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Ckd, trial and diabetes

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https://www.readbyqxmd.com/read/28077457/systems-biology-derived-biomarkers-to-predict-progression-of-renal-function-decline-in-type-2-diabetes-mellitus
#1
Gert Mayer, Hiddo J L Heerspink, Constantin Aschauer, Andreas Heinzel, Georg Heinze, Alexander Kainz, Judith Sunzenauer, Paul Perco, Dick de Zeeuw, Peter Rossing, Michelle Pena, Rainer Oberbauer
OBJECTIVE: Chronic kidney disease (CKD) in diabetes has a complex molecular and likely multifaceted pathophysiology. We aimed to validate a panel of biomarkers identified using a systems biology approach to predict the individual decline of estimated glomerular filtration rate (eGFR) in a large group of patients with type 2 diabetes mellitus and CKD at various stages. RESEARCH DESIGN AND METHODS: We used publicly available "omics" data to develop a molecular process model of CKD in diabetes and identified a representative parsimonious set of nine molecular biomarkers: chitinase 3-like protein 1, growth hormone 1, hepatocyte growth factor, matrix metalloproteinase (MMP) 2, MMP7, MMP8, MMP13, tyrosine kinase, and tumor necrosis factor receptor-1...
January 11, 2017: Diabetes Care
https://www.readbyqxmd.com/read/28045962/association-of-tsh-elevation-with-all-cause-mortality-in-elderly-patients-with-chronic-kidney-disease
#2
Mei-Hsing Chuang, Kuo-Meng Liao, Yao-Min Hung, Yi-Chang Chou, Pesus Chou
Chronic kidney disease (CKD) is a widespread condition in the global population and is more common in the elderly. Thyroid-stimulating hormone (TSH) level increases with aging, and hypothyroidism is highly prevalent in CKD patients. However, the relationship between low thyroid function and mortality in CKD patients is unclear. Therefore, we conducted a retrospective cohort study to examine the relationship between TSH elevation and all-cause mortality in elderly patients with CKD. This retrospective cohort study included individuals ≥65 years old with CKD (n = 23,786) in Taipei City...
2017: PloS One
https://www.readbyqxmd.com/read/28041817/combined-diabetes-renal-multifactorial-intervention-in-patients-with-advanced-diabetic-nephropathy-proof-of-concept
#3
Leon Fogelfeld, Peter Hart, Jadwiga Miernik, Jocelyn Ko, Donna Calvin, Bettina Tahsin, Anwar Adhami, Rajeev Mehrotra, Louis Fogg
AIMS: To evaluate efficacy of a multifactorial-multidisciplinary approach in delaying CKD 3-4 progression to ESRD. METHODS: Two-year proof-of-concept stratified randomized control trial conducted in an outpatient clinic of a large public hospital system. This intervention, led by a team of endocrinologists, nephrologists, nurse practitioners, and registered dietitians, integrated intensive diabetes-renal care with behavioral/dietary and pharmacological interventions...
December 8, 2016: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/27992863/effects-of-high-density-lipoprotein-raising-therapies-on-cardiovascular-outcomes-in-patients-with-type-2-diabetes-mellitus-with-or-without-renal-impairment-the-action-to-control-cardiovascular-risk-in-diabetes-study
#4
Vasilios Papademetriou, Laura Lovato, Costas Tsioufis, William Cushman, William B Applegate, Amy Mottle, Zubin Punthakee, Eric Nylen, Michael Doumas
BACKGROUND: The role of high density lipoprotein-raising interventions in addition to statin therapy in patients with diabetes remains controversial. Chronic kidney disease (CKD) is a strong modifier of cardiovascular (CV) outcomes. We therefore investigated the impact of CKD status at baseline on outcomes in patients with diabetes randomized to standard statin or statin plus fenofibrate treatment in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) lipid trial. METHODS: Among 5,464 participants in the ACCORD lipid trial, 3,554 (65%) were free of CKD at baseline, while 1,910 (35%) had mild to moderate CKD...
December 17, 2016: American Journal of Nephrology
https://www.readbyqxmd.com/read/27942587/chorioretinal-thinning-in-chronic-kidney-disease-links-to-inflammation-and-endothelial-dysfunction
#5
Craig Balmforth, Job J M H van Bragt, Titia Ruijs, James R Cameron, Robert Kimmitt, Rebecca Moorhouse, Alicja Czopek, May Khei Hu, Peter J Gallacher, James W Dear, Shyamanga Borooah, Iain M MacIntyre, Tom M C Pearson, Laura Willox, Dinesh Talwar, Muriel Tafflet, Christophe Roubeix, Florian Sennlaub, Siddharthan Chandran, Baljean Dhillon, David J Webb, Neeraj Dhaun
BACKGROUND. Chronic kidney disease (CKD) is strongly associated with cardiovascular disease and there is an established association between vasculopathy affecting the kidney and eye. Optical coherence tomography (OCT) is a novel, rapid method for high-definition imaging of the retina and choroid. Its use in patients at high cardiovascular disease risk remains unexplored. METHODS. We used the new SPECTRALIS OCT machine to examine retinal and retinal nerve fiber layer (RNFL) thickness, macular volume, and choroidal thickness in a prospective cross-sectional study in 150 subjects: 50 patients with hypertension (defined as a documented clinic BP greater than or equal to 140/90 mmHg (prior to starting any treatment) with no underlying cause identified); 50 with CKD (estimated glomerular filtration rate (eGFR) 8-125 ml/min/1...
December 8, 2016: JCI Insight
https://www.readbyqxmd.com/read/27917261/anti-hepatitis-c-virus-drugs-and-kidney
#6
REVIEW
Paul Carrier, Marie Essig, Marilyne Debette-Gratien, Denis Sautereau, Annick Rousseau, Pierre Marquet, Jérémie Jacques, Véronique Loustaud-Ratti
Hepatitis C virus (HCV) mainly targets the liver but can also induce extrahepatic manifestations. The kidney may be impacted via an immune mediated mechanism or a cytopathic effect. HCV patients are clearly at a greater risk of chronic kidney disease (CKD) than uninfected patients are, and the presence of CKD increases mortality. Interferon-based therapies and ribavirin are difficult to manage and are poorly effective in end-stage renal disease and hemodialysis. These patients should be given priority treatment with new direct anti-viral agents (DAAs) while avoiding peginterferon and ribavirin...
November 18, 2016: World Journal of Hepatology
https://www.readbyqxmd.com/read/27900942/association-between-chronic-kidney-disease-and-cancer-mortality-a-report-from-the-allhat
#7
Dhruti P Chen, Barry R Davis, Lara M Simpson, William C Cushman, Jeffrey A Cutler, Mirela Dobre, Charles E Ford, Gail T Louis, Paul Muntner, Suzanne Oparil, Linda B Piller, Sara L Pressel, Mark J Sarnak, Paul K Whelton, Jackson T Wright, Mahboob Rahman
BACKGROUND/OBJECTIVES: Chronic kidney disease (CKD) and cancer are both common in older patients; whether CKD increases risk for cancer is unclear. This study evaluated CKD as a risk factor for cancer mortality in a large cohort of hypertensive patients. STUDY DESIGN: We did post-hoc analyses of in-trial and post-trial data from participants in the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). SETTING AND PARTICIPANTS: Participants were ≥ 55 years old with hypertension and one other additional risk factor for coronary heart disease...
January 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/27891373/retrospective-comparison-of-clinical-characteristics-and-in-hospital-outcomes-among-diabetic-and-non-diabetic-adults-with-acute-pyelonephritis
#8
Shailesh C Trivedi, Sanjeev R Phatak, Renu S Trivedi
INTRODUCTION: Acute Pyelonephritis (APN) is a common infection in community. Diabetes Mellitus (DM) may have different effect on clinical characteristics and outcomes of APN compared to non-diabetic individuals. AIM: To compare clinical characteristics and assess outcomes of APN patients with and without DM. MATERIALS AND METHODS: A retrospective analysis of 122 patients with DM (n=61) and without DM (n=61) was conducted at a single, private, urban set-up from Gujarat, India...
October 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27883326/renal-replacement-therapy-in-patients-with-heart-and-kidney-failure
#9
Dimitrios S Goumenos, Evangelos Papachristou, Marios Papasotiriou
The incidence of chronic kidney disease (CKD) in patients with chronic heart failure (CHF) is high as CKD and CHF share underlying risk factors such as arterial hypertension, diabetes mellitus and atherosclerosis. Cardiac failure leads to renal hypoperfusion and dysfunction and then fluid overload and need for aggressive diuretic therapy. However, development of diuretic resistance represents a significant problem in the management of these patients. The role of Renal Replacement Therapy (RRT) is important for patients who do not response to conservative management of fluid overload facilitating the failing heart to restore function...
November 1, 2016: Prilozi (Makedonska Akademija Na Naukite i Umetnostite. Oddelenie za Medicinski Nauki)
https://www.readbyqxmd.com/read/27881110/prevalence-of-chronic-kidney-disease-in-patients-with-chronic-obstructive-pulmonary-disease-a-systematic-review-and-meta-analysis
#10
Swarna Gaddam, Sameer K Gunukula, James W Lohr, Pradeep Arora
BACKGROUND: The incidence and prevalence of chronic kidney disease (CKD) continue to rise worldwide. Increasing age, diabetes, hypertension, and cigarette smoking are well-recognized risk factors for CKD. Chronic obstructive pulmonary disease (COPD) is characterized by chronic airway inflammation leading to airway obstruction and parenchymal lung destruction. Due to some of the common pathogenic mechanisms, COPD has been associated with increased prevalence of CKD. METHODS: Systematic review of medical literature reporting the incidence and prevalence of CKD in patients with COPD using the Cochrane Collaboration Methodology, and conduct meta-analysis to study the cumulative effect of the eligible studies...
November 24, 2016: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/27872156/association-between-blood-pressure-and-adverse-renal-events-in-type-1-diabetes
#11
Elaine Ku, Charles E McCulloch, Michael Mauer, Stephen E Gitelman, Barbara A Grimes, Chi-Yuan Hsu
OBJECTIVE: To compare different blood pressure (BP) levels in their association with the risk of renal outcomes in type 1 diabetes and to determine whether an intensive glycemic control strategy modifies this association. RESEARCH DESIGN AND METHODS: We included 1,441 participants with type 1 diabetes between the ages of 13 and 39 years who had previously been randomized to receive intensive versus conventional glycemic control in the Diabetes Control and Complications Trial (DCCT)...
December 2016: Diabetes Care
https://www.readbyqxmd.com/read/27863354/contrast-media-use-in-patients-with-chronic-kidney-disease-undergoing-coronary-angiography-a-systematic-review-and-meta-analysis-of-randomized-trials
#12
Bhavi Pandya, Jean Chaloub, Valay Parikh, Sainath Gaddam, Jonathan Spagnola, Suzanne El-Sayegh, Marc Bogin, Ruben Kandov, James Lafferty, Sripal Bangalore
BACKGROUND: Patients with chronic kidney disease (CKD) undergoing coronary angiography (CA), adequate hydration and minimizing volume of contrast media (CM) are class 1b recommendations for preventing contrast induced nephropathy (CIN). Current data are insufficient to justify specific recommendations about isoosmolar vs. low-osmolar contrast media by the ACCF/AHA/SCAI guidelines. METHODS: Randomized trials comparing IOCM to LOCM in CKD stage 3 and above patients undergoing CA, and reporting incidence of CIN (defined by a rise in creatinine of 25% from baseline) were included in the analysis...
February 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/27830348/steroidal-and-novel-non-steroidal-mineralocorticoid-receptor-antagonists-in-heart-failure-and-cardiorenal-diseases-comparison-at-bench-and-bedside
#13
Peter Kolkhof, Frederic Jaisser, So-Young Kim, Gerasimos Filippatos, Christina Nowack, Bertram Pitt
Characterization of mice with cell-specific deletion or overexpression of the mineralocorticoid receptor (MR) shed a new light on its role in health and disease. Pathophysiological MR activation contributes to a plethora of deleterious molecular mechanisms in the development of cardiorenal diseases like chronic kidney disease (CKD) and heart failure (HF). Accordingly, the available steroidal MR antagonists (MRAs) spironolactone (first generation MRA) and eplerenone (second generation MRA) have been shown to be effective in reducing cardiovascular (CV) mortality and morbidity in patients with chronic HF and a reduced left ventricular ejection fraction (HFrEF)...
November 10, 2016: Handbook of Experimental Pharmacology
https://www.readbyqxmd.com/read/27825313/using-pharmacists-to-improve-risk-stratification-and-management-of-stage-3a-chronic-kidney-disease-a-feasibility-study
#14
Alex R Chang, Michael Evans, Christina Yule, Larissa Bohn, Amanda Young, Meredith Lewis, Elisabeth Graboski, Bethany Gerdy, William Ehmann, Jonathan Brady, Leah Lawrence, Natacha Antunes, Jamie Green, Susan Snyder, H Lester Kirchner, Morgan Grams, Robert Perkins
BACKGROUND: Measurement of albuminuria to stratify risk in chronic kidney disease (CKD) is not done universally in the primary care setting despite recommendation in KDIGO (Kidney Disease Improving Global Outcomes) guidelines. Pharmacist medication therapy management (MTM) may be helpful in improving CKD risk stratification and management. METHODS: We conducted a pragmatic, cluster-randomized trial using seven primary care clinic sites in the Geisinger Health System to evaluate the feasibility of pharmacist MTM in patients with estimated glomerular filtration rate (eGFR) 45-59 ml/min/1...
November 8, 2016: BMC Nephrology
https://www.readbyqxmd.com/read/27797889/albuminuria-changes-and-cardiovascular-and-renal-outcomes-in-type-1-diabetes-the-dcct-edic-study
#15
Ian H de Boer, Xiaoyu Gao, Patricia A Cleary, Ionut Bebu, John M Lachin, Mark E Molitch, Trevor Orchard, Andrew D Paterson, Bruce A Perkins, Michael W Steffes, Bernard Zinman
BACKGROUND AND OBJECTIVES: In trials of people with type 2 diabetes, albuminuria reduction with renin-angiotensin system inhibitors is associated with lower risks of cardiovascular events and CKD progression. We tested whether progression or remission of microalbuminuria is associated with cardiovascular and renal risk in a well characterized cohort of type 1 diabetes. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We studied 1441 participants in the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications study...
November 7, 2016: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/27783256/predictive-factors-of-renal-toxicities-related-to-anti-vegfr-multikinase-inhibitors-in-phase-1-trials
#16
Emilie Boissier, Olivier Mir, Antoine Hollebecque, Hassan Izzedine, Stéphane Ederhy, Anas Gazzah, Rastislav Bahleda, Christophe Massard, Isabelle Macquin-Mavier, Christophe Tournigand, Jean-Philippe Spano, Jean-Charles Soria, Benoît Rousseau
Purpose Renal toxicities are common with angiogenesis multikinase inhibitors (AMKI), and can be limiting in phase I trials. Factors associated with such toxicities are poorly known. The aims of this exploratory study were to describe renovascular toxicities associated with AMKI, impact on drug development and to identify baseline parameters associated with the occurrence of renal toxicities in phase I trials. Methods Consecutive patients treated with AMKI in Gustave Roussy phase I unit between October 2005 and August 2013 were included...
October 25, 2016: Investigational New Drugs
https://www.readbyqxmd.com/read/27770799/correction-of-metabolic-acidosis-improves-insulin-resistance-in-chronic-kidney-disease
#17
Antonio Bellasi, Lucia Di Micco, Domenico Santoro, Stefania Marzocco, Emanuele De Simone, Mario Cozzolino, Luca Di Lullo, Pasquale Guastaferro, Biagio Di Iorio
BACKGROUND: Correction of metabolic acidosis (MA) with nutritional therapy or bicarbonate administration is widely used in chronic kidney disease (CKD) patients. However, it is unknown whether these interventions reduce insulin resistance (IR) in diabetic patients with CKD. We sought to evaluate the effect of MA correction on endogenous insulin action in diabetic type 2 (DM2) CKD patients. METHODS: A total of 145 CKD subjects (83 men e 62 women) with DM2 treated with oral antidiabetic drugs were included in the study and followed up to 1 year...
October 22, 2016: BMC Nephrology
https://www.readbyqxmd.com/read/27754290/br-08-2-cardiovascular-risk-assessment-in-hypertensives-with-ckd
#18
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
https://www.readbyqxmd.com/read/27754192/me-03-1-role-of-aldosterne-and-mineralocorticoid-receptor-in-salt-sensitive-hypertension
#19
Toshiro Fujita
The aldosterone/mineralocorticoid receptor (MR) pathway regulate renal excretory function and control BP. Notably, we identified Rac1 as a novel ligand-independent modulator of MR (Nat Med 2008), and found involvement of the Rac1-MR pathway in rodent models of salt-sensitive hypertension (JCI 2011). In the clinical trial (EVALUATE study), effects of MR antagonist on urinary albumin excretion were assessed in 304 hypertensive CKD patients receiving renin-angiotensin system (RAS) inhibitors and sub-grouped according to the estimated dietary salt intake (Lancet Endo & Diabetes 2014)...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27754189/sp-05-2-what-should-be-the-target-blood-pressure-for-ckd-with-overt-proteinuria
#20
Daniel W Jones
Hypertension and Chronic Kidney Disease are both common. The vast majority of patients with chronic kidney disease (CKD) have hypertension. Hypertension can be both a cause and a result of CKD. Many patients with CKD, both diabetic and non-diabetic have overt proteinuria (>300 mg/day). Patients with proteinuria are at higher risk for progression of kidney disease and for atherosclerosis. Because patients with CKD are often excluded from hypertension trials with hard outcomes, there has been until recently less data than ideal to consider in making decisions...
September 2016: Journal of Hypertension
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