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Bartosz Słomiński, Maria Skrzypkowska, Monika Ryba-Stanisławowska, Agnieszka Brandt
BACKGROUND & AIM: Recent studies suggest that uric acid (UA) is a mediator of diabetic nephropathy. We hypothesized that serum UA would associate with the prevalence of diabetic nephropathy in youth with type 1 diabetes (T1D), and that this relationship would differ by sex. METHODS: We examined 120 young boys and the same number of girls with T1D. C-reactive protein (CRP), interleukin-6 (IL-6), interleukin-10 (IL-10), tumor necrosis factor α (TNF-α), uric acid, cystatin C serum concentrations, albumin excretion rate and blood pressure were also analysed...
March 12, 2018: Pediatric Diabetes
Guramrinder S Thind, Mark Loehrke, Jeffrey L Wilt
Cardiac and renal dysfunction often coexist, and one begets the other. The association is referred to as cardiorenal syndrome. One subtype, acute cardiorenal syndrome, is often described as a clinical scenario in which acute worsening of cardiac function leads to acute kidney injury. Though this definition covers the basic pathophysiologic framework, a robust clinical definition is still lacking. Acute cardiorenal syndrome is common and often leads to emergency room visits and hospitalization. Our understanding of the hemodynamic mechanisms of acute cardiorenal syndrome is advancing...
March 2018: Cleveland Clinic Journal of Medicine
Justin L Grodin
No abstract text is available yet for this article.
March 2018: Cleveland Clinic Journal of Medicine
Roberto Minutolo, Francis B Gabbai, Michele Provenzano, Paolo Chiodini, Silvio Borrelli, Carlo Garofalo, Ferdinando C Sasso, Domenico Santoro, Vincenzo Bellizzi, Giuseppe Conte, Luca De Nicola
Background: No study has assessed whether the prognosis of coexisting diabetes mellitus and chronic kidney disease (DM-CKD) is dictated by DM per se or by the extent of proteinuria. Methods: In this pooled analysis of four prospective studies in CKD patients treated with drugs inhibiting the renin-angiotensin system, we compared the risk of all-cause mortality, fatal and non-fatal cardiovascular (CV) events and end-stage renal disease (ESRD) between patients with (n = 693) and without diabetes (n = 1481) stratified by proteinuria level (<0...
March 2, 2018: Nephrology, Dialysis, Transplantation
A Gigante, E Rosato, B Barbano, F Di Mario, G Di Lazzaro-Giraldi, M L Gasperini, R Pofi, A Laviano
Cardiorenal syndrome (CRS) describes the concurrent failure of cardiac and renal function, each influencing the other. Malnutrition and cachexia frequently develop in patients with heart failure or kidney failure. However, no information is currently available on the prevalence of malnutrition in CRS patients. We studied CRS patients admitted to an internal medicine ward during a 5-month period and evaluated their clinical characteristics and nutritional status. Malnutrition risk was assessed by using the validated screening tool NRS-2002 whilst body composition was assessed by bioimpedance analysis and muscle function was measured by handgrip (HG) strength...
January 2018: Journal of Biological Regulators and Homeostatic Agents
Justin L Grodin, Spencer Carter, Bradley A Bart, Steven R Goldsmith, Mark H Drazner, W H Wilson Tang
AIMS: Mechanical ultrafiltration (UF) involves the removal of an iso-osmotic filtrate from the blood. Its benefit in acute decompensated heart failure, however, remains inconclusive. We sought to better understand the direct effects of UF in comparison to an aggressive, urine output-guided pharmacological protocol for decongestion on fluid loss, renal function, and neurohormonal activation. METHODS AND RESULTS: A per-protocol analysis of the Cardiorenal Rescue Study in Acute Decompensated Heart Failure (CARRESS-HF) trial (n = 188) was performed...
March 1, 2018: European Journal of Heart Failure
Joanne M Bargman, Michael Girsberger
BACKGROUND: Peritoneal dialysis (PD) is one of the corner stones of renal replacement therapy and should be strongly considered if preemptive kidney transplantation is not available. SUMMARY: There are several initiatives that may help the growth in the use of PD around the world. First, PD is an underused and valuable option in patients with heart failure and the chronic cardiorenal syndrome, especially in those with frequent hospitalizations despite optimal medical therapy...
January 26, 2018: Blood Purification
P Rossignol, L Juillard
Hypertension is common in patients with chronic renal disease particularly those with diabetes. It is sometimes resistant to the pharmacological treatment. The mineralocorticoid receptor antagonist spironolactone may be indicated here. The mineralocorticoid receptor antagonists have a Class 1, Level A indication for the treatment of heart failure with reduced ejection fraction. There is an associated risk of worsening renal function and of hyperkalemia which does not hinder their clinical benefit. However, an appropriate biological monitoring is warranted, along with potential dose adaptations...
June 2017: Néphrologie & Thérapeutique
Ganesh V Halade, Vasundhara Kain, Charles N Serhan
Resolvins are innate, immune responsive, bioactive mediators generated after myocardial infarction (MI) to resolve inflammation. The MI-induced bidirectional interaction between progressive left ventricle (LV) remodeling and kidney dysfunction is known to advance cardiorenal syndrome (CRS). Whether resolvins limit MI-induced cardiorenal inflammation is unclear. Thus, to define the role of exogenous resolvin D (RvD)-1 in post-MI CRS, we subjected 8-12-wk-old male C57BL/6 mice to coronary artery ligation. RvD1 was injected 3 h after MI...
February 13, 2018: FASEB Journal: Official Publication of the Federation of American Societies for Experimental Biology
Petter Bjornstad, Julie A Lovshin, Yuliya Lytvyn, Genevieve Boulet, Leif E Lovblom, Omar N Alhuzaim, Mohammed A Farooqi, Vesta Lai, Josephine Tse, Leslie Cham, Andrej Orszag, Daniel Scarr, Alanna Weisman, Hillary A Keenan, Michael H Brent, Narinder Paul, Vera Bril, Bruce A Perkins, David Z I Cherney
OBJECTIVE: Central adiposity is considered to be an important cardiorenal risk factor in the general population and in type 1 diabetes. We sought to determine the relationship between central adiposity and intrarenal hemodynamic function in adults with long-standing type 1 diabetes with and without diabetic nephropathy (DN). RESEARCH DESIGN AND METHODS: Patients with type 1 diabetes ( n = 66, duration ≥50 years) and age-/sex-matched control subjects ( n = 73) were studied...
February 2, 2018: Diabetes Care
Han-Byeol Jung, Min-Hee Kang, Hee-Myung Park
Worsening renal function and azotemia in patients with heart failure (HF) are strongly associated with disease severity and poor prognosis. Increasing interest in this correlation led to the description and classification of cardiorenal syndrome (CRS). We evaluated the role of neutrophil gelatinase-associated lipocalin (NGAL) in the early detection of CRS in dogs with HF. Ten healthy dogs and 31 dogs admitted with HF were included in our study. NGAL and troponin-I were measured on samples collected on the day of admission; creatinine was measured on admission and again on day 7...
February 1, 2018: Journal of Veterinary Diagnostic Investigation
William B White, Robert A Kloner, Dominick J Angiolillo, Michael H Davidson
Over-the-counter analgesics are used globally for the relief of acute pain. Although effective, these agents can be associated with adverse effects that may limit their use in some people. In the early 2000s, observations from clinical trials of prescription-strength and supratherapeutic doses of nonselective and cyclooxygenase-2-selective nonsteroidal anti-inflammatory drugs (NSAIDs) raised safety concerns regarding the risk of cardiovascular adverse effects with the use of these medications. Subsequently, the US Food and Drug Administration mandated additional study of the cardiovascular safety of NSAIDs for a more comprehensive understanding of their risk...
March 2018: Journal of Cardiovascular Pharmacology and Therapeutics
Konstantinos Stavropoulos, Konstantinos Imprialos, Nikiforos Stavropoulos, Sofia Bouloukou, Georgios Kerpiniotis, Kyriakos Dimitriadis, Constantinos Tsioufis, Michael Doumas
BACKGROUND: Diabetic nephropathy is a crucial microvascular complication of diabetes mellitus that is associated with elevated cardiovascular risk. SGLT-2 inhibitors are a new class of hypoglycemic drugs that positively affect several risk factors of cardiorenal damage. OBJECTIVES: To review and critically discuss available data on the association of SGLT-2 inhibitors treatment with kidney function, progress of diabetic kidney disease, and renal related outcomes, as well to unveil potential mechanisms of action that mediate such effects...
February 6, 2018: Cardiovascular & Hematological Disorders Drug Targets
Laura E Crotty Alexander, Christopher A Drummond, Mark Hepokoski, Denzil P Mathew, Alexander Moshensky, Andrew Willeford, Soumita Das, Prabhleen Singh, Zachary Yong, Jasmine H Lee, Kevin Vega, Ashley Du, John Shin, Christian Javier, Jiang Tian, Joan Heller Brown, Ellen C Breen
BACKGROUND: Electronic (e)-cigarettes theoretically may be safer than conventional tobacco. However, our prior studies demonstrated direct adverse effects of e-cigarette vapor (EV) on airway cells, including decreased viability and function. We hypothesize that repetitive, chronic inhalation of EV will diminish airway barrier function, leading to inflammatory protein release into circulation, creating a systemic inflammatory state, ultimately leading to distant organ injury and dysfunction...
January 31, 2018: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
James B Diskin, Christopher Brandon Walker, Michael D Oberle, Charles J Diskin
The fractional excretion of urea is a useful tool to evaluate renal function in oliguric states; however, it remains unexplored in nonoliguric states. We evaluated its use to predict responses in patients with type 1 cardiorenal syndrome. This was a prospective observational study of 116 patients with type 1 cardiorenal syndrome referred over a 4-year period. Fractional excretion of urea and sodium, ejection fraction, mean arterial pressure, age, sex, diabetes, brain natriuretic peptide (BNP), serum sodium and blood urea nitrogen were analyzed for effects upon serum creatinine and survival...
January 26, 2018: Therapeutic Apheresis and Dialysis
John G Kingma, Denys Simard, Jacques R Rouleau, Benoit Drolet, Chantale Simard
Inter-organ crosstalk plays an essential role in the physiological homeostasis of the heart and other organs, and requires a complex interaction between a host of cellular, molecular, and neural factors. Derangements in these interactions can initiate multi-organ dysfunction. This is the case, for instance, in the heart or kidneys where a pathological alteration in one organ can unfavorably affect function in another distant organ; attention is currently being paid to understanding the physiopathological consequences of kidney dysfunction on cardiac performance that lead to cardiorenal syndrome...
November 29, 2017: Journal of Cardiovascular Development and Disease
Marek Konop, Marek Radkowski, Marta Grochowska, Karol Perlejewski, Emilia Samborowska, Marcin Ufnal
INTRODUCTION: Increased plasma level of trimethylamine N-oxide (TMAO), a bacterial metabolite of choline, is associated with an increased cardiovascular risk. Indoxyl sulfate, a bacterial metabolite of tryptophan, is thought to be associated with higher mortality in cardiorenal syndrome. We hypothesized that enalapril, a well-established drug reducing cardiovascular mortality, may affect the plasma level of gut bacteria-derived metabolites and gut bacteria composition. MATERIALS AND METHODS: 14-16-week-old Wistar rats were maintained either on water (controls) or water solution of enalapril for two weeks (5...
February 7, 2018: Biomarkers: Biochemical Indicators of Exposure, Response, and Susceptibility to Chemicals
Julie A Lovshin, Marko Škrtić, Petter Bjornstad, Rahim Moineddin, Denis Daneman, David Dunger, Heather N Reich, Farid H Mahmud, James W Scholey, David Z I Cherney, Etienne B Sochett
AIM: Adolescents with T1DM (type 1 diabetes mellitus) are at risk for hyperfiltration and elevated urinary albumin-to-creatinine ratio (ACR), which are early indicators of diabetic nephropathy. Adolescents with T1DM also develop early changes in blood pressure, cardiovascular structure and function. Our aims were to define the relationships between hyperfiltration, ACR, and 24-Hr ambulatory blood pressure over time in adolescents with T1DM. METHODS: Normotensive, normoalbuminuric adolescents (n=98) with T1DM underwent baseline and 2-year 24-Hr ambulatory blood pressure monitoring, glomerular filtration rate (eGFR) estimated by cystatin C (Larsson equation) and ACR measurements...
December 13, 2017: American Journal of Physiology. Renal Physiology
Saraschandra Vallabhajosyula, Ankit Sakhuja, Jeffrey B Geske, Mukesh Kumar, Rahul Kashyap, Kianoush Kashani, Jacob C Jentzer
BACKGROUND: To evaluate the clinical features and outcomes of acute cardiorenal syndrome type-5 in patients with severe sepsis and septic shock. METHODS: Historical cohort study of all adult patients with severe sepsis and septic shock admitted to the intensive care units (ICU) at Mayo Clinic Rochester from January 1, 2007 through December 31, 2014. Patients with prior renal or cardiac dysfunction were excluded. Patients were divided into groups with and without cardiorenal syndrome type-5...
2018: PloS One
Samantha Neuburg, Corey Dussold, Claire Gerber, Xueyan Wang, Connor Francis, Lixin Qi, Valentin David, Myles Wolf, Aline Martin
Background: Levels of fibroblast growth factor 23 (FGF23) increase early in chronic kidney disease (CKD) and are independently associated with left ventricular hypertrophy (LVH), heart failure and death. Experimental models of CKD with elevated FGF23 and LVH are needed. We hypothesized that slow rates of CKD progression in the Col4a3 knockout (Col4a3KO) mouse model of CKD would promote development of LVH by prolonging exposure to elevated FGF23. Methods: We studied congenic Col4a3KO and wild-type (WT) mice with either 75% 129X1/SvJ (129Sv) or 94% C57Bl6/J (B6) genomes...
December 22, 2017: Nephrology, Dialysis, Transplantation
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