes. Current stroke risk prediction scores such as ABCD2, although widely used, lack optimal sensitivity and specificity. Elevated urinary albumin excretion predicts cardiovascular disease, stroke, and mortality. We explored the role of microalbuminuria (using albumin creatinine ratio (ACR)) in predicting recurrence risk in patients with TIA and minor stroke. METHODS: Urinary ACR was measured on a spot sample in 150 patients attending a daily stroke clinic with TIA or minor stroke...
September 2016: Annals of Clinical and Translational Neurology
Timothy P Murphy, Christopher J Cooper, Karol M Pencina, Ralph D'Agostino, Joseph Massaro, Donald E Cutlip, Kenneth Jamerson, Alan H Matsumoto, William Henrich, Joseph I Shapiro, Katherine R Tuttle, David J Cohen, Michael Steffes, Qi Gao, D Christopher Metzger, William B Abernethy, Stephen C Textor, John Briguglio, Alan T Hirsch, Sheldon Tobe, Lance D Dworkin
: Randomized clinical trials have not shown an additional clinical benefit of renal artery stent placement over optimal medical therapy alone. However, studies of renal artery stent placement have not examined the relationship of albuminuria and treatment group outcomes. The CORAL study (Cardiovascular Outcomes in Renal Atherosclerotic Lesions) is a prospective clinical trial of 947 participants with atherosclerotic renal artery stenosis randomized to optimal medical therapy with or without renal artery stent which showed no treatment differences (3(5...
November 2016: Hypertension
(no author information available yet)
BACKGROUND: Patients with chronic kidney disease (CKD) are at risk of progression to end-stage renal disease and cardiovascular disease. Data from other populations and animal experiments suggest that neprilysin inhibition (which augments the natriuretic peptide system) may reduce these risks, but clinical trials among patients with CKD are required to test this hypothesis. METHODS: UK Heart and Renal Protection III (HARP-III) is a multicentre, double-blind, randomized controlled trial comparing sacubitril/valsartan 97/103 mg two times daily (an angiotensin receptor-neprilysin inhibitor) with irbesartan 300 mg one time daily among 414 patients with CKD...
September 19, 2016: Nephrology, Dialysis, Transplantation
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