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https://www.readbyqxmd.com/read/28209636/a-randomized-crossover-trial-of-dietary-sodium-restriction-in-stage-3-4-ckd
#1
Rajiv Saran, Robin L Padilla, Brenda W Gillespie, Michael Heung, Scott L Hummel, Vimal Kumar Derebail, Bertram Pitt, Nathan W Levin, Fansan Zhu, Samer R Abbas, Li Liu, Peter Kotanko, Philip Klemmer
BACKGROUND AND OBJECTIVES: Patients with chronic kidney disease (CKD) are often volume expanded and hypertensive. Few controlled studies have assessed the effects of a sodium-restricted diet (SRD) in CKD. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We conducted a randomized crossover trial to evaluate the effect of SRD (target <2 g sodium per day) versus usual diet on hydration status (by bioelectrical impedance spectroscopy) and blood pressure (BP) between May of 2009 and May of 2013...
February 16, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28198732/intensive-blood-pressure-lowering-in-chronic-kidney-disease-the-time-has-come
#2
Marcel Ruzicka, Swapnil Hiremath
PURPOSE OF REVIEW: Release of the findings from the Systolic Blood Pressure Intervention Trial has resulted in a renewed examination of intensive blood pressure (BP) lowering. Only a few national hypertension guidelines (Canada and Australia) have changed recommendations, but considerable heterogeneity still exists with respect to the patient population to whom intensive BP lowering may apply. RECENT FINDINGS: There is fairly robust evidence that lower BP targets in nondiabetic chronic kidney disease (CKD) results in a decrease in heart failure and mortality...
February 13, 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/28198091/impact-of-chronic-kidney-disease-on-2-year-clinical-outcomes-in-patients-treated-with-6-month-or-24-month-dapt-duration-an-analysis-from-the-prodigy-trial
#3
Giuseppe Gargiulo, Andrea Santucci, Raffaele Piccolo, Anna Franzone, Sara Ariotti, Andrea Baldo, Giovanni Esposito, Aris Moschovitis, Stephan Windecker, Marco Valgimigli
OBJECTIVES: To assess whether moderate-to-severe CKD is a treatment modifier for benefit or harm in patients randomly allocated to 24-month versus 6-month DAPT. BACKGROUND: It is still unclear whether chronic kidney disease CKD should impact on the decision-making on optimal duration of dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI). METHODS AND RESULTS: PRODIGY trial randomized 1970 all-comer patients at 24-month versus 6-month DAPT after PCI...
February 15, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28183314/dpp-4-inhibition-has-no-acute-effect-on-bnp-and-its-n-terminal-pro-hormone-measured-by-commercial-immune-assays-a-randomized-cross-over-trial-in-patients-with-type-2-diabetes
#4
Gian Paolo Fadini, Benedetta Maria Bonora, Mattia Albiero, Martina Zaninotto, Mario Plebani, Angelo Avogaro
BACKGROUND: Use of dipeptidyl peptidase-4 inhibitors (DPP4-i) for the treatment of type 2 diabetes (T2D) has been associated with a possible increase in the risk for heart failure (HF). B-type natriuretic peptide (BNP), which is both a biomarker of HF and a hemodynamically active hormone, is a substrate of DPP-4. We herein tested the acute effects of the DPP-4i linagliptin on BNP and NT-proBNP in a cross-over placebo-controlled trial in patients with T2D with and without chronic kidney disease (CKD)...
February 10, 2017: Cardiovascular Diabetology
https://www.readbyqxmd.com/read/28178698/dipeptidyl-peptidase-4-inhibitors-in-chronic-kidney-disease-a-systematic-review-of-randomized-clinical-trials
#5
Simon R Walker, Paul Komenda, Suhail Khojah, Wafa Al-Tuwaijri, Kerry MacDonald, Brett Hiebert, Neil Tangri, Stewart W D Nadurak, Thomas W Ferguson, Claudio Rigatto, Navdeep Tangri
BACKGROUND: Chronic kidney disease (CKD) is common in patients with type 2 diabetes mellitus (T2DM) and limits therapeutic options. Dipeptidyl peptidase-4 (DPP-4) inhibitors represent a novel class of oral glucose-lowering agents and are known to be safe and effective in the general population. METHODS: We searched Cochrane, EMBASE, and PubMed from the time of their inception until March 2015. We included randomized controlled trials analyzing the efficacy (change in hemoglobin A1C [HbA1C]) and safety of DPP-4 agents in individuals with reduced kidney function (estimated glomerular filtration rate <60 mL/min/1...
February 9, 2017: Nephron
https://www.readbyqxmd.com/read/28097824/mechanisms-of-metabolic-memory-and-renal-hypoxia-as-a-therapeutic-target-in-diabetic-kidney-disease
#6
REVIEW
Yosuke Hirakawa, Tetsuhiro Tanaka, Masaomi Nangaku
Diabetic kidney disease (DKD) is a worldwide public health problem. The definition of DKD is being under discussion. Although the term DKD was originally defined as "kidney disease specific to diabetes", DKD frequently means chronic kidney disease (CKD) with diabetes mellitus and includes not only classical diabetic nephropathy, but also kidney dysfunction due to nephrosclerosis and other causes. Metabolic memory plays a crucial role in the progression of various complications of diabetes, including DKD. The mechanisms of metabolic memory in DKD are supposed to include advanced glycation end products, DNA methylation, histone modifications, and non-coding RNA including microRNA...
January 17, 2017: Journal of Diabetes Investigation
https://www.readbyqxmd.com/read/28090762/use-of-ace-inhibition-and-blood-pressure-management-in-deferring-dialysis-initiation
#7
Lucia Del Vecchio, Ugo Teatini, Francesco Locatelli
Elevated blood pressure is one of the most significant risk factor for the development of chronic kidney disease (CKD); its treatment is a milestone in CKD management. While it is accepted that a stricter blood pressure control is indicated in patients with proteinuria or microalbuminuria, the exact degree of blood pressure reduction to be obtained in CKD patients is still under debate. Following more recent interpretation of old trials, a BP target for < 140/90 mmHg is suggested for non-proteinuric CKD patients...
January 13, 2017: Panminerva Medica
https://www.readbyqxmd.com/read/28089999/impact-of-impaired-renal-function-in-patients-with-severely-calcified-coronary-lesions-treated-with-orbital-atherectomy
#8
Michael S Lee, Evan Shlofmitz, Gentian Lluri, Richard A Shlofmitz
OBJECTIVES: We evaluated the clinical outcomes of patients with chronic kidney disease (CKD) who underwent orbital atherectomy for severe coronary artery calcification (CAC) prior to stent implantation. BACKGROUND: Percutaneous coronary intervention (PCI) of lesions with severe CAC is associated with increased rates of adverse clinical events. Patients with CKD are at increased risk for atherosclerotic cardiovascular disease, including vascular calcification, and have worse outcomes after PCI...
January 15, 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28077457/systems-biology-derived-biomarkers-to-predict-progression-of-renal-function-decline-in-type-2-diabetes-mellitus
#9
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
#10
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
#11
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
#12
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...
2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/27942587/chorioretinal-thinning-in-chronic-kidney-disease-links-to-inflammation-and-endothelial-dysfunction
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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