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https://www.readbyqxmd.com/read/28526182/pharmacologic-management-of-type-2-diabetes-mellitus-available-therapies
#1
James Thrasher
Choices for the treatment of type 2 diabetes mellitus (T2DM) have multiplied as our understanding of the underlying pathophysiologic defects has evolved. Treatment should target multiple defects in T2DM and follow a patient-centered approach that considers factors beyond glycemic control, including cardiovascular risk reduction. The American Association of Clinical Endocrinologists/American College of Endocrinology and the American Diabetes Association recommend an initial approach consisting of lifestyle changes and monotherapy, preferably with metformin...
May 12, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28523406/diuretics-in-cardiorenal-syndrome-what-s-new
#2
Frederik H Verbrugge, Kevin Damman, W H Wilson Tang
No abstract text is available yet for this article.
May 18, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28515693/rolipram-improves-outcome-in-a-rat-model-of-infant-sepsis-induced-cardiorenal-syndrome
#3
Clark R Sims, Sharda P Singh, Shengyu Mu, Neriman Gokden, Dala Zakaria, Trung C Nguyen, Philip R Mayeux
While the mortality rate associated with sepsis in children has fallen over the years, it still remains unacceptably high. The development of both acute cardiac dysfunction and acute kidney injury during severe sepsis is categorized as type 5 cardiorenal syndrome (CRS) and is poorly understood in infants. To address this lack of understanding and the need for an appropriate animal model in which to conduct relevant preclinical studies, we developed a model of infant sepsis-induced CRS in rat pups then evaluated the therapeutic potential of the phosphodiesterase (PDE) 4 inhibitor, rolipram...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28514645/oleanolic-acid-modulates-the-renin-angiotensin-system-and-cardiac-natriuretic-hormone-concomitantly-with-volume-and-pressure-balance-in-rats
#4
You Mee Ahn, Yoon Hee Choi, Jung Joo Yoon, Yun Jung Lee, Kyung Woo Cho, Dae Gill Kang, Ho Sub Lee
Oleanolic acid is known to possess beneficial effects on the regulation of the cardiovascular homeostasis. However, the exact nature of the role of oleanolic acid on the regulation of body fluid balance and blood pressure homeostasis and its mechanisms involved are not well defined. Experiments were performed to identify the effects of oleanolic acid on the renin-angiotensin system and cardiac natriuretic hormone (ANP) system, and also renal function and blood pressure in normotensive and renovascular hypertensive rats...
May 14, 2017: European Journal of Pharmacology
https://www.readbyqxmd.com/read/28507167/early-activation-of-deleterious-molecular-pathways-in-the-kidney-in-experimental-heart-failure-with-atrial-remodeling
#5
Tomoko Ichiki, Brenda K Huntley, Gail J Harty, S Jeson Sangaralingham, John C Burnett
Heart failure (HF) is a major health problem with worsening outcomes when renal impairment is present. Therapeutics for early phase HF may be effective for cardiorenal protection, however the detailed characteristics of the kidney in early-stage HF (ES-HF), and therefore treatment for potential renal protection, are poorly defined. We sought to determine the gene and protein expression profiles of specific maladaptive pathways of ES-HF in the kidney and heart. Experimental canine ES-HF, characterized by de-novo HF with atrial remodeling but not ventricular fibrosis, was induced by right ventricular pacing for 10 days...
May 2017: Physiological Reports
https://www.readbyqxmd.com/read/28479167/trajectory-of-congestion-metrics-by-ejection-fraction-in%C3%A2-patients-with-acute-heart-failure-from-the-heart-failure%C3%A2-network
#6
Andrew P Ambrosy, Ankeet S Bhatt, Dianne Gallup, Kevin J Anstrom, Javed Butler, Adam D DeVore, G Michael Felker, Marat Fudim, Stephen J Greene, Adrian F Hernandez, Jacob P Kelly, Marc D Samsky, Robert J Mentz
Differences in the clinical course of congestion by underlying ejection fraction (EF) have not been well-characterized in acute heart failure (AHF). A post hoc analysis was performed using pooled data from the Diuretic Optimization Strategies Evaluation in Acute Heart Failure, Cardiorenal Rescue Study in Acute Decompensated Heart Failure, and Renal Optimization Strategies Evaluation in Acute Heart Failure trials. All patients were admitted for a primary diagnosis of AHF. Patients were grouped as reduced EF ≤40%, borderline 40% < EF < 50%, or preserved EF ≥50%...
April 12, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28453557/perivascular-radiofrequency-renal-denervation-lowers-blood-pressure-and-ameliorates-cardiorenal-fibrosis-in-spontaneously-hypertensive-rats
#7
Shujie Wei, Dan Li, Yan Zhang, Linan Su, Yunrong Zhang, Qiang Wang, Dachun Yang, De Li, Yongjian Yang, Shuangtao Ma
BACKGROUND: Catheter-based renal denervation (RDN) is a promising approach to treat hypertension, but innervation patterns limit the response to endovascular RDN and the post-procedural renal artery narrowing or stenosis questions the endovascular ablation strategy. This study was performed to investigate the anti-hypertensive and target organ protective effects of perivascular RDN in spontaneously hypertensive rats (SHR). METHODS: SHR and normotensive Wistar-Kyoto (WKY) rats were divided into sham group (n = 10), radiofrequency ablation group (n = 20) in which rats received bilateral perivascular ablation with radiofrequency energy (2 watts), and chemical (10% phenol in 95% ethanol) ablation group (n = 12)...
2017: PloS One
https://www.readbyqxmd.com/read/28449154/dual-raas-blockade-with-aliskiren-in-patients-with-severely-impaired-chronic-kidney-disease
#8
Franz Maximilian Rasche, Claudia Joel, Thomas Ebert, Thomas Frese, Filip Barinka, Volker Busch, Wilma Gertrud Rasche, Tom H Lindner, Jochen Schneider, Stephan Schiekofer
Dual renin-angiotensin-aldosterone blockade (dRAASb) is purposed in the prevention of the cardiorenal syndrome (CRS). However, all attempts with dRAASb even in patients with moderate impaired chronic kidney disease (CKD) were terminated due to the typical severe adverse events (SAE), e. g., hyperkalemia and rise of serum creatinine. The aim of our study with the direct renin inhibitor aliskiren was to evaluate the effect of dRAASb with a washout phase in patients with severely advanced CKD. We have studied 45 patients (G3b to 4, A2 and >A3; median glomerular filtration rate (GFR) CKD-EPI 31 (23-40) ml/min per 1...
April 27, 2017: Experimental and Clinical Endocrinology & Diabetes
https://www.readbyqxmd.com/read/28433216/implications-of-alternative-hepatorenal-prognostic-scoring-systems-in-acute-heart-failure-from-dose-ahf-and-rose-ahf
#9
Justin L Grodin, Dianne Gallup, Kevin J Anstrom, G Michael Felker, Horng H Chen, W H Wilson Tang
Because hepatic dysfunction is common in patients with heart failure (HF), the Model for End-Stage Liver Disease (MELD) may be attractive for risk stratification. Although alternative scores such as the MELD-XI or MELD-Na may be more appropriate in HF populations, the short-term clinical implications of these in patients with acute heart failure (AHF) are unknown. The MELD-XI and MELD-Na were calculated at baseline in 453 patients with AHF in the DOSE-AHF and ROSE-AHF trials. The correlations and associations for each score with cardiorenal biomarkers, short-term end points at 72 hours including worsening renal function and clinical events to 60 days were determined...
March 29, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28411233/vasculopathy-in-the-setting-of-cardiorenal-syndrome-the-roles-of-protein-bound-uremic-toxins
#10
Jingbin Guo, Lu Lu, Yue Hua, Kevin Huang, Ian Wang, Li Huang, Qiang Fu, Aihua Chen, Paul Chan, Huimin Fan, Zhong-Min Liu, Bing Hui Wang
Chronic kidney disease (CKD) often leads to and accelerates the progression of cardiovascular disease (CVD), whilst CVD also causes kidney dysfunction. This bidirectional interaction leads to the development of a complex syndrome known as cardiorenal syndrome (CRS). CRS not only involves both the heart and the kidney, but also the vascular system through a vast array of contributing factors. In addition to hemodynamic, neuro-hormonal, mechanical and biochemical factors, the non-dialyzable protein-bound uremic toxins (PBUTs) are also key contributing factors that have been demonstrated through in vitro, in vivo and clinical observations...
April 14, 2017: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/28408434/renal-and-vascular-effects-of-uric-acid-lowering-in-normouricemic-patients-with-uncomplicated-type-1-diabetes
#11
Yuliya Lytvyn, Ronnie Har, Amy Locke, Vesta Lai, Derek Fong, Andrew Advani, Bruce A Perkins, David Z I Cherney
Higher plasma uric acid (PUA) levels are associated with lower GFR and higher blood pressure (BP) in patients with type 1 diabetes (T1D). Our aim was to determine the impact of PUA lowering on renal and vascular function in patients with uncomplicated T1D.T1D patients (n=49) were studied under eu- and hyperglycemic conditions at baseline and after PUA lowering with febuxostat (FBX) for 8 weeks. Healthy controls (HC) were studied under normoglycemic conditions (n=24). PUA, GFR (inulin), effective renal plasma flow (ERPF, paraaminohippurate), BP and hemodynamic responses to an infusion of angiotensin II (assessment of intrarenal RAAS) were measured pre- and post-FBX...
April 13, 2017: Diabetes
https://www.readbyqxmd.com/read/28405987/cardiorenal-syndrome-clinical-outcome-study
#12
H R Shah, N P Singh, N P Aggarwal, D Singhania, A Kumar
BACKGROUND: Over recent years, the field of medicine has been challenged by the twin epidemic of heart failure and renal insufficiency. The coexistence of the two problems in the same patient, referred to as cardiorenal syndrome (CRS), is defined as 'disorders of the heart and kidneys whereby acute or chronic dysfunction in one organ may induce acute or chronic dysfunction of the other. The mechanisms underlying this interaction are complex and multifactorial in nature. OBJECTIVE OF STUDY: Identify and classify patients admitted with cardiorenal syndrome into various subtypes and assess clinical outcome at discharge and at three months...
December 2016: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28404591/intravital-imaging-of-the-kidney-in-a-rat-model-of-salt-sensitive-hypertension
#13
Bradley T Endres, Ruben M Sandoval, George J Rhodes, Silvia B Campos-Bilderback, Malgorzata M Kamocka, Christopher McDermott-Roe, Alexander Staruschenko, Bruce A Molitoris, Aron M Geurts, Oleg Palygin
Hypertension is one of the most prevalent diseases worldwide, and a major risk factor for renal failure and cardiovascular disease. The role of albuminuria, a common feature of hypertension and robust predictor of cardiorenal disorders, remains incompletely understood. The goal of this study was to investigate the mechanisms leading to albuminuria in the kidney of a rat model of hypertension, the Dahl salt-sensitive (SS) rat. To determine the relative contributions of the glomerulus and proximal tubule (PT) to albuminuria, we applied intravital two-photon-based imaging to investigate the complex renal physiological changes that occur during salt-induced hypertension...
April 12, 2017: American Journal of Physiology. Renal Physiology
https://www.readbyqxmd.com/read/28403554/continuous-veno-venous-hemofiltration-improves-survival-of-patients-with-congestive-heart-failure-and-cardiorenal-syndrome-compared-to-slow-continuous-ultrafiltration
#14
Vedran Premuzic, Nikolina Basic-Jukic, Bojan Jelakovic, Petar Kes
Continuous veno-venous hemofiltration (CVVH) could modulate the inflammatory response by removal of circulating cytokines and therefore improve cardiac function in patients with heart failure (HF). We hypothesized that patients with developed cardiorenal syndrome and treated with CVVH have lower risk for mortality than other patients treated with slow continuous ultrafiltration (SCUF). This was a prospective, longitudinal follow-up study for 24 months duration. In total, 120 patients were recruited from the intensive care units...
April 12, 2017: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/28341415/diuretic-strategies-in-acute-heart-failure-and-renal-dysfunction-conventional-vs-carbohydrate-antigen-125-guided-strategy-clinical-trial-design
#15
Sergio García-Blas, Clara Bonanad, Pau Llàcer, Silvia Ventura, José María Núñez, Ruth Sánchez, Carlos Chamorro, Lorenzo Fácila, Rafael de la Espriella, Juana María Vaquer, Alberto Cordero, Mercè Roqué, Víctor Ortiz, Paolo Racugno, Vicent Bodí, Ernesto Valero, Enrique Santas, María Del Carmen Moreno, Gema Miñana, Arturo Carratalá, Lourdes Bondanza, Ana Payá, Ingrid Cardells, Raquel Heredia, Mauricio Pellicer, Guillermo Valls, Patricia Palau, María José Bosch, Rafael Raso, Andrés Sánchez, Vicente Bertomeu-González, Vicente Bertomeu-Martínez, Vicente Montagud-Balaguer, Cristina Albiach-Montañana, Jezabel Pendás-Meneau, Goitzane Marcaida, Sonia Cervantes-García, Rodolfo San Antonio, Elisabet de Mingo, Francisco J Chorro, Juan Sanchis, Julio Núñez
INTRODUCTION AND OBJECTIVES: The optimal treatment of patients with acute heart failure (AHF) and cardiorenal syndrome type 1 (CRS-1) is far from being well-defined. Arterial hypoperfusion in concert with venous congestion plays a crucial role in the pathophysiology of CRS-I. Plasma carbohydrate antigen 125 (CA125) has emerged as a surrogate of fluid overload in AHF. The aim of this study was to evaluate the clinical usefulness of CA125 for tailoring the intensity of diuretic therapy in patients with CRS-1...
March 21, 2017: Revista Española de Cardiología
https://www.readbyqxmd.com/read/28341374/cardiorenal-disease-connection-during-post-menopause-the-protective-role-of-estrogen-in-uremic-toxins-induced-microvascular-dysfunction
#16
REVIEW
Jiayi Pei, Magdalena Harakalova, Hester den Ruijter, Gerard Pasterkamp, Dirk J Duncker, Marianne C Verhaar, Folkert W Asselbergs, Caroline Cheng
Female gender, post-menopause, chronic kidney disease (CKD) and (CKD linked) microvascular disease are important risk factors for developing heart failure with preserved ejection fraction (HFpEF). Enhancing our understanding of the interrelation between these risk factors could greatly benefit the identification of new drug targets for future therapy. This review discusses the evidence for the protective role of estradiol (E2) in CKD-associated microvascular disease and related HFpEF. Elevated circulating levels of uremic toxins (UTs) during CKD may act in synergy with hormonal changes during post-menopause and could lead to coronary microvascular endothelial dysfunction in HFpEF...
March 14, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28337255/combined-therapy-with-melatonin-and-exendin-4-effectively-attenuated-the-deterioration-of-renal-function-in-rat-cardiorenal-syndrome
#17
Kuan-Hung Chen, Chih-Hung Chen, Christopher Glenn Wallace, Yen-Ta Chen, Chih-Chao Yang, Pei-Hsun Sung, Hsin-Ju Chiang, Yi-Ling Chen, Sarah Chua, Hon-Kan Yip, Jiin-Tsuey Cheng
This study tested the hypothesis that combined therapy with melatonin (Mel) and exendin-4 (Ex4) would be superior to either therapy alone for preventing the deterioration of renal function in cardiorenal syndrome (CRS). Male adult Sprague Dawley rats (n = 48) were randomly and equally divided into sham-control (SC), chronic kidney disease (CKD; induced by 5/6 nephrectomy), CRS (CKD + dilated cardiomyopathy, DCM; induced by doxorubicin 7 mg/kg i.p. every 5 days, 4 doses), CRS-Mel (20 mg/kg/day), CRS-Ex4 (10 µg/kg/day) and CRS-Mel-Ex4...
2017: American Journal of Translational Research
https://www.readbyqxmd.com/read/28333655/biochemical-and-electrocardiographic-studies-on-the-beneficial-effects-of-gallic-acid-in-cyclophosphamide-induced-cardiorenal-dysfunction
#18
Omolola Rachel Ogunsanwo, Ademola Adetokunbo Oyagbemi, Temidayo Olutayo Omobowale, Ebunoluwa Racheal Asenuga, Adebowale Bernard Saba
Background Cardiac toxicity is one of the life-threatening complications of cancer therapy. Cyclophosphamide (CYP) is an alkylating agent with potent antineoplastic and immunosuppressive properties and possibly the most widely used antineoplastic agent. Chronic cardiotoxicity associated with CYP is characterized by progressive heart failure developing from weeks to years after therapy. Methods In this study, rats were administered with (60 mg/kg and 120 mg/kg) alone or in combination with single intraperitoneal (200 mg/kg) administration of CYP for 7 days...
March 22, 2017: Journal of Complementary & Integrative Medicine
https://www.readbyqxmd.com/read/28332017/the-relationship-between-the-renal-reabsorption-of-cysteine-and-the-lowered-urinary-ph-in-diabetics
#19
Susumu Ogawa, Junko Takiguchi, Manami Shimizu, Kazuhiro Nako, Masashi Okamura, Yoshitaka Kinouchi, Sadayoshi Ito
BACKGROUND/AIMS: In diabetic patients, reduced urinary pH (UpH) is a predictive factor for cardiorenal-vascular disorders. Synthesis of glutathione, an anti-oxidative stress substance, is induced to counteract renal oxidative stress. UpH declines as glutamate is consumed, as does the synthesis of ammonia from glutamate. Glutathione is synthesized from glutamate and cysteine; however, in diabetes, the relationship between lowered UpH and the roles of renal amino acids is unknown. We, therefore, examined the relationship between amino-acid kinetics, UpH, and renal function...
March 22, 2017: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/28329085/renal-sodium-avidity-in-heart-failure-from-pathophysiology-to-treatment-strategies
#20
Wilfried Mullens, Frederik Hendrik Verbrugge, Petra Nijst, Wai Hong Wilson Tang
Increased neurohumoral stimulation resulting in excessive sodium avidity and extracellular volume overload are hallmark features of decompensated heart failure. Especially in case of concomitant renal dysfunction, the kidneys often fail to elicit effective natriuresis. While assessment of renal function is generally performed by measuring serum creatinine-a surrogate for glomerular filtration-, this only represents part of the nephron's function. Alterations in tubular sodium handling are at least equally important in the development of volume overload and congestion...
February 23, 2017: European Heart Journal
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