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Diabetes in CKD

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https://www.readbyqxmd.com/read/28540891/chronic-renal-failure-an-autopsy-study
#1
Anitha Padmanabhan, Sanjay Gohil, N M Gadgil, Prerna Sachdeva
Diabetes and hypertension are at present the major causes of chronic kidney disease (CKD) and end-stage renal disease (ESRD) worldwide. The stages 0-5 of CKD are defined according to the estimated glomerular filtration rate. The term chronic renal failure (CRF) typically corresponds to CKD stages 3-5. Cardiovascular disease is the main cause of morbidity and mortality in patients of CRF and ESRD. This study was undertaken to analyze the age and sex incidence, clinical features, etiology, pathology of various organs in detail, and causes of death of CRF patients...
May 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28540059/obesity-and-kidney-disease-hidden-consequences-of-the-epidemic
#2
EDITORIAL
Csaba P Kovesdy, Susan L Furth, Carmine Zoccali
Obesity has become a worldwide epidemic, and its prevalence has been projected to grow by 40% in the next decade. This increasing prevalence has implications for the risk of diabetes, cardiovascular disease, and also for chronic kidney disease (CKD). A high body mass index is one of the strongest risk factors for new-onset CKD. In individuals affected by obesity, a compensatory hyperfiltration occurs to meet the heightened metabolic demands of the increased body weight. The increase in intraglomerular pressure can damage the kidneys and raise the risk of developing CKD in the long term...
2017: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/28537783/association-of-mild-to-moderate-reduction-in-glomerular-filtration-rate-with-subclinical-atherosclerosis-in-postmenopausal-women
#3
Florina Parv, Andrei Beceanu, Rodica Avram, Romulus Zorin Timar, Bogdan Timar, Florica Gadalean
BACKGROUND: Due to loss of hormonal protective effects, postmenopausal women have an increased cardiovascular (CV) risk. Chronic kidney disease (CKD) is a well-established risk factor for CV disease, but little is known whether mild-to-moderate kidney dysfunction is associated with atherosclerosis burden in the postmenopausal asymptomatic women. MATERIALS AND METHODS: Subclinical atherosclerosis was evaluated in 125 postmenopausal women with no clinical form of atherosclerosis, by carotid and femoral ultrasonography, ankle-brachial index (ABI), and flow-mediated dilation (FMD)...
May 24, 2017: Journal of Women's Health
https://www.readbyqxmd.com/read/28535811/pesticide-exposures-and-chronic-kidney-disease-of-unknown-etiology-an-epidemiologic-review
#4
REVIEW
Mathieu Valcke, Marie-Eve Levasseur, Agnes Soares da Silva, Catharina Wesseling
The main causes of chronic kidney disease (CKD) globally are diabetes and hypertension but epidemics of chronic kidney disease of unknown etiology (CKDu) occur in Central America, Sri Lanka, India and beyond. Althoug also being observed in women, CKDu concentrates among men in agricultural sectors. Therefore, suspicions fell initially on pesticide exposure, but currently chronic heat stress and dehydration are considered key etiologic factors. Responding to persistent community and scientific concerns about the role of pesticides, we performed a systematic review of epidemiologic studies that addressed associations between any indicator of pesticide exposure and any outcome measure of CKD...
May 23, 2017: Environmental Health: a Global Access Science Source
https://www.readbyqxmd.com/read/28533146/bioactive-lipids-derived-from-arachidonic-acid-metabolism-in-different-types-of-renal-replacement-therapy
#5
Joanna Stępniewska, Barbara Dołęgowska, Kamila Puchałowicz, Edyta Gołembiewska, Kazimierz Ciechanowski
INTRODUCTION: Metabolism and plasma concentration of lipids and lipid-derived compounds play an important role in kidney physiology and pathological processes. The component of membrane phospholipids - arachidonic acid (AA) and its active derivatives - eicosanoids are involved in the development of hypertension, diabetes, inflammation and may contribute to progression of chronic kidney disease (CKD). The purpose of the study was to determine, whether the type of renal replacement therapy has an effect on eicosanoids metabolism...
May 19, 2017: Chemistry and Physics of Lipids
https://www.readbyqxmd.com/read/28532555/integration-of-care-in-management-of-ckd-in-resource-limited-settings
#6
REVIEW
Ikechi G Okpechi, Aminu K Bello, Oluwatoyin I Ameh, Charles R Swanepoel
The prevalence of noncommunicable diseases, including chronic kidney disease (CKD), continues to increase worldwide, and mortality from noncommunicable diseases is projected to surpass communicable disease-related mortality in developing countries. Although the treatment of CKD is expensive, unaffordable, and unavailable in many developing countries, the current structure of the health care system in such countries is not set up to deliver comprehensive care for patients with chronic conditions, including CKD...
May 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28529721/the-impact-of-antihypertensives-on-kidney-disease
#7
REVIEW
Diego F Marquez, Gema Ruiz-Hurtado, Luis Ruilope
Arterial hypertension and chronic kidney disease (CKD) are intimately related. The control of blood pressure (BP) levels is strongly recommended in patients with CKD in order to protect the kidney against the accompanying elevation in global cardiovascular (CV) risk. Actually, the goal BP in patients with CKD involves attaining values <140/90 mmHg except if albuminuria is present. In this case, it is often recommended to attain values <130/80 mmHg, although some guidelines still recommend <140/90 mmHg...
2017: F1000Research
https://www.readbyqxmd.com/read/28526542/two-year-outcome-and-risk-factors-for-mortality-in-patients-with-coronary-artery-disease-and-renal-failure-the-prospective-observational-cad-ref-registry
#8
Christiane Engelbertz, Holger Reinecke, Günter Breithardt, Roland E Schmieder, Manfred Fobker, Dieter Fischer, Boris Schmitz, Hans O Pinnschmidt, Karl Wegscheider, Hermann Pavenstädt, Eva Brand
BACKGROUND: Chronic kidney disease (CKD) and coronary artery disease (CAD) are strongly associated. CAD is the most frequent cause of cardiovascular death in patients with CKD. METHODS: The prospective observational nationwide multicenter Coronary Artery Disease and REnal Failure (CAD-REF) Registry enrolled 3352 patients with angiographically documented CAD classified according to their baseline estimated glomerular filtration rate (eGFR) into 5 groups according to the K/DOQI-guidelines...
May 7, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28526011/risk-of-acute-kidney-injury-and-survival-in-patients-treated-with-metformin-an-observational-cohort-study
#9
Samira Bell, Bassam Farran, Stuart McGurnaghan, Rory J McCrimmon, Graham P Leese, John R Petrie, Paul McKeigue, Naveed Sattar, Sarah Wild, John McKnight, Robert Lindsay, Helen M Colhoun, Helen Looker
BACKGROUND: Whether metformin precipitates lactic acidosis in patients with chronic kidney disease (CKD) remains under debate. We examined whether metformin use was associated with an increased risk of acute kidney injury (AKI) as a proxy for lactic acidosis and whether survival among those with AKI varied by metformin exposure. METHODS: All individuals with type 2 diabetes and available prescribing data between 2004 and 2013 in Tayside, Scotland were included. The electronic health record for diabetes which includes issued prescriptions was linked to laboratory biochemistry, hospital admission, death register and Scottish Renal Registry data...
May 19, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28525624/early-and-asymptomatic-cardiac-dysfunction-in-chronic-kidney-disease
#10
Shanmugakumar Chinnappa, Edward White, Nigel Lewis, Omer Baldo, Yu-Kang Tu, Griet Glorieux, Raymond Vanholder, Meguid El Nahas, Andrew Mooney
Background: . Heart failure (HF) is highly prevalent and associated with high mortality in chronic kidney disease (CKD). However, the pathophysiology of cardiac dysfunction in CKD, especially in the early asymptomatic stage, is not well understood. We studied subclinical cardiac dysfunction in asymptomatic CKD patients without comorbid cardiac disease or diabetes mellitus by evaluating peak cardiac performance. Methods.: In a cross-sectional study ( n  = 130) we investigated 70 male non-diabetic CKD patients (21 CKD stage 2-3a, 27 CKD stage 3b-4 and 22 CKD stage 5) employing specialized cardiopulmonary exercise testing to measure peak cardiac output and cardiac power output non-invasively...
May 19, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28522656/comparison-between-different-measures-of-body-fat-with-kidney-function-decline-and-incident-ckd
#11
Magdalena Madero, Ronit Katz, Rachel Murphy, Anne Newman, Kushang Patel, Joachim Ix, Carmen Peralta, Suzanne Satterfield, Linda Fried, Michael Shlipak, Mark Sarnak
BACKGROUND AND OBJECTIVES: Although anthropometric measures of body fat are associated with development of CKD, they may not be able to distinguish between various forms of fat and therefore may be less accurate than computed tomography (CT) measures. We compared the association of CT and anthropometric measures of obesity with kidney outcomes in the Health Aging and Body Composition Study. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Participants were recruited from March of 1997 through July of 1998...
May 18, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28522654/diabetic-kidney-disease-challenges-progress-and-possibilities
#12
Radica Z Alicic, Michele T Rooney, Katherine R Tuttle
Diabetic kidney disease develops in approximately 40% of patients who are diabetic and is the leading cause of CKD worldwide. Although ESRD may be the most recognizable consequence of diabetic kidney disease, the majority of patients actually die from cardiovascular diseases and infections before needing kidney replacement therapy. The natural history of diabetic kidney disease includes glomerular hyperfiltration, progressive albuminuria, declining GFR, and ultimately, ESRD. Metabolic changes associated with diabetes lead to glomerular hypertrophy, glomerulosclerosis, and tubulointerstitial inflammation and fibrosis...
May 18, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28522651/pregnancy-and-glomerular-disease-a-systematic-review-of-the-literature-with-management-guidelines
#13
Kimberly Blom, Ayodele Odutayo, Kate Bramham, Michelle A Hladunewich
During pregnancy, CKD increases both maternal and fetal risk. Adverse maternal outcomes include progression of underlying renal dysfunction, worsening of urine protein, and hypertension, whereas adverse fetal outcomes include fetal loss, intrauterine growth restriction, and preterm delivery. As such, pregnancy in young women with CKD is anxiety provoking for both the patient and the clinician providing care, and because the heterogeneous group of glomerular diseases often affects young women, this is an area of heightened concern...
May 18, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28521802/identification-of-chronic-kidney-disease-patient-characteristics-influencing-the-renoprotective-effects-of-febuxostat-therapy-a-retrospective-follow-up-study
#14
Akinori Yamaguchi, Makoto Harada, Yosuke Yamada, Koji Hashimoto, Yuji Kamijo
BACKGROUND: The ability of antihyperuricemic therapy to exert renoprotective effects in patients with chronic kidney disease (CKD) is controversial. In the present study, we studied patient characteristics that may mask favorable impact of antihyperuricemic therapy on the progression of CKD. METHODS: This was a single-center, retrospective, follow-up study. One-hundred and seventy-eight CKD patients with hyperuricemia who received febuxostat therapy were included in this study...
May 18, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28520799/nonenzymatic-glycosylation-of-human-serum-albumin-and-its-effect-on-antibodies-profile-in-patients-with-diabetes-mellitus
#15
Alok Raghav, Jamal Ahmad, Khursheed Alam
BACKGROUND: Albumin glycation and subsequent formation of advanced glycation end products (AGEs) correlate with diabetes and associated complications. METHODS: Human Serum Albumin (HSA) was modified with D-glucose for a 40 day period under sterile conditions at 37°C. Modified samples along with native HSA (unmodified) were analyzed for structural modifications by UV and fluorescence, FTIR, Liquid chromatography mass spectrometry (LCMS) and X-ray crystallography...
2017: PloS One
https://www.readbyqxmd.com/read/28519964/association-between-serum-25-hydroxyvitamin-d-and-glycated-hemoglobin-levels-in-type-2-diabetes-patients-with-chronic-kidney-disease
#16
Lee Ling Lim, Yong Muh Ng, Pei San Kang, Soo Kun Lim
AIMS/INTRODUCTION: Vitamin D is suggested to influence glucose homeostasis. An inverse relationship between serum 25-hydroxyvitamin D [25(OH)D] and glycemic control in non-chronic kidney disease (CKD) patients with type 2 diabetes (T2D) was reported. We aimed to examine this association among T2D patients with CKD. MATERIALS AND METHODS: 100 T2D participants with stage 3-4 CKD were recruited. Blood for HbA1c , serum 25(OH)D, renal, and lipid profiles were drawn at enrolment...
May 18, 2017: Journal of Diabetes Investigation
https://www.readbyqxmd.com/read/28514729/meglitinides-increase-the-risk-of-hypoglycemia-in-diabetic-patients-with-advanced-chronic-kidney-disease-a-nationwide-population-based-study
#17
Pei-Chen Wu, Vin-Cent Wu, Cheng-Jui Lin, Chi-Feng Pan, Chih-Yang Chen, Tao-Min Huang, Che-Hsiung Wu, Likwang Chen, Chih-Jen Wu
The safety of short-acting meglitinides in diabetic patients with advanced chronic kidney disease (CKD) has not been widely reported.Diabetic patients with advanced CKD who had a serum creatinine level of > 6 mg/dL a hematocrit level of ≦ 28% and received erythropoiesis-stimulating agent treatment between 2000 and 2010, were included in this nationwide study in Taiwan.The outcomes of interest were defined as hypoglycemia and long-term mortality. The risks of hypoglycemia and death were analyzed using Cox proportional hazards models, with end-stage renal disease and anti-diabetic drugs as time-dependent variables...
April 27, 2017: Oncotarget
https://www.readbyqxmd.com/read/28502983/alkaline-phosphatase-a-novel-treatment-target-for-cardiovascular-disease-in-ckd
#18
REVIEW
Mathias Haarhaus, Vincent Brandenburg, Kamyar Kalantar-Zadeh, Peter Stenvinkel, Per Magnusson
Cardiovascular disease is the main cause of early death in the settings of chronic kidney disease (CKD), type 2 diabetes mellitus (T2DM), and ageing. Cardiovascular events can be caused by an imbalance between promoters and inhibitors of mineralization, which leads to vascular calcification. This process is akin to skeletal mineralization, which is carefully regulated and in which isozymes of alkaline phosphatase (ALP) have a crucial role. Four genes encode ALP isozymes in humans. Intestinal, placental and germ cell ALPs are tissue-specific, whereas the tissue-nonspecific isozyme of ALP (TNALP) is present in several tissues, including bone, liver and kidney...
May 15, 2017: Nature Reviews. Nephrology
https://www.readbyqxmd.com/read/28502971/targeting-the-keap1-nrf2-system-to-prevent-kidney-disease-progression
#19
Masahiro Nezu, Norio Suzuki, Masayuki Yamamoto
BACKGROUND: Nuclear factor erythroid 2-related factor 2 (NRF2) is a critical transcription factor for the antioxidative stress response and it activates a variety of cytoprotective genes related to redox and detoxification. NRF2 activity is regulated by the oxidative-stress sensor molecule Kelch-like ECH-associated protein 1 (KEAP1) that induces proteasomal degradation of NRF2 through ubiquitinating NRF2 under unstressed conditions. Because oxidative stress is a major pathogenic and aggravating factor for kidney diseases, the KEAP1-NRF2 system has been proposed to be a therapeutic target for renal protection...
May 13, 2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/28499044/determinants-of-decline-of-renal-function-in-treated-hypertensive-patients-the-campania-salute-network
#20
Costantino Mancusi, Raffaele Izzo, Giovanni de Simone, Maria Viviana Carlino, Grazia Canciello, Eugenio Stabile, Nicola de Luca, Bruno Trimarco, Maria Angela Losi
Background.: Hypertension is a leading cause of chronic kidney disease (CKD) and a decrease in glomerular filtration rate (GFR) is associated with a higher prevalence of hypertension and an increased proportion of suboptimal blood pressure (BP) control. Methods.: To investigate characteristics associated with GFR decline, we selected 4539 hypertensive patients from the Campania Salute Network (mean age 53 ± 11 years) with at least 3 years of follow-up (FU) and no more than Stage III CKD...
May 12, 2017: Nephrology, Dialysis, Transplantation
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