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Ckd, trial and diabetes

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https://www.readbyqxmd.com/read/28340246/considerations-on-glycaemic-control-in-older-and-or-frail-individuals-with-diabetes-and-advanced-kidney-disease
#1
Nicolae Mircea Panduru, Ionut Nistor, Per-Henrik Groop, Wim Van Biesen, Ken Farrington, Adrian Covic
The increasing prevalence of chronic kidney disease (CKD) and diabetes over the last decade has resulted in increasing numbers of frail older patients with a combination of these conditions. Current treatment guidelines may not necessarily be relevant for such patients, who are mostly excluded from the trials upon which these recommendations are based. There is a paucity of data upon which to base the management of older patients with CKD. Nearly all current guidelines recommend less-tight glycaemic control for the older population, citing the lack of proven medium-term benefits and concerns about the high short-term risk of hypoglycaemia...
March 13, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28297698/magnesium-replacement-improves-the-metabolic-profile-in-obese-and-pre-diabetic-patients-with-mild-to-moderate-chronic-kidney-disease-a-3-month-randomised-double-blind-placebo-controlled-study
#2
Omer Toprak, Huseyin Kurt, Yasin Sarı, Cihat Şarkış, Halil Us, Ali Kırık
BACKGROUND/AIMS: Magnesium is an essential mineral for many metabolic functions. There is very little information on the effect of magnesium supplementation on metabolic profiles of chronic kidney disease (CKD) patients. The aim of this study was to assess the influence of magnesium supplementation on metabolic profiles of pre-diabetic, obese and mild-to-moderate CKD patients with hypomagnesemia. METHODS: A total of 128 hypomagnesemic, pre-diabetic and obese patients with an estimated glomerular filtration rate between 90 and 30 ml/min/1...
March 13, 2017: Kidney & Blood Pressure Research
https://www.readbyqxmd.com/read/28288249/association-of-intensive-blood-pressure-control-and-kidney-disease-progression-in-nondiabetic-patients-with-chronic-kidney-disease-a-systematic-review-and-meta-analysis
#3
Wan-Chuan Tsai, Hon-Yen Wu, Yu-Sen Peng, Ju-Yeh Yang, Hung-Yuan Chen, Yen-Ling Chiu, Shih-Ping Hsu, Mei-Ju Ko, Mei-Fen Pai, Yu-Kang Tu, Kuan-Yu Hung, Kuo-Liong Chien
Importance: The optimal blood pressure (BP) target remains debated in nondiabetic patients with chronic kidney disease (CKD). Objective: To compare intensive BP control (<130/80 mm Hg) with standard BP control (<140/90 mm Hg) on major renal outcomes in patients with CKD without diabetes. Data Sources: Searches of PubMed, MEDLINE, Embase, and Cochrane Library for publications up to March 24, 2016. Study Selection: Randomized clinical trials that compared an intensive vs a standard BP target in nondiabetic adults with CKD, reporting changes in glomerular filtration rate (GFR), doubling of serum creatinine level, 50% reduction in GFR, end-stage renal disease (ESRD), or all-cause mortality...
March 13, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28285957/comparison-of-renal-outcomes-in-patients-treated-by-zenith-%C3%A2-fenestrated-and-zenith-%C3%A2-abdominal-aortic-aneurysm-stent-grafts-in-us-prospective-pivotal-trials
#4
L R de Souza, G S Oderich, M A Farber, S Haulon, P V Banga, A H Pereira, P Gloviczki, S C Textor, F Jia
OBJECTIVE/BACKGROUND: Fenestrated endovascular repair (FEVAR) has been used to treat complex abdominal aortic aneurysms (AAAs). The risk of renal function deterioration compared with infrarenal endovascular aortic repair (EVAR) has not been determined. METHODS: Patients with preserved renal function (estimated glomerular filtration rate [eGFR] > 45 mL/minute) enrolled in two prospective, non-randomised studies evaluating Zenith fenestrated and AAA stent grafts were matched (1:2) by propensity scores for age, sex, hypertension, diabetes, and pre-operative eGFR...
March 10, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28266136/the-effects-of-dipeptidyl-peptidase-4-inhibitors-in-type-2-diabetic-patients-with-moderate-to-severe-chronic-kidney-disease-meta-analysis-of-randomized-controlled-trials-by-using-unadjusted-data
#5
Man Yang, Ling Wang, Lijie Gu, Weijie Yuan
BACKGROUND: Three meta-analyses evaluated the effects of dipeptidyl peptidase-4 (DPP-4) inhibitors in type 2 diabetic patients with chronic kidney disease (CKD) recently. However, direct combination of adjusted and unadjusted data in these meta-analyses, which may be questionable. The present study aimed to perform a meta-analysis of the effects of DPP-4 inhibitors in type 2 diabetic patients with moderate to severe CKD, by using unadjusted data from randomized controlled trials (RCTs)...
March 7, 2017: Journal of Diabetes
https://www.readbyqxmd.com/read/28253088/association-between-telomere-length-chronic-kidney-disease-and-renal-traits-a-systematic-review
#6
Oluwatoyin I Ameh, Ikechi G Okpechi, Collet Dandara, André-Pascal Kengne
Telomere length (TL) is an important biological variable that can influence a variety of disease-related complex traits as well as host-environment interactions such as drug and nutritional responses. Chronic kidney disease (CKD) is a common global health challenge especially with the currently aging world population. We conducted a PubMed database search according to the preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines for systematic reviews. Studies in adults (18 years and above) in which TL was determined and correlated with CKD, renal traits, and function were included, while animal model studies were excluded...
March 2017: Omics: a Journal of Integrative Biology
https://www.readbyqxmd.com/read/28237959/comparison-of-efficacy-and-safety-between-benidipine-and-hydrochlorothiazide-in-fosinopril-treated-hypertensive-patients-with-chronic-kidney-disease-protocol-for-a-randomised-controlled-trial
#7
Cheng Xue, Chenchen Zhou, Bo Yang, Jiayi Lv, Bing Dai, Shengqiang Yu, Yi Wang, Guanren Zhao, Changlin Mei
INTRODUCTION: Co-administration of a diuretic or calcium channel blocker with an ACE inhibitor are both preferred combinations in patients with hypertensive chronic kidney disease (CKD). According to the available evidence, it is still unknown which combination plays a more active role in renal protection. We hypothesised that a combination of fosinopril and benidipine may delay the progression of CKD more effectively than a combination of fosinopril and hydrochlorothiazide (HCTZ). METHODS AND ANALYSIS: This study will be a multicentred, prospective, double-blind, randomised parallel controlled trial for hypertensive CKD patients in China...
February 24, 2017: BMJ Open
https://www.readbyqxmd.com/read/28209636/a-randomized-crossover-trial-of-dietary-sodium-restriction-in-stage-3-4-ckd
#8
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...
March 7, 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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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...
June 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
#15
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
#16
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
#17
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
#18
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...
March 2017: 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
#19
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
#20
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
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