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Hypertension in CKD

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https://www.readbyqxmd.com/read/28820061/renin-angiotensin-system-and-cytokines-in-chronic-kidney-disease-clinical-and-experimental-evidence
#1
Ariadna Andrade Saldanha Silva, Beranardo Bahia Finotti, Amanda Oliveira Lauar, Thiago Ruiz Rodrigues Prestes, Ana Cristina Simões E Silva
Chronic kidney disease (CKD) has become a major public health problem in Brazil and worldwide. There are many causes of CKD, being the congenital anomalies of the kidney and urinary tract and the glomerular diseases very common in pediatric patients, while diabetic nephropathy, CKD due to chronic arterial hypertension and glomerular diseases are predominant in adult patients. Many endogenous mediators have been related to the pathophysiology of CKD, being relevant the effects of the renin-angiotensin system (RAS) and the immune-inflammatory mediators including cytokines...
August 18, 2017: Protein and Peptide Letters
https://www.readbyqxmd.com/read/28819567/systemic-associations-with-residual-subretinal-fluid-after-ranibizumab-in-diabetic-macular-edema
#2
Meng-Ju Tsai, Yi-Ting Hsieh, Elizabeth P Shen, Yi-Jie Peng
PURPOSE: To investigate the impact of systemic diseases on the occurrence of subretinal fluid (SRF) in diabetic macular edema (DME) and prognostic factors for residual SRF following three consecutive monthly intravitreal ranibizumab. METHODS: Ninety-seven eyes from 68 patients with DME who completed 3 consecutive monthly injections of ranibizumab were enrolled. Systemic parameters mainly included chronic kidney disease (CKD), hypertension, HbA1c, and insulin dependence...
2017: Journal of Ophthalmology
https://www.readbyqxmd.com/read/28818842/what-s-new-in-paediatric-hypertension
#3
REVIEW
Rowena Lalji, Kjell Tullus
Paediatric hypertension predisposes to hypertension and cardiovascular disease in adult life. Despite clear guidelines, there remains a lack of screening. Diagnosis remains challenging given the high rate of false-positive high blood pressure (BP) readings at a single visit; thus, multiple visits are required to confirm the diagnosis. Depending on the normative data sets used, hypertension in overweight and obese children can be underestimated by up to 20%. Specific BP targets are required for subgroups such as adolescents, children with chronic kidney disease (CKD) and type 1 diabetes...
August 17, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/28814591/spleno-renal-artery-transposition-in-a-solitary-functioning-kidney-for-treatment-resistant-hypertension-and-acute-kidney-injury
#4
Subash Somalanka, Fiona E Harris, Eric Chemla, Rebecca Jo Suckling, Pauline A Swift
Renal Artery Stenosis (RAS) is an important cause of treatment-resistant hypertension. Uncontrolled hypertension with RAS can cause progressive chronic kidney disease (CKD) leading to end-stage kidney disease. Therapeutic revascularisation can be helpful in appropriate circumstances where pharmaceutical intervention has failed and significant renovascular disease contributes to resistant hypertension. We present an interesting case of a Caucasian male with peripheral vasculopathy, abdominal aortic aneurysm (AAA), single functioning kidney and ostial RAS caused by stent struts from an endovascular AAA stent graft...
August 16, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28809621/cardiovascular-risk-factors-and-mortality-in-children-with-chronic-kidney-disease
#5
Abdullahi Mudi, Caroline Dickens, Cecil Levy, Daynia Ballot
BACKGROUND: Cardiovascular disease (CVD) begins early in children with chronic kidney disease (CKD), and its progression is determined by the presence of single or multiple cardiovascular risk factors (CVRFs). OBJECTIVE: To determine the prevalence of CVRFs in children with CKD and their association with mortality in children on chronic dialysis. METHODS: This comparative cross-sectional study recruited children aged 5 - 18 years with all stages of CKD...
July 28, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28808366/clinical-features-and-outcomes-of-patients-with-posterior-reversible-encephalopathy-syndrome
#6
M S Kalaiselvan, M K Renuka, A S Arunkumar
AIMS: The aim of this study was to study the clinical features and outcomes of patients with posterior reversible encephalopathy syndrome (PRES) admitted to the Intensive Care Unit (ICU). SUBJECTS AND METHODS: All adult patients admitted to our ICU with acute onset neurologic symptoms with focal vasogenic edema on magnetic resonance imaging (MRI) were included in the study. Data were collected on demography, coexisting illness, admission severity of illness, neurological symptoms, blood pressure, treatment initiated, and MRI findings...
July 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28805480/current-evidence-on-the-use-of-anti-raas-agents-in-congenital-or-acquired-solitary-kidney
#7
Mariadelina Simeoni, Annarita Armeni, Chiara Summaria, Annamaria Cerantonio, Giorgio Fuiano
RATIONAL: The inhibition of renin-angiotensin-aldosterone system (RAAS) is a major strategy for slowing the progression of chronic kidney disease (CKD). The utility of anti-RAAS agents in patients with congenital or acquired solitary kidney is still controversial. OBJECTIVE: A systematic literature review was conducted. MAIN FINDINGS: The conclusions of the few available studies on the topic are homogeneously in agreement with a long-term reno-protective activity of anti-RAAS drugs in patients with solitary kidney, especially if patients are hypertensive or proteinuric...
November 2017: Renal Failure
https://www.readbyqxmd.com/read/28802945/effect-of-dual-compared-to-no-or-single-renin-angiotensin-system-blockade-on-risk-of-renal-replacement-therapy-or-death-in-predialysis-patients-prepare-2-study
#8
Pauline W M Voskamp, Friedo W Dekker, Merel van Diepen, Ellen K Hoogeveen
Current guidelines on hypertension treatment in chronic kidney disease (CKD) patients discourage combined angiotensin-converting enzyme inhibitor (ACEi) and angiotensin II receptor blocker (ARB) use due to the risk of an increased kidney function decline. However, dual compared to single renin-angiotensin system (RAS) blockade may have more efficacy with regard to hypertension and proteinuria. Among incident predialysis patients (CKD 4-5), we compared dual with no or single RAS blockade regarding kidney function decline and risk of renal replacement therapy (RRT) or death...
July 22, 2017: Journal of the American Society of Hypertension: JASH
https://www.readbyqxmd.com/read/28782823/drugs-and-the-kidneys-clinical-pharmacology-perspectives
#9
EDITORIAL
John Vincent
The focus of this edition of Clinical Pharmacolgoy & Therapeutics (CPT) is on drugs and renal function and will not include a detailed discussion of kidney disease and its treatment. It is well recognized that drugs affect the kidneys in different ways, while kidney disease impacts drug metabolism and response. It is impossible to underestimate the value of the kidneys to man in health and disease, from regulation of fluid and electrolyte balance to participating in drug metabolism and transport. Additionally, the kidneys serve as targets for drugs used to treat cardiovascular (CV) diseases including hypertension and heart failure, metabolic diseases such as diabetes mellitus and obesity, chronic kidney disease (CKD), as well as playing a role in the regulation of several hormones...
September 2017: Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28782299/continuous-erythropoiesis-receptor-activator-cera-for-the-anaemia-of-chronic-kidney-disease
#10
REVIEW
Valeria M Saglimbene, Suetonia C Palmer, Marinella Ruospo, Patrizia Natale, Jonathan C Craig, Giovanni Fm Strippoli
BACKGROUND: Continuous erythropoiesis receptor activator (CERA) is a newer, longer acting ESA which might be preferred to other ESAs (epoetin or darbepoetin) based on its lower frequency of administration. Different dosing requirements and molecular characteristics of CERA compared with other ESAs may lead to different health outcomes (mortality, cardiovascular events, quality of life) in people with anaemia and chronic kidney disease (CKD). OBJECTIVES: To assess benefits and harms of CERA compared with other epoetins (darbepoetin alfa and epoetin alfa or beta) or placebo/no treatment or CERA with differing strategy of administration for anaemia in individuals with CKD...
August 7, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28781372/uromodulin-from-physiology-to-rare-and-complex-kidney-disorders
#11
REVIEW
Olivier Devuyst, Eric Olinger, Luca Rampoldi
Uromodulin (also known as Tamm-Horsfall protein) is exclusively produced in the kidney and is the most abundant protein in normal urine. The function of uromodulin remains elusive, but the available data suggest that this protein might regulate salt transport, protect against urinary tract infection and kidney stones, and have roles in kidney injury and innate immunity. Interest in uromodulin was boosted by genetic studies that reported involvement of the UMOD gene, which encodes uromodulin, in a spectrum of rare and common kidney diseases...
September 2017: Nature Reviews. Nephrology
https://www.readbyqxmd.com/read/28771472/micrornas-in-the-mir-17-and-mir-15-families-are-downregulated-in-chronic-kidney-disease-with-hypertension
#12
Priyanka Nandakumar, Adrienne Tin, Megan L Grove, Jianzhong Ma, Eric Boerwinkle, Josef Coresh, Aravinda Chakravarti
BACKGROUND: In older adults (aged 70-74 years), African-Americans have 4-fold higher risk of developing hypertension-attributed end-stage renal disease (ESRD) than European-Americans. A hypothesized mechanism linking hypertension and progressive chronic kidney disease (CKD) is the innate immune response and inflammation. Persons with CKD are also more susceptible to infection. Gene expression in peripheral blood can provide a view of the innate immune activation profile. We aimed to identify differentially expressed genes, microRNAs, and pathways in peripheral blood between cases with CKD and high blood pressure under hypertension treatment versus controls without CKD and with controlled blood pressure in African Americans...
2017: PloS One
https://www.readbyqxmd.com/read/28767208/lithium-use-but-not-valproate-use-is-associated-with-a-higher-risk-of-chronic-kidney-disease-in-older-adults-with-mental-illness
#13
Soham Rej, Nathan Herrmann, Kenneth Shulman, Hadas D Fischer, Kinwah Fung, Ziv Harel, Andrea Gruneir
OBJECTIVE: Lithium is an essential mood disorder treatment; however, it remains unclear whether lithium increases chronic kidney disease (CKD) risk. There are few data on this in the elderly, even though older adults may be particularly susceptible to CKD. We wished to determine whether lithium is associated with increased CKD risk relative to valproate in older adults. METHODS: This nested case-control study analyzed province-wide administrative health data from mental health service users aged ≥ 66 years in Ontario, Canada, from 2003 to 2014...
August 1, 2017: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/28767097/sympathetic-overactivity-in-chronic-kidney-disease-consequences-and-mechanisms
#14
REVIEW
Jasdeep Kaur, Benjamin E Young, Paul J Fadel
The incidence of chronic kidney disease (CKD) is increasing worldwide, with more than 26 million people suffering from CKD in the United States alone. More patients with CKD die of cardiovascular complications than progress to dialysis. Over 80% of CKD patients have hypertension, which is associated with increased risk of cardiovascular morbidity and mortality. Another common, perhaps underappreciated, feature of CKD is an overactive sympathetic nervous system. This elevation in sympathetic nerve activity (SNA) not only contributes to hypertension but also plays a detrimental role in the progression of CKD independent of any increase in blood pressure...
August 2, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28765150/heart-failure-increases-the-risk-of-adverse-renal-outcomes-in-patients-with-normal-kidney-function
#15
Lekha K George, Santhosh K G Koshy, Miklos Z Molnar, Fridtjof Thomas, Jun L Lu, Kamyar Kalantar-Zadeh, Csaba P Kovesdy
BACKGROUND: Heart failure (HF) is associated with poor cardiac outcomes and mortality. It is not known whether HF leads to poor renal outcomes in patients with normal kidney function. We hypothesized that HF is associated with worse long-term renal outcomes. METHODS AND RESULTS: Among 3 570 865 US veterans with estimated glomerular filtration rate (eGFR) ≥60 mL min(-1) 1.73 m(-2) during October 1, 2004 to September 30, 2006, we identified 156 743 with an International Classification of Diseases, Ninth Revision, diagnosis of HF...
August 2017: Circulation. Heart Failure
https://www.readbyqxmd.com/read/28762362/prevalence-and-pattern-of-potential-drug-drug-interactions-among-chronic-kidney-disease-patients-in-south-western-nigeria
#16
J Fasipe Olumuyiwa, A Akinbodewa Akinwumi, O Adejumo Ademola, B Akawa Oluwole, E Okaka Ibiene
BACKGROUND: Management of chronic kidney disease (CKD) patients often requires the use of multiple drugs due to a high number of cardiovascular risk factors and complications associated with the disease. Multiple drugs predispose to potential drug-drug interactions (DDIs) which may be associated with increased morbidity, mortality, length of hospital stay and health-care cost. OBJECTIVES: This study determined the prevalence and pattern of potential DDIs among CKD patients attending Kidney Care Centre, in Ondo City, Nigeria...
April 2017: Nigerian Postgraduate Medical Journal
https://www.readbyqxmd.com/read/28762361/prevalence-of-chronic-kidney-disease-and-its-risk-factors-among-adults-in-a-semi-urban-community-of-south-east-nigeria
#17
Chimezie Godswill Okwuonu, Innocent Ijezie Chukwuonye, Oluseyi Ademola Adejumo, Emmanuel Idoko Agaba, Louis Ikechukwu Ojogwu
BACKGROUND: Chronic kidney disease (CKD) is an increasingly prevalent problem worldwide. Treatment of end-stage kidney disease is beyond the reach of an average Nigerian. The prevention and early detection are imperative to reducing its burden. AIM: The aim of this study was to determine the prevalence of CKD and some of its risk factors among adults in a representative semi-urban Nigerian population. SUBJECTS AND METHODS: A cross-sectional study involving 400 randomly selected adults...
April 2017: Nigerian Postgraduate Medical Journal
https://www.readbyqxmd.com/read/28758975/elevated-soluble-urokinase-plasminogen-activator-receptor-and-proenkephalin-serum-levels-predict-the-development-of-acute-kidney-injury-after-cardiac-surgery
#18
Jana C Mossanen, Jessica Pracht, Tobias U Jansen, Lukas Buendgens, Christian Stoppe, Andreas Goetzenich, Joachim Struck, Rüdiger Autschbach, Gernot Marx, Frank Tacke
Acute kidney injury (AKI) develops in up to 40% of patients after cardiac surgery. The soluble urokinase plasminogen activator receptor (suPAR) has been identified as a biomarker for incident chronic kidney disease (CKD). Proenkephalin (proENK) also has been shown to be a biomarker for renal dysfunction. We hypothesized that pre-surgery suPAR and proENK levels might predict AKI in patients undergoing cardiac surgery. Consecutive patients (n = 107) undergoing elective cardiac surgery were studied prospectively...
July 31, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28754555/elastin-insufficiency-causes-hypertension-structural%C3%A2-defects-and-abnormal-remodeling-of%C3%A2-renal-vascular-signaling
#19
Elizabeth A Owens, Li Jie, Beverly A S Reyes, Elisabeth J Van Bockstaele, Patrick Osei-Owusu
Elastin deficiency causes vascular stiffening, a leading risk for hypertension and chronic kidney disease (CKD). The mechanisms mediating hypertension and/or CKD pathogenesis due to elastin deficiency are poorly understood. Using the elastin heterozygous (Eln+/-) mouse model, we tested whether renal dysfunction due to elastin deficiency occurs independently of and precedes the development of hypertension. We assessed blood pressure and renal hemodynamics in 30-day and 12-week-old male and female mice. At P30, blood pressure of Eln+/- mice was similar to wild-type controls; however, renal blood flow was lower, whereas renal vascular resistance was augmented at baseline in Eln+/- mice...
July 26, 2017: Kidney International
https://www.readbyqxmd.com/read/28753930/pregnancy-proteinuria-plant-based-supplemented-diets-and-focal-segmental-glomerulosclerosis-a-report-on-three-cases-and-critical-appraisal-of-the-literature
#20
Rossella Attini, Filomena Leone, Benedetta Montersino, Federica Fassio, Fosca Minelli, Loredana Colla, Maura Rossetti, Cristiana Rollino, Maria Grazia Alemanno, Antonella Barreca, Tullia Todros, Giorgina Barbara Piccoli
Chronic kidney disease (CKD) is increasingly recognized in pregnant patients. Three characteristics are associated with a risk of preterm delivery or small for gestational age babies; kidney function reduction, hypertension, and proteinuria. In pregnancy, the anti-proteinuric agents (ACE-angiotensin converting enzyme-inhibitors or ARBS -angiotensin receptor blockers) have to be discontinued for their potential teratogenicity, and there is no validated approach to control proteinuria. Furthermore, proteinuria usually increases as an effect of therapeutic changes and pregnancy-induced hyperfiltration...
July 19, 2017: Nutrients
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