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Ckd, trial and diabetes

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https://www.readbyqxmd.com/read/29164839/residual-renal-and-cardiovascular-disease-risk-in-conventionally-treated-patients-with-type-2-diabetes-the-potential-of-non-traditional-biomarkers-and-treatments-related-redox-metabolism
#1
Karima Zitouni, Mia Steyn, Kenneth A Earle
Diabetes is a leading cause of chronic kidney disease (CKD) in the developed world. Promoters of the progression of kidney disease include the traditional profile of cardiovascular risk factors. However, the development of CKD and vulnerability to end-stage renal disease (ESRD) is highly variable. Determinants of the susceptibility to ESRD may include non-traditional risk factors such as gene-environment interactions, socio-geographic factors and/or treatment strategies. We review the conflicting clinical relevance of studies implicating pathways related to oxidative stress...
November 21, 2017: Minerva Medica
https://www.readbyqxmd.com/read/29155387/the-impact-of-chronic-kidney-disease-on-outcomes-following-percutaneous-coronary-interventions-versus-coronary-artery-bypass-grafting-in-patients-with-complex-coronary-artery-disease-5-year-follow-up-of-the-syntax-trial
#2
Milan Milojevic, Stuart J Head, Michael J Mack, Friedrich W Mohr, Marie-Claude Morice, Keith D Dawkins, David R Holmes, Patrick W Serruys, A Pieter Kappetein
AIMS: To investigate short-term and 5-year follow-up results from patients randomized to coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI) with paclitaxel-eluting stents in the SYNTAX trial, focusing on patients with chronic kidney disease (CKD). METHODS AND RESULTS: Baseline glomerular filtration rate estimates (eGFR) were available in 1638 patients (PCI=852 and CABG=786). The Kidney Disease Improving Global Outcomes threshold was used to define staging of CKD...
November 21, 2017: EuroIntervention
https://www.readbyqxmd.com/read/29142980/effectiveness-of-multifaceted-care-approach-on-adverse-clinical-outcomes-in-nondiabetic-ckd-a-systematic-review-and-meta-analysis
#3
Aminu K Bello, Bilal Qarni, Arian Samimi, Julius Okel, Trish Chatterley, Ikechi G Okpechi, Ben Vandermeer, Branko Braam
Introduction: The risk of major adverse events associated with chronic kidney disease (CKD) could potentially be reduced with effective medical interventions. The impact of multifaceted interventions as compared with usual care in patients with nondiabetic CKD is unclear. We performed a systematic review to analyze the impact of multifaceted interventions on reducing the risk of major adverse events in this population. Methods: Systematic review and meta-analysis...
July 2017: KI Reports
https://www.readbyqxmd.com/read/29132351/therapeutic-efficacy-of-pentoxifylline-on-proteinuria-and-renal-progression-an-update
#4
REVIEW
Yung-Ming Chen, Wen-Chih Chiang, Shuei-Liong Lin, Tun-Jun Tsai
Blood pressure control with renin-angiotensin system (RAS) blockade has remained the gold standard for treating patients with proteinuric chronic kidney disease (CKD) up to date. Nevertheless, RAS blockade slows but does not halt the progression of kidney disease, thus highlighting the need to search for additional therapeutic approaches. The nonselective phosphodiesterase (PDE) inhibitor pentoxifylline (PTX) is an old drug that exhibits prominent anti-inflammatory, anti-proliferative and anti-fibrotic activities both in vitro and in vivo...
November 13, 2017: Journal of Biomedical Science
https://www.readbyqxmd.com/read/29128444/metabolomics-and-gene-expression-analysis-reveal-down-regulation-of-the-citric-acid-tca-cycle-in-non-diabetic-ckd-patients
#5
Stein Hallan, Maryam Afkarian, Leila R Zelnick, Bryan Kestenbaum, Shoba Sharma, Rintaro Saito, Manjula Darshi, Gregory Barding, Daniel Raftery, Wenjun Ju, Matthias Kretzler, Kumar Sharma, Ian H de Boer
Chronic kidney disease (CKD) is a public health problem with very high prevalence and mortality. Yet, there is a paucity of effective treatment options, partly due to insufficient knowledge of underlying pathophysiology. We combined metabolomics (GCMS) with kidney gene expression studies to identify metabolic pathways that are altered in adults with non-diabetic stage 3-4 CKD versus healthy adults. Urinary excretion rate of 27 metabolites and plasma concentration of 33 metabolites differed significantly in CKD patients versus controls (estimate range-68% to +113%)...
October 31, 2017: EBioMedicine
https://www.readbyqxmd.com/read/29127652/dapagliflozin-as-a-cause-of-acute-tubular-necrosis-with-heavy-consequences-a-case-report
#6
Christos Pleros, Elisavet Stamataki, Antonia Papadaki, Nikolaos Damianakis, Rafaela Poulidaki, Charikleia Gakiopoulou, Ioannis Tzanakis
A 50-year-old man with type II diabetes, hypertension and dyslipidemia, presented with non-oliguric acute kidney injury (AKI) and anemia. Renal biopsy showed acute tubular necrosis (ATN) with extensive cytoplasmic vacuolization and areas of tubulitis. These findings were ultimately attributed to dapagliflozin, which he started 3 months earlier due to poor glycemic control. ATN with similar microscopic findings has been described with larger doses of dapagliflozin in non-clinical trials. Our patient was started on dialysis and remained dialysis-dependent for 4 weeks while his renal function improved gradually thereafter...
November 10, 2017: CEN Case Reports
https://www.readbyqxmd.com/read/29106631/effect-of-renin-angiotensin-aldosterone-system-blockade-in-adults-with-diabetes-mellitus-and-advanced-chronic-kidney-disease-not-on-dialysis-a-systematic-review-and-meta-analysis
#7
Ionut Nistor, Johan De Sutter, Christiane Drechsler, David Goldsmith, Maria Jose Soler, Charles Tomson, Andrzej Wiecek, Mihaela-Dora Donciu, Davide Bolignano, Wim Van Biesen, Adrian Covic
The presumed superiority of renin-angiotensin-aldosterone system (RAAS)-blocking agents over other antihypertensive agents in patients with diabetes to delay development of end-stage kidney disease (ESKD) has recently been challenged. In addition, there is ongoing uncertainty whether RAAS-blocking agents reduce mortality and/or delay ESKD in patients with diabetes and chronic kidney disease (CKD) stages 3-5. In this subgroup, there might be an expedited need for renal replacement therapy (RRT) when RAAS-blocking agents are used...
July 2, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29102959/randomized-controlled-trial-of-trc101-to-increase-serum-bicarbonate-in-patients-with-ckd
#8
David A Bushinsky, Thomas Hostetter, Gerrit Klaerner, Yuri Stasiv, Claire Lockey, Sarah McNulty, Angela Lee, Dawn Parsell, Vandana Mathur, Elizabeth Li, Jerry Buysse, Robert Alpern
BACKGROUND AND OBJECTIVES: Metabolic acidosis is common in patients with CKD and has significant adverse effects on kidney, muscle, and bone. We tested the efficacy and safety of TRC101, a novel, sodium-free, nonabsorbed hydrochloric acid binder, to increase serum bicarbonate in patients with CKD and metabolic acidosis. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: One hundred thirty-five patients were enrolled in this randomized, double-blind, placebo-controlled, multicenter, in-unit study (designated the TRCA-101 Study)...
November 4, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29102249/blood-glucose-and-pressure-controls-in-diabetic-kidney-disease-narrative-review-of-adherence-barriers-and-evidence-of-achievement
#9
REVIEW
Fergus William Gardiner, Ezekiel Uba Nwose, Phillip Taderera Bwititi, Judith Crockett, Lexin Wang
AIMS: To review the epidemiology and the clinical evidence regarding achieving blood pressure (BP) and blood glucose control in patients with chronic kidney disease (CKD) and diabetes mellitus (DM), with emphasis on adherence and barriers within the context of Australian clinical guidelines. This article then considers Australian services aimed at BP, DM, and CKD, guideline adherence and control. METHODS: Evidence from PubMed-listed articles published between 1994 and 2016 is considered, including original research, focusing on randomised controlled trials and prospective studies, review articles, meta- analyses, expert and professional bodies' guidelines as well as our experience...
September 15, 2017: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/29101421/long-term-follow-up-of-intensive-glycaemic-control-on-renal-outcomes-in-the-veterans-affairs-diabetes-trial-vadt
#10
Lily Agrawal, Nasrin Azad, Gideon D Bahn, Ling Ge, Peter D Reaven, Rodney A Hayward, Domenic J Reda, Nicholas V Emanuele
AIMS/HYPOTHESIS: We conducted an analysis of data collected during the Veterans Affairs Diabetes Trial (VADT) and the follow-up study (VADT-F) to determine whether intensive (INT) compared with standard (STD) glycaemic control during the VADT resulted in better long-term kidney outcomes. METHODS: VADT randomly assigned 1791 veterans from 20 Veterans Affairs (VA) medical centres who had type 2 diabetes mellitus and a mean HbA1c of 9.4 ± 2% (79.2 mmol/mol) at baseline to receive either INT or STD glucose control for a median of 5...
November 3, 2017: Diabetologia
https://www.readbyqxmd.com/read/29098323/three-question-set-from-michigan-neuropathy-screening-instrument-adds-independent-prognostic-information-on-cardiovascular-outcomes-analysis-of-altitude-trial
#11
Jelena P Seferovic, Marc A Pfeffer, Brian Claggett, Akshay S Desai, Dick de Zeeuw, Steven M Haffner, John J V McMurray, Hans-Henrik Parving, Scott D Solomon, Nish Chaturvedi
AIMS/HYPOTHESIS: The self-administered Michigan Neuropathy Screening Instrument (MNSI) is used to diagnose diabetic peripheral neuropathy. We examined whether the MNSI might also provide information on risk of death and cardiovascular outcomes. METHODS: In this post hoc analysis of the Aliskiren Trial in Type 2 Diabetes Using Cardio-Renal Endpoints (ALTITUDE) trial, we divided 8463 participants with type 2 diabetes and chronic kidney disease (CKD) and/or cardiovascular disease (CVD) into independent training (n = 3252) and validation (n = 5211) sets...
November 3, 2017: Diabetologia
https://www.readbyqxmd.com/read/29095051/body-fat-indicators-and-kidney-function-decline-in-older-post-myocardial-infarction-patients-the-alpha-omega-cohort-study
#12
Kevin Esmeijer, Johanna M Geleijnse, Erik J Giltay, Theo Stijnen, Friedo W Dekker, Johan W de Fijter, Daan Kromhout, Ellen K Hoogeveen
Background Obesity increases risk of hypertension and diabetes, the leading causes of end-stage renal disease. The effect of obesity on kidney function decline in stable post-myocardial infarction patients is poorly documented. This relation was investigated in a large cohort of older post-myocardial infarction patients. Design Data were analysed from 2410 post-myocardial infarction patients in the Alpha Omega Trial, aged 60-80 years receiving optimal pharmacotherapy treatment (79% men, 18% diabetes). Methods Cystatin C based estimated glomerular filtration rate (eGFRcysC) was calculated at baseline and after 41 months, using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation...
January 1, 2017: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/29070043/the-effect-of-renal-denervation-in-an-experimental-model-of-chronic-renal-insufficiency-the-remnant-kidney-denervation-in-pigs-study-redip-study
#13
Jean-Claude Lubanda, Miroslav Chochola, Mikuláš Mlček, Petr Neužil, Josef Marek, Štěpán Havránek, Sylvie Kuchynková, Zdeňka Fingrová, Kao-Hsuan Aimee Huang, Aleš Linhart
BACKGROUND: Renal denervation (RDN) is a promising therapeutic method in cardiology. Its currently most investigated indication is resistant hypertension. Other potential indications are atrial fibrillation, type 2 diabetes mellitus and chronic renal insufficiency among others. Previous trials showed conflicting but promising results, but the real benefits of RDN are still under investigation. Patients with renal insufficiency and resistant hypertension are proposed to be a good target for this therapy due to excessive activation of renal sympathetic drive...
October 25, 2017: Journal of Translational Medicine
https://www.readbyqxmd.com/read/29061170/translating-recent-results-from-the-cardiovascular-outcomes-trials-into-clinical-practice-recommendations-from-the-central-and-eastern-european-diabetes-expert-group-ceedeg
#14
REVIEW
Guntram Schernthaner, Roger Lehmann, Martin Prázný, Leszek Czupryniak, Kristine Ducena, Peter Fasching, Andrej Janež, Avraham Karasik, Peter Kempler, Emil Martinka, Marina V Shestakova, Lea Smirčić Duvnjak, Tsvetalina Tankova
AIMS: These recommendations aim to improve care for patients with type 2 diabetes (T2D) at high cardiovascular (CV) risk in Central and Eastern Europe. Cardiovascular disease (CVD) and/or chronic kidney disease (CKD) are major interdependent comorbidities in patients with T2D, accounting for 50% of mortality. Following recent CV outcomes trial (CVOT) results, including those from EMPA-REG OUTCOME(®), LEADER(®), SUSTAIN™-6 and, most recently, the CANVAS study, it is essential to develop regional expert consensus recommendations to aid physicians in interpreting these newest data to clinical practice...
October 23, 2017: Cardiovascular Diabetology
https://www.readbyqxmd.com/read/29049415/effect-of-diacerein-on-renal-function-and-inflammatory-cytokines-in-participants-with-type-2-diabetes-mellitus-and-chronic-kidney-disease-a-randomized-controlled-trial
#15
RANDOMIZED CONTROLLED TRIAL
Fabiana Piovesan, Glaucia S Tres, Leila B Moreira, Michael E Andrades, Hugo K Lisboa, Sandra C Fuchs
Diacerein seems to improve metabolic control and reduce inflammatory marker levels in individuals with type 2 diabetes mellitus (Type 2 DM), but for participants with chronic kidney disease (CKD) its effect is unknown. This study aimed to evaluate the effect of diacerein vs. placebo on urinary albumin/creatinine ratio (ACR), glomerular filtration rate (GFR), and inflammatory cytokines in type 2 DM participants with CKD. Blood pressure (BP) and metabolic control were secondary outcomes. This randomized, placebo-controlled, parallel trial of adjuvant treatment of type 2 DM with diacerein enrolled seventy-two participants with CKD, aged 30-80 years, with glycated hemoglobin levels from 53-97 mmol/mol (7...
2017: PloS One
https://www.readbyqxmd.com/read/29046987/blood-pressure-parameters-and-their-associations-with-death-in-patients-with-chronic-kidney-disease
#16
REVIEW
Samaya Qureshi, Robert Lorch, Sankar D Navaneethan
PURPOSE OF REVIEW: Optimal blood pressure (BP) parameters among patients with chronic kidney disease (CKD) have been a matter of debate. This review critically evaluates recent literature to better define the associations of BP parameters and death among individuals with non-dialysis-dependent CKD. RECENT FINDINGS: Observational studies report a "U- or J-shaped" association between BP and all-cause mortality in CKD and caution-intensive BP lowering in the elderly...
October 18, 2017: Current Hypertension Reports
https://www.readbyqxmd.com/read/29044707/the-effect-of-vitamin-d-supplementation-on-bone-metabolic-markers-in-chronic-kidney-disease
#17
Ashok Kumar Yadav, Vivek Kumar, Vinod Kumar, Debasish Banerjee, Krishan Lal Gupta, Vivekanand Jha
Use of active forms of vitamin D is advocated in patients with chronic kidney disease (CKD) for treatment of mineral bone disease because of the presumption that native forms of vitamin D would not undergo significant activation to calcitriol, the most active biological form of vitamin D. We present secondary analysis looking at bone turnover in subjects who completed the randomized, double blind, placebo-controlled trial investigating the effect of cholecalciferol supplementation on vascular function in nondiabetic CKD stage G3-G4 and vitamin D ≤20 ng/mL (Clinical Trials Registry of India: CTRI/2013/05/003648)...
October 17, 2017: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
https://www.readbyqxmd.com/read/29038285/metabolic-effects-of-diet-and-exercise-in-patients-with-moderate-to-severe-ckd-a-randomized-clinical-trial
#18
T Alp Ikizler, Cassianne Robinson-Cohen, Charles Ellis, Samuel A E Headley, Katherine Tuttle, Richard J Wood, Elizabeth Elspeth Evans, Charles M Milch, Kelsey Anne Moody, Michael Germain, Chutatip Limkunakul, Aihua Bian, Thomas G Stewart, Jonathan Himmelfarb
CKD is steadily increasing along with obesity worldwide. Furthermore, obesity is a proinflammatory risk factor for progression of CKD and cardiovascular disease. We tested the hypothesis that implementation of caloric restriction and aerobic exercise is feasible and can improve the proinflammatory metabolic milieu in patients with moderate to severe CKD through a pilot, randomized, 2×2 factorial design trial. Of 122 participants consented, 111 were randomized to receive caloric restriction and aerobic exercise, caloric restriction alone, aerobic exercise alone, or usual care...
October 16, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/29031006/the-kidney-and-cvots
#19
EDITORIAL
Zachary Bloomgarden
Chronic kidney disease (CKD) affects a substantial minority of persons with type 2 diabetes. Analysis of US National Health and Nutrition Examination Survey (NHANES) datasets from 2007 through 2012 showed stage 3 or worse disease (estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m(2) ) in nearly one in five patients, with increasing age, blood pressure, obesity and levels of glycemia all associated with higher likelihood ((1) ), comparable to findings from surveys from many other areas, which also show micro- or macroalbuminuria to be present in one sixth to one third of diabetic persons ((2) )...
October 14, 2017: Journal of Diabetes
https://www.readbyqxmd.com/read/29021336/pooled-analysis-of-multiple-crossover-trials-to-optimize-individual-therapy-response-to-renin-angiotensin-aldosterone-system-intervention
#20
Sergei I Petrykiv, Gozewijn Dirk Laverman, Frederik Persson, Liffert Vogt, Peter Rossing, Martin H de Borst, Ronald T Gansevoort, Dick de Zeeuw, Hiddo J L Heerspink
BACKGROUND AND OBJECTIVES: In the treatment of CKD, individual patients show a wide variation in their response to many drugs, including renin-angiotensin-aldosterone system inhibitors (RAASi). To investigate whether therapy resistance to RAASi can be overcome by uptitrating the dose of drug, changing the mode of intervention (with drugs from similar or different classes), or lowering dietary sodium intake, we meta-analyzed individual responses to different modes of interventions. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Randomized crossover trials were analyzed to assess correlation of individual responses to RAASi and nonsteroidal anti-inflammatory drugs (NSAIDs; n=395 patients)...
November 7, 2017: Clinical Journal of the American Society of Nephrology: CJASN
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