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John A Kellum
PURPOSE OF REVIEW: Acute kidney injury is common and is associated with increased morbidity and mortality. Rates of acute kidney injury in most settings remain high and in some settings are increasing. Moreover, outcomes associated with acute kidney injury remain relatively poor. This review focuses on recent advances in understanding of acute kidney injury and discusses possible interventions based on these advances. RECENT FINDINGS: Acute kidney injury is not a disease with a single etiology and clinical course but rather a loose collection of syndromes whose unifying phenotype is an acute loss of glomerular filtration...
October 18, 2016: Current Opinion in Critical Care
Matthew Weir, George L Bakris, Coleman Gross, Martha R Mayo, Dahlia Garza, Jinwei Yuan, Lance Berman, Gordon H Williams
OBJECTIVE: Elevated serum aldosterone can be vasculotoxic and facilitates cardiorenal damage. Renin-angiotensin-aldosterone inhibitors (RAASi) reduce serum aldosterone levels and/or block its effects but can cause hyperkalemia (HK). Patiromer, a nonabsorbed potassium binder, decreases serum potassium (K) in CKD patients on RAASi. We examined the effect of patiromer on serum aldosterone levels, plasma renin activity (PRA), systolic (SBP) and diastolic blood pressure (DBP), and urinary albumin-to-creatinine ratio (UACR) in CKD patients on RAASi with HK (serum K 5...
September 2016: Journal of Hypertension
Bernt Johan von Scholten, Frederik Persson, Signe Rosenlund, Peter Hovind, Jens Faber, Tine Willum Hansen, Peter Rossing
AIMS: Patients with type 2 diabetes and albuminuria have high cardiorenal morbidity and mortality despite multifactorial treatment. Short-term reduction in albuminuria is considered suggestive of long-term renoprotective effects. We evaluated the renal effects of the glucagon-like peptide-1 (GLP-1) receptor agonist liraglutide on top of multifactorial care, including renin-angiotensin-system (RAS)-inhibition. MATERIALS AND METHODS: Randomised, double-blind, placebo-controlled, cross-over trial including patients with type 2 diabetes and persistent albuminuria (urinary albumin-to-creatinine ratio > 30 mg/g) and estimated glomerular filtration rate (eGFR) ≥30 mL/min/1...
October 17, 2016: Diabetes, Obesity & Metabolism
Yaw A Nyame, Helen Liang, Hans C Arora, Bradley C Gill, Peter Caputo, Daniel Ramirez, Matthew J Maurice, Khaled Fareed, Robert J Stein, Georges-Pascal Haber, Andrew J Stephenson, Amr Fergany, Jihad Kaouk
PURPOSE: Currently no data exists to guide renal surgeons on the perioperative use of renin-angiotensin (RAS) blockers despite their potential cardiorenal benefits. This study aims to assess the impact of resuming RAS blockers on postoperative renal function and adverse cardiac events following partial nephrectomy. PATIENTS AND METHODS: This is an observational analysis of patients undergoing robotic-assisted laparoscopic partial nephrectomy from 2006-2014 at a single institution...
October 13, 2016: Journal of Urology
Jiří Charvát
Symptomatic cardiorenal syndrome presents the clinical condition with the serious prognosis when treatment is hardly succesful. A lot of inflammatory and hormonal factors used as biomarkers in clinical practice participate on the initiation, development and progression of cardiorenal syndrome. It means they play role of mediators between heart and kidney and therefore have the significant position in clinical presentation. However the mutual relations between heart and kidney are formed earlier already in the asymptomatic period...
2016: Vnitr̆ní Lékar̆ství
Kevin D Burns, Yuliya Lytvyn, Farid H Mahmud, Denis Daneman, Livia Deda, David B Dunger, John E Deanfield, R Neil Dalton, Yesmino Elia, Ronnie Har, Julie A D Van, Timothy J Bradley, Cameron Slorach, Wei Hui, Fengxia Xiao, Joseph Zimpelmann, Luc Mertens, Rahim Moineddin, Heather N Reich, Etienne B Sochett, James W Scholey, David Z I Cherney
AIMS: The relationship between the renal renin-angiotensin aldosterone system (RAAS) and cardiorenal pathophysiology is unclear. Our aims were to assess (1) levels of urinary RAAS components and (2) the association between RAAS components and HbA1c, urine albumin/creatinine ratio (ACR), estimated glomerular filtration rate (eGFR) and blood pressure in otherwise healthy adolescents with type 1 diabetes mellitus (TID) vs. healthy controls (HC). METHODS: Urinary angiotensinogen and ACE2 levels, activity of ACE and ACE2, blood pressure (BP), HbA1c, ACR and eGFR were measured in 65 HC and 194 T1D from the Adolescent Type 1 Diabetes Cardio-Renal Intervention Trial (AdDIT)...
October 12, 2016: American Journal of Physiology. Renal Physiology
S Sakthi Selva Kumar
No abstract text is available yet for this article.
January 2016: Journal of the Association of Physicians of India
Alireza Khoshdel, Shane Carney, Saxon White, Alastair Gillies
INTRODUCTION: Kidney disease increases the risk of cardiovascular disease. The corollary of that observation should be that cardiovascular disease would not only increase the risk of kidney dysfunction, but also cause kidney damage, a concept not previously proposed. MATERIALS AND METHODS: Hemodynamic response to a graded exercise stress test was measured in 70 candidates to evaluate the association of heart rate and blood pressure change, heart rate reserve, chronotropic incompetence (percentage of achievement of maximal predicted heart rate), and circulatory power with development of kidney failure (glomerular filtration rate < 30 mL/min/1...
September 2016: Iranian Journal of Kidney Diseases
E Martinelli, C Locatelli, S Bassis, S Crosara, S Paltrinieri, P Scarpa, I Spalla, A M Zanaboni, C Quintavalla, P Brambilla
BACKGROUND: Veterinary literature lacks data about cardiovascular-renal disorders (CvRD) and cardiorenal-anemia syndrome (CRAS) in dogs. HYPOTHESIS: A direct correlation exists between ACVIM class and IRIS stage; chronic kidney disease (CKD) complicates chronic mitral valve disease (CMVD) more often than does anemia in dogs. ANIMALS: One hundred and fifty-eight client-owned dogs with CMVD. METHODS: Signalment, physical examination findings, electrocardiography, thoracic radiographs, echocardiography, and blood analysis were retrospectively evaluated to assess the prevalence of CKD and anemia in dogs with CMVD and to investigate the relationships among ACVIM class, IRIS stage, and survival...
September 2016: Journal of Veterinary Internal Medicine
Ana Luísa Pinheiro da Silva, Manuel Joaquim Vaz da Silva
The Acute Dialysis Quality Initiative consensus conference proposed a classification of cardiorenal syndrome (CRS), aiming for a better delineation of each subtype. Although the exact pathophysiology of type 4 CRS is not completely understood, the mechanisms involved are probably multifactorial. There is growing evidence that oxidative stress is a major connector in the development and progression of type 4 CRS. Giving its complexity, poor prognosis and increasing incidence, type 4 CRS is becoming a significant public health problem...
October 3, 2016: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
Naomi Nakazawa, Keisuke Nakabayashi, Toshiaki Oka
Renal congestion contributes to the cardiorenal syndrome. There are some heart failure cases that are refractory to diuretic therapy. If the dose of diuretics is titrated, it leads to irreversible renal dysfunction. Early administration of tolvaptan is effective in treating fluid retention and congestion. However, in case of tolvaptan resistance, starting extracorporeal ultrafiltration (ECUM) at an early stage should be considered. Tolvaptan has been proven efficient, and we believe it should be incorporated with the classical method, ECUM...
October 4, 2016: BMJ Case Reports
Wenxue Hu, Wenna He, Wei Liu, Xiaowu Fang, Yanhua Wu, Feng Yu, Wenke Hao
BACKGROUND/AIMS: Cardiorenal syndrome type 1 (CRS1) is a syndrome characterized by a rapid worsening of cardiac function leading to acute kidney injury (AKI). The aims of this study were to investigate the risk factors and the prognosis of CRS1 in elderly patients. METHODS: A total of 312 elderly patients (≥60 years old) with acute heart failure (AHF) were studied. They were assigned as CRS1 (suffered from in-hospital AKI) or NCRS1 (without AKI) group. Clinical and laboratory data were recorded...
September 28, 2016: Kidney & Blood Pressure Research
Silvia Lai, Mauro Ciccariello, Mira Dimko, Alessandro Galani, Silvio Lucci, Rosario Cianci, Amalia Mariotti
: Bakground/Aims: Cardiovascular diseases represent the leading causes of morbidity and mortality in patients with cronich kidney disease (CKD). The pathogenesis includes a complex, bidirectional interaction between heart and kidney termed cardiorenal syndrome type 4. The aim of study was to evaluate the association between renal and cardiovascular ultrasonographic parameters and identify early markers of cardiovascular risk. METHODS: A total of 35 patients with CKD and 25 healthy controls, were enrolled and we have evaluated inflammatory indexes, mineral metabolism, renal function, renal and cardiovascular ultrasonographic parameters...
September 26, 2016: Kidney & Blood Pressure Research
Chan Joon Kim, Ik-Jun Choi, Hun-Jun Park, Tae Hoon Kim, Pum-Joon Kim, Kiyuk Chang, Sang Hong Baek, Wook Sung Chung, Ki-Bae Seung
BACKGROUND: Dysfunctional interplay between the heart and kidneys may lead to the development of anemia. The aim of this study was to evaluate the impact of cardiorenal anemia syndrome (CRAS) on short- and long-term outcomes among patients hospitalized with heart failure (HF). METHODS: We enrolled 303 patients hospitalized with HF. We divided the patients into two groups: a CRAS group (n = 64) and a non-CRAS group (n = 239). We defined CRAS as HF accompanied by (1) an estimated glomerular filtration rate <60 ml/min/1...
August 2016: Cardiorenal Medicine
Matthew Weir, George L Bakris, Coleman Gross, Martha R Mayo, Dahlia Garza, Jinwei Yuan, Lance Berman, Gordon H Williams
OBJECTIVE: Elevated serum aldosterone can be vasculotoxic and facilitates cardiorenal damage. Renin-angiotensin-aldosterone inhibitors (RAASi) reduce serum aldosterone levels and/or block its effects but can cause hyperkalemia (HK). Patiromer, a nonabsorbed potassium binder, decreases serum potassium (K) in CKD patients on RAASi. We examined the effect of patiromer on serum aldosterone levels, plasma renin activity (PRA), systolic (SBP) and diastolic blood pressure (DBP), and urinary albumin-to-creatinine ratio (UACR) in CKD patients on RAASi with HK (serum K 5...
September 2016: Journal of Hypertension
Reem Alshaman, Luan Truong, Adebayo Oyekan
Despite the presence of many studies on the role of mechanistic target of rapamycin (mTOR) in cardiorenal tissues, the definitive role of mTOR in the pathogenesis of renal injury subsequent to ischemia-reperfusion (IR) remains unclear. The aims of the current study were to characterize the role of mTOR in normal kidney function and to investigate the role of mTOR activation in IR-induced kidney injury. In euvolemic anesthetized rats, treatment with the mTOR inhibitor rapamycin increased blood pressure (121±2 to 144±3 mmHg; P<0...
August 24, 2016: Clinical and Experimental Pharmacology & Physiology
Akinleye Stephen Akinrinde, Olutayo Omobowale, Ademola Oyagbemi, Ebunoluwa Asenuga, Temitayo Ajibade
Cobalt (Co) toxicity is a potential public health problem due to recent renewed use of Co in orthopedic implants, dietary supplements, and blood doping in athletes and horses. We investigated the protective roles of kolaviron (KV), a bi-flavonoid of Garcinia kola, and gallic acid (GA) on cobalt chloride (CoCl2)-induced cardiorenal damage in rats. CoCl2 caused significant increases (p < 0.05) in serum creatine kinase-myocardial band (CK-MB), lactate dehydrogenase (LDH), aspartate transaminase (AST), xanthine oxidase (XO), urea, creatinine, malondialdehyde, H2O2, nitric oxide, as well as C-reactive protein expression, along with significant (p < 0...
July 5, 2016: Canadian Journal of Physiology and Pharmacology
Chunbo Chen, Xiaobing Yang, Ying Lei, Yan Zha, Huafeng Liu, Changsheng Ma, Jianwei Tian, Pingyan Chen, Tiecheng Yang, Fan Fan Hou
BACKGROUND AND OBJECTIVES: A major challenge in early treatment of acute cardiorenal syndrome (CRS) is the lack of predictors for progression of AKI. We aim to investigate the utility of urinary angiotensinogen and other renal injury biomarkers in predicting AKI progression in CRS. DESIGN, SETTINGS, PARTICIPANTS, & MEASUREMENTS: In this prospective, multicenter study, we screened 732 adults who admitted for acute decompensated heart failure from September 2011 to December 2014, and evaluated whether renal injury biomarkers measured at time of AKI diagnosis can predict worsening of AKI...
September 7, 2016: Clinical Journal of the American Society of Nephrology: CJASN
Florence Sens, Éric Pouliquen, Sandrine Lemoine, Éric Bonnefoy-Cudraz, Laurent Juillard
Kidney dysfunction during congestive heart failure, although frequent, is often neglected. Yet, it represents a life-threatening condition, oven when the kidney dysfunction is moderate. The initial approach involvus strict application of recommendations, cardiologic and nephrologic joined management and close follow-up involving patient's general practitioner. Cases of true diuretics resistance are infrequent and late. Yet, it represents a significant turning point. Mortality is high, with a major individual unpredictability...
June 2016: La Revue du Praticien
Éric Thervet
The pathophysiology of cardiorenal syndromes (SCR) is becoming better understood. The traditional view was that the left ventricular systolic dysfunction leads to a decrease in renal blood flow. Although this mechanism still makes sense as a contributing factor to SCR, its role as the principal pathophysiological SCR component or even as essential hemodynamic underlying factor has been challenged by recent discoveries. Regarding hemodynamic, the role of increased venous pressure is more and more accepted as demonstrated by the increase in abdominal pressure...
June 2016: La Revue du Praticien
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