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https://www.readbyqxmd.com/read/29045728/how-do-primary-care-doctors-in-england-and-wales-code-and-manage-people-with-chronic-kidney-disease-results-from-the-national-chronic-kidney-disease-audit
#1
Lois G Kim, Faye Cleary, David C Wheeler, Ben Caplin, Dorothea Nitsch, Sally A Hull
Background: In the UK, primary care records are electronic and require doctors to ascribe disease codes to direct care plans and facilitate safe prescribing. We investigated factors associated with coding of chronic kidney disease (CKD) in patients with reduced kidney function and the impact this has on patient management. Methods: We identified patients meeting biochemical criteria for CKD (two estimated glomerular filtration rates <60 mL/min/1.73 m2 taken >90 days apart) from 1039 general practitioner (GP) practices in a UK audit...
October 16, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28976899/community-noise-exposure-and-its-effect-on-blood-pressure-and-renal-function-in-patients-with-hypertension-and-cardiovascular-disease
#2
Angel M Dzhambov, Mariya P Tokmakova, Penka D Gatseva, Nikolai G Zdravkov, Dolina G Gencheva, Nevena G Ivanova, Krasimir I Karastanev, Stefka V Vladeva, Aleksandar T Donchev, Svetlan M Dermendzhiev
BACKGROUND: Road traffic noise (RTN) is a risk factor for cardiovascular disease (CVD) and hypertension; however, few studies have looked into its association with blood pressure (BP) and renal function in patients with prior CVD. AIM: This study aimed to explore the effect of residential RTN exposure on BP and renal function in patients with CVD from Plovdiv Province. MATERIALS AND METHODS: We included 217 patients with ischemic heart disease and/or hypertension from three tertiary hospitals in the city of Plovdiv (March - May 2016)...
September 1, 2017: Folia Medica
https://www.readbyqxmd.com/read/28971600/fgf23-level-and-intima-media-thickness-are-elevated-from-early-stages-of-chronic-kidney-disease
#3
Andreja Figurek, Goce Spasovski, Snjezana Popovic-Pejicic
Considering high cardiovascular (CV) risk in chronic kidney disease (CKD), the aim of this cross-sectional study was to assess the association between carotid intima-media thickness (IMT) and fibroblast growth factor (FGF) 23 as important players in CV pathophysiology. Eighty-seven patients with mean estimated glomerular filtration rate 40.1 mL/min per 1.73 m(2) were involved. FGF23 and IMT were elevated from early stages of CKD. Mean IMT value was 1.10 ± 0.20 mm, being significantly elevated starting from early CKD, showing no correlation with FGF23 (r = -0...
October 3, 2017: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/28960806/regional-evidence-and-international-recommendations-to-guide-lipid-management-in-asian-patients-with-type-2-diabetes-with-special-reference-to-renal-dysfunction
#4
REVIEW
Titus Wl Lau, Kevin Ek Tan, Jason Cj Choo, T G Ng, Tavintharan S, Juliana C N Chan
The anticipated increase in the prevalence and incidence of type 2 diabetes in Asia, and its associated cardiovascular-renal complications will place a significant burden on patients, caregivers and society. Despite the proven effectiveness of lipid management in reducing these complications, there are major treatment gaps especially in Asian patients with young-onset diabetes and chronic kidney disease. Recent international guidelines recommended the adoption of absolute risk estimation of atherosclerosis and cardiovascular disease to guide treatment intensity...
September 28, 2017: Journal of Diabetes
https://www.readbyqxmd.com/read/28935472/treatment-of-superficial-femoral-artery%C3%A2-restenosis
#5
Andrew J Miller, Edwin A Takahashi, William S Harmsen, Kristin C Mara, Sanjay Misra
PURPOSE: To determine the predictors of restenosis, major adverse limb events (MALEs), postoperative death (POD), and all-cause mortality after repeat endovascular treatment of superficial femoral artery (SFA) restenosis. MATERIALS AND METHODS: This was a retrospective review of 440 patients with 518 SFA lesions who were treated between January 2002 and October 2011. Ninety-six limbs were treated for restenosis with bare metal stents (BMSs) or percutaneous transluminal angioplasty (PTA), of which 28 limbs developed another restenosis requiring a third procedure...
September 19, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28836857/uric-acid-and-incident-chronic-kidney-disease-in-dyslipidemic-individuals
#6
Fotios Barkas, Moses Elisaf, Evangelos Liberopoulos, Rigas Kalaitzidis, George Liamis
BACKGROUND: Elevated uric acid (UA) is a recognized risk factor for chronic kidney disease (CKD). This study aimed to investigate whether this association exists in dyslipidemic patients receiving multifactorial treatment. METHODS: An observational study conducted in Greece including 1,269 dyslipidemic individuals followed-up in a lipid clinic for ≥3 years. Estimated glomerular filtration rate (eGFR) was calculated by CKD-EPI equation and CKD was defined as ≤60 mL/min/1...
September 21, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28835613/residual-risk-factors-to-predict-major-adverse-cardiovascular-events-in-atherosclerotic-cardiovascular-disease-patients-with-and-without-diabetes-mellitus
#7
Fang-Ju Lin, Wei-Kung Tseng, Wei-Hsian Yin, Hung-I Yeh, Jaw-Wen Chen, Chau-Chung Wu
A prospective observational study was conducted to investigate the residual risk factors to predict recurrence of major adverse cardiovascular events (MACE) in atherosclerotic cardiovascular disease (ASCVD) patients with a high prevalence under lipid-lowering therapy, particularly in the subpopulations of diabetic and nondiabetic individuals. A total of 5,483 adults (with a mean age of 66.4 and 73.3% male) with established coronary heart disease, cerebrovascular disease, or peripheral artery disease were identified from the T-SPARCLE multi-center registry...
August 23, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28796030/the-renoprotective-effects-of-simvastatin-and-atorvastatin-in-patients-with-acute-coronary-syndrome-undergoing-percutaneous-coronary-intervention-an-observational-study
#8
Huan Ma, Yong Liu, Haixia Xie, Guolin Zhang, Huimin Zhan, Zhi Liu, Ping Wang, Qingshan Geng, Lan Guo
Some statins, such as atorvastatin, have proven renoprotective effects. The comparative renoprotective potential of simvastatin is less clear. This study aimed to compare the renoprotective effects of simvastatin with atorvastatin in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI). This observational study examined the medical records of 271 patients who were treated at the Guangdong Cardiovascular Institute from April 2004 to February 2008. Patients had received either 40 mg simvastatin (n = 128) or 20 mg atorvastatin (n = 143), daily, for a period of at least 6 months following PCI...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28682890/efficacy-of-short-term-moderate-or-high-dose-rosuvastatin-in-preventing-contrast-induced-nephropathy-a-meta-analysis-of-15-randomized-controlled-trials
#9
REVIEW
Min Liang, Shicheng Yang, Naikuan Fu
BACKGROUND: The prophylactic efficacy of statin pretreatment for the prevention of contrast-induced nephropathy (CIN) in patients undergoing coronary angiography (CAG) or percutaneous coronary intervention (PCI) remains controversial. The aim of the study was to perform a meta-analysis of randomized controlled trials (RCTs) to assess the effectiveness of short-term moderate or high-dose rosuvastatin pretreatment in preventing CIN. METHODS: We included RCTs comparing short-term moderate or high-dose rosuvastatin treatment versus low-dose rosuvastatin treatment or placebo for preventing CIN...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28676027/the-co-existence-of-nash-and-chronic-kidney-disease-boosts-cardiovascular-risk-are-there-any-common-therapeutic-options
#10
Marianna Papademetriou, Vasilios G Athyros, Eleni Geladari, Michael Doumas, Costas Tsioufis, Vasilios Papademetriou
Non-alcoholic fatty liver disease (NAFLD) is becoming the most common chronic liver disease. NAFLD may evolve to non-alcoholic steatohepatitis (NASH), which is causally related to cirrhosis and cardiovascular disease (CVD) mortality. There is no generally accepted effective treatment for NAFLD/NASH. Chronic kidney disease (CKD) is relatively common and might co-exist with NAFLD/NASH, aggravate one another, and increase CVD risk. Common therapies could improve outcome. Potent statins at high doses, such as atorvastatin and rosuvastatin, ameliorate NAFLD/NASH and reduce the mortality rates by half as compared with those on the same statins but without liver disease...
June 20, 2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/28635327/within-visit-blood-pressure-variability-and-cardiovascular-risk-factors-in-hypertensive-patients-with-non-dialysis-chronic-kidney-disease
#11
Kengo Azushima, Hiromichi Wakui, Kazushi Uneda, Sona Haku, Ryu Kobayashi, Kohji Ohki, Sho Kinguchi, Kotaro Haruhara, Tetsuya Fujikawa, Yoshiyuki Toya, Satoshi Umemura, Kouichi Tamura
As there may be an association between within-visit blood pressure (BP) variability and cardiovascular disease (CVD), we investigated the clinical significance of this BP variability in non-dialysis chronic kidney disease (CKD) patients. MATERIALS AND METHODS: According to the median of coefficient of variation (CV) of three systolic BP (SBP) readings within a single visit, we divided hypertensive patients with stage G1-4 CKD already treated with antihypertensive therapy into the high SBP-CV group and the low SBP-CV group...
June 21, 2017: Clinical and Experimental Hypertension: CHE
https://www.readbyqxmd.com/read/28628255/still-a-reasonable-goal-targeting-cholesterol-in-dialysis-and-advanced-chronic-kidney-disease-patients
#12
EDITORIAL
Gunnar H Heine, Kyrill S Rogacev, Oliver Weingärtner, Gunther Marsche
Chronic kidney disease (CKD) patients have a high burden of cardiovascular disease. In the general population, lipid metabolism disorders, which cause the initiation and progression of atherosclerotic vascular changes, are major targets for preventive and therapeutic strategies in cardiovascular medicine. However, data from large cohort studies and from clinical trials suggest that the treatment guidelines on cardiovascular disease prevention and therapy cannot uncritically be transferred from individuals with intact renal function to CKD patients...
June 19, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28623740/detection-of-atherosclerotic-cardiovascular-disease-influences-the-perceived-need-for-aggressive-lipid-management
#13
G B John Mancini, Milan Gupta, Michelle Tsigoulis, Christopher P Cannon, Jacques Genest, Kausik K Ray, Raul D Santos, Gerald F Watts, Paolo Raggi
BACKGROUND AND AIMS: Overt atherosclerotic cardiovascular disease (ASCVD) warrants aggressive lipid lowering. Imaging for ambiguous symptoms suggesting ischemia or for clarification of CV risk in asymptomatic individuals often uncovers previously unknown ASCVD. Guidelines do not provide clear recommendations for aggressive lipid lowering in such cases. We explored physicians' perception, as influenced by tests that detect ASCVD, regarding appropriateness of getting to lipid goals and for theoretically accessing proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i)...
June 3, 2017: Atherosclerosis
https://www.readbyqxmd.com/read/28614117/role-of-amp-activated-protein-kinase-in-kidney-tubular-transport-metabolism-and-disease
#14
Roshan Rajani, Nuria M Pastor-Soler, Kenneth R Hallows
PURPOSE OF REVIEW: AMP-activated protein kinase (AMPK) is a metabolic sensor that regulates cellular energy balance, transport, growth, inflammation, and survival functions. This review explores recent work in defining the effects of AMPK on various renal tubular epithelial ion transport proteins as well as its role in kidney injury and repair in normal and disease states. RECENT FINDINGS: Recently, several groups have uncovered additional functions of AMPK in the regulation of kidney and transport proteins...
September 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/28607686/improving-care-for-patients-with-or-at-risk-for-chronic-kidney-disease-using-electronic-medical-record-interventions-a-pragmatic-cluster-randomized-trial-protocol
#15
Danielle M Nash, Noah M Ivers, Jacqueline Young, R Liisa Jaakkimainen, Amit X Garg, Karen Tu
BACKGROUND: Many patients with or at risk for chronic kidney disease (CKD) in the primary care setting are not receiving recommended care. OBJECTIVE: The objective of this study is to determine whether a multifaceted, low-cost intervention compared with usual care improves the care of patients with or at risk for CKD in the primary care setting. DESIGN: A pragmatic cluster-randomized trial, with an embedded qualitative process evaluation, will be conducted...
2017: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/28553032/stroke-in-patients-with-chronic-kidney-disease%C3%A2-how-do-we-approach-and-manage-it
#16
REVIEW
S Nayak-Rao, M P Shenoy
Renal failure is a potent risk factor for stroke, which is a leading cause of morbidity and mortality worldwide. The risk of stroke is 5-30 times higher in patients with chronic kidney disease (CKD), especially on dialysis. Case fatality rates are also higher reaching almost 90%. It is therefore important to understand the factors that predispose to stroke in this vulnerable population to better apply preventive strategies. The heightened risk of stroke in CKD represents the interplay of the vascular co-morbidities that occur with renal impairment and factors specific to renal failure such as malnutrition-inflammation-atherosclerosis complex, the effect of uremic toxins, dialysis techniques, vascular access, and the use of anticoagulants to maintain flow in the extracorporeal circuit...
May 2017: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/28534128/cathepsin-l-activity-correlates-with-proteinuria-in-chronic-kidney-disease-in-humans
#17
Yu Cao, Xing Liu, Ying Li, Yao Lu, Hua Zhong, Weihong Jiang, Alex F Chen, Timothy R Billiar, Hong Yuan, Jingjing Cai
BACKGROUND: The presence and severity of proteinuria is considered an important prognostic marker in patients with chronic kidney disease (CKD) and is associated with mortality and morbidity. Cathepsin L is highly expressed in the foot processes of podocytes in the kidney, which serves as an ultrafiltration barrier. Cathepsin L is also up-regulated in the setting of inflammation as a feature of CKD. Therefore, we postulated that proteinuria severity in CKD patients might correlate with increased serum levels of cathepsin L...
August 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28507057/benefit-of-ezetimibe-added-to-simvastatin-in-reduced-kidney-function
#18
RANDOMIZED CONTROLLED TRIAL
John W Stanifer, David M Charytan, Jennifer White, Yuliya Lokhnygina, Christopher P Cannon, Matthew T Roe, Michael A Blazing
Efficacy of statin-based therapies in reducing cardiovascular mortality in individuals with CKD seems to diminish as eGFR declines. The strongest evidence supporting the cardiovascular benefit of statins in individuals with CKD was shown with ezetimibe plus simvastatin versus placebo. However, whether combination therapy or statin alone resulted in cardiovascular benefit is uncertain. Therefore, we estimated GFR in 18,015 individuals from the IMPROVE-IT (ezetimibe plus simvastatin versus simvastatin alone in individuals with cardiovascular disease and creatinine clearance >30 ml/min) and examined post hoc the relationship of eGFR with end points across treatment arms...
October 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28502499/effects-of-statin-therapy-on-cerebrovascular-and-renal-outcomes-in-patients-with-predialysis-advanced-chronic-kidney-disease-and-dyslipidemia
#19
Chang-Min Chung, Ming-Shyan Lin, Jen-Te Hsu, Ju-Feng Hsiao, Shih-Tai Chang, Kuo-Li Pan, Chun-Liang Lin, Yu-Sheng Lin
BACKGROUND: Treatment with statin may be beneficial for patients with chronic kidney disease (CKD). However, the debate over the clinical importance of statin in patients with predialysis advanced CKD remains unresolved. OBJECTIVES: The objective of the article was to evaluate the effect of statin on mortality, cerebrovascular, and renal outcomes in patients with predialysis advanced CKD and dyslipidemia. METHODS: Data on predialysis advanced CKD patients were retrieved from the National Health Insurance Research Database based on the guidelines for prescribing regular erythropoietin-stimulating agent in CKD patients...
March 2017: Journal of Clinical Lipidology
https://www.readbyqxmd.com/read/28460629/effect-on-non-vascular-outcomes-of-lowering-ldl-cholesterol-in-patients-with-chronic-kidney-disease-results-from-the-study-of-heart-and-renal-protection
#20
C Reith, N Staplin, W G Herrington, W Stevens, J Emberson, R Haynes, M Mafham, J Armitage, A Cass, J C Craig, L Jiang, T Pedersen, C Baigent, M J Landray
BACKGROUND: Reducing LDL cholesterol (LDL-C) with statin-based therapy reduces the risk of major atherosclerotic events among patients with chronic kidney disease (CKD), with no evidence of an excess risk of cancer or death from any non-vascular cause. However, non-randomized data have suggested that statin therapy may have effects (both adverse and beneficial) on particular non-vascular conditions that do not cause death. METHODS: The Study of Heart and Renal Protection (SHARP) randomized patients with CKD to simvastatin 20 mg plus ezetimibe 10 mg (simvastatin/ezetimibe) daily versus matching placebo...
May 1, 2017: BMC Nephrology
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