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Therapy diabetes chronic kidney disease

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https://www.readbyqxmd.com/read/29325997/reduced-cortical-oxygenation-predicts-a-progressive-decline-of-renal-function-in-patients-with-chronic-kidney-disease
#1
Menno Pruijm, Bastien Milani, Edward Pivin, Agata Podhajska, Bruno Vogt, Matthias Stuber, Michel Burnier
Renal tissue hypoxia is a final pathway in the development and progression of chronic kidney disease (CKD), but whether renal oxygenation predicts renal function decline in humans has not been proven. Therefore, we performed a prospective study and measured renal tissue oxygenation by blood oxygenation level-dependent magnetic resonance imaging (BOLD-MRI) in 112 patients with CKD, 47 with hypertension without CKD, and 24 healthy control individuals. Images were analyzed with the twelve-layer concentric objects method that divided the renal parenchyma in 12 layers of equal thickness and reports the mean R2* value of each layer (a high R2* corresponds to low oxygenation), along with the change in R2* between layers called the R2* slope...
January 9, 2018: Kidney International
https://www.readbyqxmd.com/read/29325084/metformin-use-reverses-the-increased-mortality-associated-with-diabetes-mellitus-during-tuberculosis-treatment
#2
Nicholas R Degner, Jann-Yuan Wang, Jonathan E Golub, Petros C Karakousis
Background: The global type 2 diabetes mellitus (DM) epidemic threatens progress made in reducing tuberculosis (TB)-related mortality worldwide. Previous clinical studies have not fully evaluated potential confounding variables in addressing the impact of DM on TB treatment outcomes. The antidiabetic agent metformin regulates autophagy and may play a role as a host-directed therapeutic adjuvant to antitubercular treatment. Methods: We conducted a retrospective cohort study comprising patients aged ≥13 years undergoing treatment for culture-confirmed, drug-susceptible pulmonary TB...
January 6, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29318219/extending-metformin-use-in-diabetic-kidney-disease-a-pharmacokinetic-study%C3%A2-in%C3%A2-stage-4-diabetic-nephropathy
#3
Ajith Munasinghe Dissanayake, Mark Christopher Wheldon, Jafar Ahmed, Christopher John Hood
Introduction: Metformin use in advanced chronic kidney disease is controversial. This study sought to examine the pharmacokinetics, safety, and efficacy of low-dose metformin in patients with type 2 diabetes and stage 4 chronic kidney disease. Methods: In this open-label, phase I trial, 3 consecutive cohorts (1, 2, and 3) of 6 patients each were recruited to receive 250-, 500-, or 1000-mg once-daily doses of metformin, respectively. All patients underwent a first-dose pharmacokinetic profile and weekly trough metformin concentrations for the duration of 4 weeks of daily therapy...
July 2017: KI Reports
https://www.readbyqxmd.com/read/29317956/effect-of-angiotensin-converting-enzyme-inhibitor-calcium-antagonist-combination-therapy-on-renal-function-in-hypertensive-patients-with-chronic-kidney-disease-chikushi-anti-hypertension-trial-benidipine-and-perindopril
#4
Tetsu Okuda, Keisuke Okamura, Kazuyuki Shirai, Hidenori Urata
Background: Appropriate blood pressure control suppresses progression of chronic kidney disease (CKD). If an angiotensin-converting enzyme (ACE) inhibitor is ineffective, adding a calcium antagonist is recommended. We compared the long-term effect of two ACE inhibitor/calcium antagonist combinations on renal function in hypertensive patients with CKD. Methods: Patients who failed to achieve the target blood pressure (systolic/diastolic: < 130/80 mm Hg) with perindopril monotherapy were randomized to either combined therapy with perindopril and the L-type calcium antagonist amlodipine (group A) or perindopril and the T/L type calcium antagonist benidipine (group B)...
February 2018: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/29295829/medication-therapy-management-after-hospitalization-in-ckd-a-randomized-clinical-trial
#5
Katherine R Tuttle, Radica Z Alicic, Robert A Short, Joshua J Neumiller, Brian J Gates, Kenn B Daratha, Celestina Barbosa-Leiker, Sterling M McPherson, Naomi S Chaytor, Brad P Dieter, Stephen M Setter, Cynthia F Corbett
BACKGROUND AND OBJECTIVES: CKD is characterized by remarkably high hospitalization and readmission rates. Our study aim was to test a medication therapy management intervention to reduce subsequent acute care utilization. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: The CKD Medication Intervention Trial was a single-blind (investigators), randomized clinical trial conducted at Providence Health Care in Spokane, Washington. Patients with CKD stages 3-5 not treated by dialysis who were hospitalized for acute illness were recruited...
January 2, 2018: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29285942/-non-alcoholic-fatty-liver-disease-as-a-component-of-the-metabolic-syndrome-and-its-causal-correlations-with-other-extrahepatic-diseases
#6
Tamás Halmos, Ilona Suba
Non-alcoholic fatty liver disease is the most common non-infectious chronic liver-disease in our age, and is a spectrum of all the diseases associated with increased fat accumulation in the hepatocytes. Its development is promoted by sedentary life-style, over-feeding, and certain genetic predisposition. Prevalence in the adult population, even in Hungary is ~30%. In a part of cases, this disease may pass into non-alcoholic steatohepatitis, later into fibrosis, rarely into primary hepatocellular cancer. Fatty liver is closely and bidirectionally related to the metabolic syndrome and type 2 diabetes, and nowadays there is a general consensus that fatty liver is the hepatic manifestation of the metabolic sycndrome...
December 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/29282014/spectrum-characteristics-of-patients-with-chronic-kidney-disease-ckd-with-increasing-age-in-a-major-metropolitan-renal-service
#7
Usman Mahmood, Helen G Healy, Adrian Kark, Anne Cameron, Zaimin Wang, Rajitha Abeysekera, Wendy E Hoy
BACKGROUND: Aim of our study is to describe, in people with CKD, the demographic and clinical characteristics and outcomes with increasing age. The prevalence of CKD in Western populations, where longevity is the norm, is about 10-15%, but how age influence different characteristics of patients with CKD is largely not known. METHODS: One thousand two hundred sixty-five patients enrolled in the CKD.QLD registry at the Royal Brisbane and Women's Hospital were grouped according to age at consent i...
December 28, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/29275368/use-of-mineralocorticoid-receptor-antagonists-in-patients-with-heart-failure-and-comorbid-diabetes-mellitus-or-chronic-kidney-disease
#8
Lauren B Cooper, Steven J Lippmann, Melissa A Greiner, Abhinav Sharma, Jacob P Kelly, Gregg C Fonarow, Clyde W Yancy, Paul A Heidenreich, Adrian F Hernandez
BACKGROUND: Perceived risks of hyperkalemia and acute renal insufficiency may limit use of mineralocorticoid receptor antagonist (MRA) therapy in patients with heart failure, especially those with diabetes mellitus or chronic kidney disease. METHODS AND RESULTS: Using clinical registry data linked to Medicare claims, we analyzed patients hospitalized with heart failure between 2005 and 2013 with a history of diabetes mellitus or chronic kidney disease. We stratified patients by MRA use at discharge...
December 23, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29248384/efficacy-and-tolerability-of-telmisartan-amlodipine-hydrochlorothiazide-versus-telmisartan-amlodipine-combination-therapy-for-essential-hypertension-uncontrolled-with-telmisartan-amlodipine-the-phase-iii-multicenter-randomized-double-blind-tahyti-study
#9
Ki-Chul Sung, Yong-Seog Oh, Dong-Hun Cha, Soon-Jun Hong, Kyung-Heon Won, Ki-Dong Yoo, Seung-Woon Rha, Young-Keun Ahn, Jeong-Cheon Ahn, Ji-Yong Jang, Tack-Jong Hong, Sang-Kyoon Cho, Sang-Ho Park, Min-Su Hyon, Chang-Wook Nam, In-Ho Chae, Byung-Su Yoo, Jong-Min Song, Jin-Ok Jeong, Young Won Yoon, Byung-Soo Kim, Tae-Hyun Yang, Deok-Kyu Cho, Sang-Hyun Kim, Yu-Jeong Choi, Ji-Hun Ahn, Dong-Woon Jeon, Hyo-Soo Kim
PURPOSE: This 8-week study in Korea aimed to evaluate the efficacy and tolerability of a telmisartan/amlodipine + hydrochlorothiazide (TAH) combination versus telmisartan/amlodipine (TA) combination in patients with essential hypertension that did not respond appropriately to 4-week treatment with TA. METHODS: All patients who met the inclusion criteria received TA (40/5 mg) during a 4-week run-in period (period 1). Patients who met the criteria for essential hypertension (mean sitting systolic blood pressure [MSSBP], ≥140 and <200 mm Hg, or ≥130 and<200 mm Hg in those with diabetes mellitus or chronic kidney disease) after period 1 were randomly assigned to receive TA 40/5 mg + hydrochlorothiazide 12...
December 13, 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/29239764/treatment-choices-for-the-glycaemic-management-of-patients-with-type-2-diabetes-and-chronic-kidney-disease-analysis-of-the-sail-patient-linked-dataset
#10
Thinzar Min, Gareth I Davies, Sam Rice, James Chess, Jeffrey W Stephens
AIMS: Chronic kidney disease (CKD) is common in type 2 diabetes and limits the treatment choices for glycaemic control. Our aim was to examine real-world prescribing for managing hyperglycaemia in the presence of CKD. METHODS: The SAIL (Secure Anonymised Information Linkage) databank was used to examine prescribing during the period from the 1st of January to 30th December 2014. CKD was defined as:- none or mild CKD, eGFR ≥60mL/min/1.73m2; moderate CKD eGFR <60mL/min/1...
November 23, 2017: Diabetes & Metabolic Syndrome
https://www.readbyqxmd.com/read/29229085/prevalence-of-comorbidities-in-copd-patients-by-disease-severity-in-a-german-population
#11
Timm Greulich, Benjamin J D Weist, Andreas Rembert Koczulla, Sabina Janciauskiene, Andreas Klemmer, Wolfram Lux, Peter Alter, Claus F Vogelmeier
Chronic obstructive pulmonary disease (COPD) is commonly associated with multiple comorbidities. Our objective was to assess the prevalence of comorbidities in patients with COPD and to relate their prevalence to the severity of the disease by using a large German health care database. Based on the retrospective analysis of a two-year (2013-2014) database from the German Statutory Health Insurance system, we obtained a representative sample of 4,075,493 german insurants. This sample included 146,141 patients with COPD (age: ≥35 years)...
November 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/29226693/higher-pulse-pressure-and-risk-for-cardiovascular-events-in-patients-with-essential-hypertension-the-campania-salute-network
#12
Costantino Mancusi, Maria A Losi, Raffaele Izzo, Grazia Canciello, Maria V Carlino, Giovanni Albano, Nicola De Luca, Bruno Trimarco, Giovanni de Simone
Background Increased pulse pressure is associated with structural target organ damage, especially in elderly patients, increasing cardiovascular risk. Design In this analysis, we investigated whether high pulse pressure retains a prognostic effect also when common markers of target organ damage are taken into account. Methods We analysed an unselected cohort of treated hypertensive patients from the Campania Salute Network registry ( n = 7336). Participants with available cardiac and carotid ultrasound were required to be free of prevalent cardiovascular disease, with ejection fraction ≥50%, and no more than stage III Chronic Kidney Disease...
January 1, 2017: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/29223646/exploring-the-effects-of-dpp-4-inhibitors-on-the-kidney-from-the-bench-to-clinical-trials
#13
REVIEW
Giuseppe Coppolino, Christian Leporini, Laura Rivoli, Francesco Ursini, Eugenio Donato di Paola, Valeria Cernaro, Franco Arturi, Davide Bolignano, Emilio Russo, Giovambattista De Sarro, Michele Andreucci
Dipeptidyl-peptidase-4 (DPP-4) inhibitors are a relatively new class of non-insulin glucose-lowering agents, belonging to the incretin family, which are able to improve glycemic control with a favorable safety profile, since they are associated with a low risk of hypoglycemia, no weight gain, and good tolerability in patients with chronic renal failure. Some experimental and clinical studies suggest that these drugs may exert significant pleiotropic effects, in particular on chronic kidney disease (CKD) progression, but data from clinical trials are still controversial...
December 6, 2017: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/29218066/arterial-stiffness-and-hypertension-which-comes-first
#14
Monica Ecobici, Claudiu Stoicescu
Arterial hypertension is one of the traditional risk factors involved in the development of cardiovascular events, while arterial stiffness is an independent predictor of cardiovascular disease in patients with hypertension. It seems that the risk factors involved in the pathology of uncontrolled hypertension are similar to those that contribute to the development of arterial stiffness. After evidence showed that arterial stiffness is an independent prognostic factor for the occurrence of cardiovascular events in patients with arterial hypertension, the importance of assessing arterial stiffness was recognized in a document drafted by the European Society of Hypertension in 2007...
September 2017: Mædica
https://www.readbyqxmd.com/read/29217879/iga-dominant-infection-related-glomerulonephritis-in-india-a-single-center-experience
#15
J Dhanapriya, T Balasubramaniyan, S P Maharajan, T Dineshkumar, R Sakthirajan, N Gopalakrishnan, M Nagarajan
IgA-dominant infection-related glomerulonephritis (IRGN) is a distinct morphologic variant of IRGN, characterized by dominant or codominant glomerular deposits of IgA, mostly in elderly and patients with diabetes. More cases are being reported in recent times due to increased awareness of the disease entity and increased rate of Staphylococcus infection. It usually presents as rapidly progressive renal failure with proteinuria, and treatment guidelines for this disease entity are not well defined. We report here 12 cases of IgA-dominant IRGN seen over a period of 5 years from a single center...
November 2017: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/29216260/angiotensin-receptor-blockers-are-associated-with-lower-mortality-than-ace-inhibitors-in-predialytic-stage-5-chronic-kidney-disease-a-nationwide-study-of-therapy-with-renin-angiotensin-system-blockade
#16
Chih-Ching Lin, Yu-Te Wu, Wu-Chang Yang, Min-Juei Tsai, Jia-Sin Liu, Chi-Yu Yang, Szu-Yuan Li, Shuo-Ming Ou, Der-Cherng Tarng, Chih-Cheng Hsu
Dual renin angiotensin system (RAS) blockade using angiotensin-receptor blockers (ARBs) in combination with angiotensin converting enzyme inhibitors (ACEIs) is reported to improve proteinuria in both diabetic and non-diabetic patients. However, its renoprotective effect and safety remain uncertain in patients with advanced chronic kidney disease (CKD). From January 1, 2000 through June 30, 2009, we enrolled 14,117 pre-dialytic stage 5 CKD patients with serum creatinine >6mg/dL and hematocrit <28% under the treatment with erythropoiesis stimulating agents and RAS blockade...
2017: PloS One
https://www.readbyqxmd.com/read/29208058/low-protein-diet-supplemented-with-ketoacids-delays-the-progression-of-diabetic-nephropathy-by-inhibiting-oxidative-stress-in-the-kkay-mice-model
#17
Dongmei Liu, Ming Wu, Lin Li, Xiang Gao, Bo Yang, Shuqin Mei, Lili Fu, Changlin Mei
Diabetic nephropathy (DN) is a major cause of chronic kidney disease. We aimed to investigate the effect of the low-protein diets (LPD) supplemented with ketoacids (LPD+KA) in KKAy mice, an early type 2 DN model. KKAy mice were treated with normal protein diet (NPD), LPD or LPD+KA from 12 to 24 weeks of age. A period of 12-week treatment with LPD significantly reduced albuminuria as compared with that observed after NPD treatment. Treatment with LPD+KA further reduced albuminuria as compared with that observed with LPD treatment alone...
December 6, 2017: British Journal of Nutrition
https://www.readbyqxmd.com/read/29207225/-association-between-vertebral-fractures-and-vascular-calcifications
#18
REVIEW
Giovanni Piscopo, Luigi Morrone
Several cross-sectional and prospective studies highlight the existence of an association between bone fractures and abdominal aortic calcifications, especially if particularly severe and independent from confounders such as aging, smoking habits and diabetes. This phenomenon affects not only the general population but also patients with chronic kidney disease in which cortical bone lesions are prevalent. Moreover, bone fractures and aortic calcifications have been proved to be linked to increased cardiovascular morbidity and mortality, both in the general populations and in patients with chronic kidney disease, who notoriously show elevated cardiovascular risks...
December 5, 2017: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/29202452/systemic-inflammation-is-associated-with-exaggerated-skeletal-muscle-protein-catabolism-in-maintenance-hemodialysis-patients
#19
Serpil M Deger, Adriana M Hung, Jorge L Gamboa, Edward D Siew, Charles D Ellis, Cindy Booker, Feng Sha, Haiming Li, Aihua Bian, Thomas G Stewart, Roy Zent, William E Mitch, Naji N Abumrad, T Alp Ikizler
BACKGROUND: Systemic inflammation and muscle wasting are highly prevalent and coexist in patients on maintenance hemodialysis (MHD). We aimed to determine the effects of systemic inflammation on skeletal muscle protein metabolism in MHD patients. METHODS: Whole body and skeletal muscle protein turnover were assessed by stable isotope kinetic studies. We incorporated expressions of E1, E214K, E3αI, E3αII, MuRF-1, and atrogin-1 in skeletal muscle tissue from integrin β1 gene KO CKD mice models...
November 16, 2017: JCI Insight
https://www.readbyqxmd.com/read/29193154/prevalence-and-predictors-of-peripheral-neuropathy-in-non-diabetic-children-with-chronic-kidney-disease
#20
Sangeetha Yoganathan, Arvind Bagga, Sheffali Gulati, G S Toteja, Pankaj Hari, Aditi Sinha, Ravindra Mohan Pandey, Mohammad Irshad
INTRODUCTION: The aim of this study was to determine the prevalence and predictors of peripheral neuropathy in non-diabetic children with chronic kidney disease (CKD). METHODS: Fifty-one consecutive normally nourished children, aged 3-18 years, with CKD stage IV and V of non-diabetic etiology were enrolled from May to December 2012. Nerve conduction studies were performed in fifty children. Blood samples were analyzed for the biochemical parameters, trace elements and micronutrients...
November 29, 2017: Muscle & Nerve
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