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Diabetes in CKD

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https://www.readbyqxmd.com/read/28213568/estimated-glomerular-filtration-rate-and-albuminuria-are-associated-with-biomarkers-of-cardiac-injury-in-a-population-based-cohort-study-the-maastricht-study
#1
Remy J H Martens, Dorien M Kimenai, Jeroen P Kooman, Coen D A Stehouwer, Frans E S Tan, Otto Bekers, Pieter C Dagnelie, Carla J H van der Kallen, Abraham A Kroon, Karel M L Leunissen, Frank M van der Sande, Nicolaas C Schaper, Simone J S Sep, Miranda T Schram, Jeroen D van Suijlen, Marja P van Dieijen-Visser, Steven J R Meex, Ronald M A Henry
BACKGROUND: Chronic kidney disease (CKD) is associated with an increased cardiovascular disease mortality risk. It is, however, less clear at what point in the course from normal kidney function to CKD the association with cardiovascular disease appears. Studying the associations of estimated glomerular filtration rate (eGFR) and albuminuria with biomarkers of (subclinical) cardiac injury in a population without substantial CKD may clarify this issue. METHODS: We examined the cross-sectional associations of eGFR and urinary albumin excretion (UAE) with high-sensitivity cardiac troponin (hs-cTn) T, hs-cTnI, and N-terminal probrain natriuretic-peptide (NT-proBNP) in 3103 individuals from a population-based diabetes-enriched cohort study...
February 17, 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/28212407/epidemiology-of-low-proteinuric-chronic-kidney-disease-in-renal-clinics
#2
Luca De Nicola, Michele Provenzano, Paolo Chiodini, Silvio Borrelli, Luigi Russo, Antonio Bellasi, Domenico Santoro, Giuseppe Conte, Roberto Minutolo
CKD patients with low-grade proteinuria (LP) are common in nephrology clinics. However, prevalence, characteristics, and the competing risks of ESRD and death as the specific determinants, are still unknown. We analyzed epidemiological features of LP status in a prospective cohort of 2,340 patients with CKD stage III-V referred from ≥6 months in 40 nephrology clinics in Italy. LP status was defined as proteinuria <0.5 g/24h according to current KDIGO guidelines. Patients with higher proteinuria constituted the control group (CON)...
2017: PloS One
https://www.readbyqxmd.com/read/28209636/a-randomized-crossover-trial-of-dietary-sodium-restriction-in-stage-3-4-ckd
#3
Rajiv Saran, Robin L Padilla, Brenda W Gillespie, Michael Heung, Scott L Hummel, Vimal Kumar Derebail, Bertram Pitt, Nathan W Levin, Fansan Zhu, Samer R Abbas, Li Liu, Peter Kotanko, Philip Klemmer
BACKGROUND AND OBJECTIVES: Patients with chronic kidney disease (CKD) are often volume expanded and hypertensive. Few controlled studies have assessed the effects of a sodium-restricted diet (SRD) in CKD. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We conducted a randomized crossover trial to evaluate the effect of SRD (target <2 g sodium per day) versus usual diet on hydration status (by bioelectrical impedance spectroscopy) and blood pressure (BP) between May of 2009 and May of 2013...
February 16, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28209453/-detection-and-classification-of-chronic-kidney-disease-in-primary-care-and-importance-of-albuminuria
#4
P J Labrador, S González-Sanchidrián, S Polanco, E Davin, J M Fuentes, J R Gómez-Martino
INTRODUCTION: Chronic kidney disease (CKD) is a public health problem, and Primary Care (PC) plays a key role in its detection and classification based on estimated glomerular filtration rate (eGFR), as well as the level of albuminuria for its proper management. The aim of this study was to analyse the prevalence and classification of CKD in patients attended in PC. MATERIAL AND METHODS: An analysis was made of CKD prevalence and classification according to the Kidney Disease-Improving Global Outcomes guidelines in PC patients...
February 13, 2017: Semergen
https://www.readbyqxmd.com/read/28208907/current-practice-of-hypertension-in-india-focus-on-blood-pressure-goals
#5
Jagdish S Hiremath, Vijay M Katekhaye, Vijay S Chamle, Rishi M Jain, Amit I Bhargava
INTRODUCTION: Recommended Blood Pressure (BP) goals in elderly and those with co-morbid conditions like Diabetes Mellitus (DM) and Chronic Kidney Disease (CKD) vary in different Hypertension (HTN) management guidelines. AIM: To understand currently followed BP goals and practices among the physicians involved in management of HTN in India. MATERIALS AND METHODS: A cross-sectional, observational survey was conducted at 66(th) annual conference of Cardiological Society of India (CSICON-2014, Hyderabad)...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28198732/intensive-blood-pressure-lowering-in-chronic-kidney-disease-the-time-has-come
#6
Marcel Ruzicka, Swapnil Hiremath
PURPOSE OF REVIEW: Release of the findings from the Systolic Blood Pressure Intervention Trial has resulted in a renewed examination of intensive blood pressure (BP) lowering. Only a few national hypertension guidelines (Canada and Australia) have changed recommendations, but considerable heterogeneity still exists with respect to the patient population to whom intensive BP lowering may apply. RECENT FINDINGS: There is fairly robust evidence that lower BP targets in nondiabetic chronic kidney disease (CKD) results in a decrease in heart failure and mortality...
February 13, 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/28198091/impact-of-chronic-kidney-disease-on-2-year-clinical-outcomes-in-patients-treated-with-6-month-or-24-month-dapt-duration-an-analysis-from-the-prodigy-trial
#7
Giuseppe Gargiulo, Andrea Santucci, Raffaele Piccolo, Anna Franzone, Sara Ariotti, Andrea Baldo, Giovanni Esposito, Aris Moschovitis, Stephan Windecker, Marco Valgimigli
OBJECTIVES: To assess whether moderate-to-severe CKD is a treatment modifier for benefit or harm in patients randomly allocated to 24-month versus 6-month DAPT. BACKGROUND: It is still unclear whether chronic kidney disease CKD should impact on the decision-making on optimal duration of dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI). METHODS AND RESULTS: PRODIGY trial randomized 1970 all-comer patients at 24-month versus 6-month DAPT after PCI...
February 15, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28196649/diabetes-control-and-the-risks-of-esrd-and-mortality-in%C3%A2-patients%C3%A2-with-ckd
#8
Sankar D Navaneethan, Jesse D Schold, Stacey E Jolly, Susana Arrigain, Wolfgang C Winkelmayer, Joseph V Nally
BACKGROUND: Diabetes is the leading cause of end-stage renal disease (ESRD) and a significant contributor to mortality in the general population. We examined the associations of hemoglobin A1c (HbA1c) levels with ESRD and death in a population with diabetes and chronic kidney disease (CKD). STUDY DESIGN: Cohort study. SETTING & PARTICIPANTS: 6,165 patients with diabetes (treated with oral hypoglycemic agents and/or insulin) and CKD stages 1 to 5 at a large health care system...
February 10, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28187786/low-renal-replacement-therapy-incidence-among-slowly-progressing-elderly-chronic-kidney-disease-patients-referred-to-nephrology-care-an-observational-study
#9
Ulrika Hahn Lundström, Alessandro Gasparini, Rino Bellocco, Abdul Rashid Qureshi, Juan-Jesus Carrero, Marie Evans
BACKGROUND: Elderly patients with advanced chronic kidney disease (CKD) have a high risk of death before reaching end-stage kidney disease. In order to allocate resources, such as advanced care nephrology where it is most needed, it is essential to know which patients have the highest absolute risk of advancing to renal replacement therapy (RRT). METHODS: We included all nephrology-referred CKD stage 3b-5 patients in Sweden 2005-2011 included in the Swedish renal registry (SRR-CKD) who had at least two serum creatinine measurements one year apart (+/- 6 months)...
February 10, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28185105/evaluation-of-the-framingham-heart-study-risk-factors-and-risk-score-for-incident-chronic-kidney-disease-at-10%C3%A2-years-in-a-thai-general-population
#10
Krittika Saranburut, Prin Vathesatogkit, Anchalee Chittamma, Somlak Vanavanan, Nisakron Thongmung, Tuangrat Tangstheanphan, Piyamitr Sritara, Chagriya Kitiyakara
PURPOSE: Asians have some of the highest rates of end-stage renal disease, but there is limited information on the risk factors for chronic kidney disease (CKD) in the Asian general population. A risk score for incident CKD for the general population has been developed from the US Framingham Heart Study (FHS) Offspring cohort. This score has been validated on Caucasians and African-Americans, but has not been tested on Asians. We aimed to assess the importance of the FHS risk factors and the performance of the FHS risk score in predicting incident CKD at 10 years in a Thai community-based population...
February 9, 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28183314/dpp-4-inhibition-has-no-acute-effect-on-bnp-and-its-n-terminal-pro-hormone-measured-by-commercial-immune-assays-a-randomized-cross-over-trial-in-patients-with-type-2-diabetes
#11
Gian Paolo Fadini, Benedetta Maria Bonora, Mattia Albiero, Martina Zaninotto, Mario Plebani, Angelo Avogaro
BACKGROUND: Use of dipeptidyl peptidase-4 inhibitors (DPP4-i) for the treatment of type 2 diabetes (T2D) has been associated with a possible increase in the risk for heart failure (HF). B-type natriuretic peptide (BNP), which is both a biomarker of HF and a hemodynamically active hormone, is a substrate of DPP-4. We herein tested the acute effects of the DPP-4i linagliptin on BNP and NT-proBNP in a cross-over placebo-controlled trial in patients with T2D with and without chronic kidney disease (CKD)...
February 10, 2017: Cardiovascular Diabetology
https://www.readbyqxmd.com/read/28182761/kidney-function-and-specific-mortality-in-60-80-years-old-post-myocardial-infarction-patients-a-10-year-follow-up-study
#12
Ellen K Hoogeveen, Johanna M Geleijnse, Erik J Giltay, Sabita S Soedamah-Muthu, Janette de Goede, Linda M Oude Griep, Theo Stijnen, Daan Kromhout
Chronic kidney disease (CKD) is highly prevalent among older post-myocardial infarction (MI) patients. It is not known whether CKD is an independent risk factor for mortality in older post-MI patients with optimal cardiovascular drug-treatment. Therefore, we studied the relation between kidney function and all-cause and specific mortality among older post-MI patients, without severe heart failure, who are treated with state-of-the-art pharmacotherapy. From 2002-2006, 4,561 Dutch post-MI patients were enrolled and followed until death or January 2012...
2017: PloS One
https://www.readbyqxmd.com/read/28182041/assessment-of-health-related-quality-of-life-and-its-determinants-in-patients-with-chronic-kidney-disease
#13
M Manavalan, A Majumdar, K T Harichandra Kumar, P S Priyamvada
Health-related quality of life is an important, yet neglected aspect of chronic kidney disease (CKD) care. We evaluated the quality of life and its determinants across CKD 3 to 5D using a kidney disease specific tool (Kidney Disease Quality of Life-SF™) in an underprivileged, predominantly rural population with high rates of illiteracy and unemployment. The scores of individual domains were summarized to three composite scores - physical composite summary (PCS), mental composite summary (MCS), and kidney disease component summary score (KDCS)(...
January 2017: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/28181150/effectiveness-of-targeted-screening-for-chronic-kidney-disease-in-the-community-setting-a-systematic-review
#14
Pankti A Gheewala, Syed Tabish R Zaidi, Matthew D Jose, Luke Bereznicki, Gregory M Peterson, Ronald L Castelino
BACKGROUND: Targeted screening interventions for chronic kidney disease (CKD) are increasingly being implemented in various community settings. However, the overall success of these programs is uncertain. Therefore, the aim of this review is to determine whether targeted screening is effective in detecting people with undiagnosed CKD. METHODS: We performed a systematic literature review, and included studies of targeted screening intervention implemented in any community-based setting...
February 8, 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/28178698/dipeptidyl-peptidase-4-inhibitors-in-chronic-kidney-disease-a-systematic-review-of-randomized-clinical-trials
#15
Simon R Walker, Paul Komenda, Suhail Khojah, Wafa Al-Tuwaijri, Kerry MacDonald, Brett Hiebert, Neil Tangri, Stewart W D Nadurak, Thomas W Ferguson, Claudio Rigatto, Navdeep Tangri
BACKGROUND: Chronic kidney disease (CKD) is common in patients with type 2 diabetes mellitus (T2DM) and limits therapeutic options. Dipeptidyl peptidase-4 (DPP-4) inhibitors represent a novel class of oral glucose-lowering agents and are known to be safe and effective in the general population. METHODS: We searched Cochrane, EMBASE, and PubMed from the time of their inception until March 2015. We included randomized controlled trials analyzing the efficacy (change in hemoglobin A1C [HbA1C]) and safety of DPP-4 agents in individuals with reduced kidney function (estimated glomerular filtration rate <60 mL/min/1...
February 9, 2017: Nephron
https://www.readbyqxmd.com/read/28177140/serum-phosphate-is-associated-with-fracture-risk-the-rotterdam-study-and-mros
#16
N Campos-Obando, W N H Koek, E R Hooker, B C J van der Eerden, H A Pols, A Hofman, J P T M van Leeuwen, A G Uitterlinden, C M Nielson, M C Zillikens
Extreme phosphate levels (P) have been associated with mineralization defects and increased fracture risk. Whether P within normal range is related to bone health in the general population is not well understood. To investigate the association of P with bone mineral density (BMD) and fracture risk, we assessed two population-based cohorts: the Dutch Rotterdam Study (RS-I, RS-II, RS-III; n = 6791) and the US Osteoporotic Fractures in Men (MrOS; n = 5425) study. The relationship of P with lumbar spine (LS) and femoral neck (FN) BMD was tested in all cohorts via linear models; fracture risk was tested in RS-I, RS-II and MrOS through Cox models, after follow-up of 8...
February 8, 2017: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
https://www.readbyqxmd.com/read/28177092/-newer-anti-diabetic-therapies-and-chronic-kidney-disease
#17
Luca Di Lullo, Claudio Ronco, Vincenzo Barbera, Mario Cozzolino, Francesca Santoboni, Annalisa Villani, Antonio De Pascalis, Antonio Bellasi
Worldwide, an estimated 200 million people have chronic kidney disease (CKD), whose most common causes include hypertension, arteriosclerosis, and diabetes. About 40% of patients with diabetes develop CKD. Intensive blood glucose control through pharmacological intervention can delay CKD progression. Standard therapies for the treatment of type 2 diabetes include metformin, sulfonylureas, meglitinides, thiazolidinediones and insulin. While these drugs have an important role in the management of type 2 diabetes, only the thiazolidinedione pioglitazone can be used across the spectrum of CKD (stages 25) and without dose adjustment...
January 2017: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/28176820/dipstick-proteinuria-level-is-significantly-associated-with-pre-morbid-and-in-hospital-functional-status-among-hospitalized-older-adults-a-preliminary-study
#18
Chia-Ter Chao, Hung-Bin Tsai, Chih-Kang Chiang, Jenq-Wen Huang, Kuan-Yu Hung
Although chronic kidney disease (CKD) is associated with functional decline, whether proteinuria alone is associated with functional statuses over the course of acute illnesses independent of CKD is unclear. During 2014, we prospectively enrolled non-dialysis patients aged ≥65 years, and all participants underwent spot dipstick urinalysis on admission, divided into 3 groups according to the results (none, trace to 1 + , and 2 + or higher); functional status was evaluated using the pre-morbid and in-hospital Barthel index (BI) scores...
February 8, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28166744/effect-of-large-weight-reductions-on-measured-and-estimated-kidney-function
#19
Bernt Johan von Scholten, Frederik Persson, Maria S Svane, Tine W Hansen, Sten Madsbad, Peter Rossing
BACKGROUND: When patients experience large weight loss, muscle mass may be affected followed by changes in plasma creatinine (pCr). The MDRD and CKD-EPI equations for estimated GFR (eGFR) include pCr. We hypothesised that a large weight loss reduces muscle mass and pCr causing increase in eGFR (creatinine-based equations), whereas measured GFR (mGFR) and cystatin C-based eGFR would be unaffected if adjusted for body surface area. METHODS: Prospective, intervention study including 19 patients...
February 6, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28166298/estimation-of-chronic-kidney-disease-incidence-from-prevalence-and-mortality-data-in-american-indians-with-type-2-diabetes
#20
Pavithra Vijayakumar, Annika Hoyer, Robert G Nelson, Ralph Brinks, Meda E Pavkov
The objective was to estimate chronic kidney disease (CKD) incidence rates from prevalence and mortality data, and compare the estimates with observed (true) incidence rates in a well-characterized population with diabetes. Pima Indians aged 20 years and older with type 2 diabetes were followed from 1982 through 2007. CKD was defined by estimated GFR (eGFR) <60 ml/min/1.72 m2 or albumin-to-creatinine ratio (ACR) ≥30 mg/g. True CKD incidence and mortality rates were computed for the whole study period, and prevalence for the intervals 1982-1994 and 1995-2007...
2017: PloS One
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