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Diabetic renal disease

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https://www.readbyqxmd.com/read/28743130/sglt-2-inhibition-a-potential-new-treatment-for-diabetic-kidney-disease
#1
Robert D Toto
Diabetic nephropathy is the leading cause of kidney failure. Treatments with drugs that block the renin-angiotensin system have proven beneficial in slowing kidney disease progression among those with diabetes; their benefit is limited and they do not stop disease progression. Despite multiple clinical trials of various interventions including dual blockade of the renin-angiotensin system over the past 15 years, no new therapies have emerged to slow kidney disease progression in diabetes. SGLT-2 inhibitors are a new class of antiglycemic drugs that have been shown to lower blood glucose by inhibition of the sodium-glucose transporter 2 in the proximal tubule of the kidney...
July 26, 2017: Nephron
https://www.readbyqxmd.com/read/28742648/vitamin-d-deficiency-supplementation-and-cardiovascular-health
#2
Naveen Trehan, Luis Afonso, Diane L Levine, Phillip D Levy
Vitamin D has been traditionally recognized as a vitamin quintessential for bone-mineral health. In the past 2 decades, numerous experimental and observational studies have highlighted the role of vitamin D in immunity, metabolic syndrome (obesity and diabetes), cancers, renal disease, memory, and neurological dysfunction. In this article, we review important studies that focused on the impact of vitamin D on blood pressure, myocardial infarction, peripheral arterial disease, heart failure, and statin intolerance...
September 2017: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/28742644/update-on-sglt2-inhibitors-new-data-released-at-the-american-diabetes-association
#3
Sara Lee
Sodium-glucose cotransporter 2 (SGLT2) inhibitors are one of the newer classes of antiglycemic agents approved for the management of patients with type 2 diabetes mellitus. Due to their unique mechanism of action, SGLT2 inhibitors have shown to be beneficial beyond glucose control. The improvement in cardiovascular (CV) outcomes was first observed in the landmark EMPA-REG OUTCOMES study. Following these results, numerous CV outcome trials were designed to identify whether the beneficial CV and renal effects observed with empagliflozin are unique or a drug class effect...
September 2017: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/28740847/fournier-s-gangrene-lessons-learned-from-multimodal-and-multidisciplinary-management-of-perineal-necrotizing-fasciitis
#4
Orestis Ioannidis, Loukiani Kitsikosta, Dimitris Tatsis, Ioannis Skandalos, Aggeliki Cheva, Aikaterini Gkioti, Ioannis Varnalidis, Savvas Symeonidis, Natalia Antigoni Savvala, Styliani Parpoudi, George K Paraskevas, Manousos George Pramateftakis, Efstathios Kotidis, Ioannis Mantzoros, Konstantinos George Tsalis
BACKGROUND: Fournier's gangrene (FG) is a rapidly evolving necrotizing fasciitis of the perineum and the genital area, the scrotum as it most commonly affects man in the vast majority of cases. It is polymicrobial in origin, due to the synergistic action of anaerobes and aerobes and has a very high mortality. There are many predisposing factors including diabetes mellitus, alcoholism, immunosuppression, renal, and hepatic disease. The prognosis of the disease depends on a lot of factors including but not limited to patient age, disease extent, and comorbidities...
2017: Frontiers in Surgery
https://www.readbyqxmd.com/read/28738974/partial-nephrectomy-vs-radical-nephrectomy-for-stage-i-renal-cell-carcinoma-in-the-presence-of-predisposing-systemic-diseases-for-chronic-kidney-disease
#5
Ömer Demir, Ozan Bozkurt, Serdar Çelik, Kaan Çömez, Güven Aslan, Uğur Mungan, İlhan Çelebi, Adil Esen
Aim of this study is to compare the effects of partial nephrectomy (PN) and radical nephrectomy (RN) for stage I renal cell carcinoma (RCC) on renal functions in patients with diabetes mellitus (DM) and/or hypertension (HT). Charts of patients who underwent surgery for stage I RCC in our department were retrospectively reviewed and patients with DM and/or HT were enrolled. Preoperative and postoperative estimated glomerular filtration rates (eGFR) were calculated according to the Modification of Diet in Renal Disease (MDRD) formulation for both RN and PN groups...
July 2017: Kaohsiung Journal of Medical Sciences
https://www.readbyqxmd.com/read/28738808/carotid-plaque-rather-than-intima-media-thickness-as-a-predictor-of-recurrent-vascular-events-in-patients-with-acute-ischemic-stroke
#6
Hyun Ju Yoon, Kye Hun Kim, Hyukjin Park, Jae Yeong Cho, Young Joon Hong, Hyung Wook Park, Ju Han Kim, Youngkeun Ahn, Myung Ho Jeong, Jeong Gwan Cho, Jong Chun Park
BACKGROUND: To investigate the impacts of carotid plaque and intima-media thickness (IMT) on future vascular events (VEs) in the patients with acute ischemic stroke. METHODS: A total of 479 consecutive Korean patients with acute ischemic stroke were divided into 2 groups according to development of VEs; VE group (65.4 ± 10.9 years) vs no VE group (62.8 ± 13.2 years). VEs were defined as the development of recurrent stroke, coronary events, peripheral arterial disease, and death...
July 24, 2017: Cardiovascular Ultrasound
https://www.readbyqxmd.com/read/28738364/risk-factors-for-community-acquired-pneumonia-in-adults-a-systematic-review-of-observational-studies
#7
Jordi Almirall, Mateu Serra-Prat, Ignasi Bolíbar, Valentina Balasso
We performed a systematic review of the literature to establish conclusive evidence of risk factors for community-acquired pneumonia (CAP). Observational studies (cross-sectional, case-control, and cohort studies) the primary outcome of which was to assess risk factors for CAP in both hospitalized and ambulatory adult patients with radiologically confirmed pneumonia were selected. The Newcastle-Ottawa Scale specific for cohort and case-control designs was used for quality assessment. Twenty-nine studies (20 case-control, 8 cohort, and 1 cross-sectional) were selected, with 44...
July 25, 2017: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/28734104/predictors-of-early-renal-function-decline-in-adults-with-type%C3%A2-1-diabetes-the-coronary-artery-calcification-in-type-1-diabetes-and-the-pittsburgh-epidemiology-of-diabetes-complications-studies
#8
P Bjornstad, T Costacou, R G Miller, D M Maahs, M J Rewers, T J Orchard, J K Snell-Bergeon
AIM: Diabetic kidney disease is one of the leading complications of Type 1 diabetes, but its prediction remains a challenge. We examined predictors of rapid decline in estimated GFR (eGFR) in two Type 1 diabetes cohorts: the Coronary Artery Calcification in Type 1 Diabetes (CACTI) and the Pittsburgh Epidemiology of Diabetes Complications (EDC). METHODS: A select subset of participants (CACTI: n = 210 and EDC: n = 98) diagnosed before 17 years of age with Type 1 diabetes duration ≥ 7 years, and follow-up data on eGFR by CKD-EPI creatinine for up to 8 years were included in the analyses...
July 22, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28733566/newly-diagnosed-end-stage-kidney-disease-in-a-single-centre-in-sabah
#9
K W Wong, S Lojikip, F S Chan, K W Goh, H C Pang
AIM: To study the epidemiology, clinical characteristics, vascular access, and the short term survival of ESRD patients initiated on dialysis from Hospital Queen Elizabeth (HQE). BACKGROUND: The number of patients with ESRD is increasing in Sabah, Malaysia. Most patients present late and some live in remote areas with difficult access to healthcare services. Many therefore present with potentially fatal complications. METHODS: All the newly confirmed ESRD patients who were initiated on renal replacement therapy (RRT) from 1 January to 31 December 2014 were included...
June 2017: Medical Journal of Malaysia
https://www.readbyqxmd.com/read/28733432/should-bilateral-internal-thoracic-artery-grafting-be-used-in-patients-after-recent-myocardial-infarction
#10
Dan Loberman, Dmitry Pevni, Rephael Mohr, Yosef Paz, Nahum Nesher, Mohamad Khaled Midlij, Yanai Ben-Gal
BACKGROUND: Bilateral internal thoracic artery grafting (BITA) is associated with improved survival. However, surgeons do not commonly use BITA in patients after myocardial infarction (MI) because survival is good with single internal thoracic artery grafting (SITA). We aimed to compare the outcomes of BITA with those of SITA and other approaches in patients with multivessel disease after recent MI. METHODS AND RESULTS: In total, 938 patients with recent MI (<3 months) who underwent BITA between 1996 and 2011 were compared with 682 who underwent SITA...
July 21, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28732570/incident-type-2-diabetes-is-associated-with-hdl-but-not-with-its-anti-oxidant-constituent-paraoxonase-1-the-prospective-cohort-prevend-study
#11
Setor K Kunutsor, Lyanne M Kieneker, Stephan J L Bakker, Richard W James, Robin P F Dullaart
OBJECTIVE: High-density lipoprotein cholesterol (HDL-C) is an established risk marker for cardiovascular disease and consistently associated with type 2 diabetes risk. Serum paraoxonase-1 (PON-1) - an anti-oxidant constituent of HDL - is inversely associated with cardiovascular disease risk, but its relationship with incident type 2 diabetes is uncertain. We aimed to investigate the prospective association between PON-1 and type 2 diabetes risk. METHODS: PON-1 was measured as its arylesterase activity at baseline in the Prevention of Renal and Vascular End-stage Disease (PREVEND) prospective study of 5947 predominantly Caucasian participants aged 28-75years with no pre-existing diabetes, that recorded 500 type 2 diabetes cases during a median follow-up of 11...
August 2017: Metabolism: Clinical and Experimental
https://www.readbyqxmd.com/read/28731931/renal-function-and-its-association-with-blood-pressure-in-middle-eastern-immigrants-and-native-swedes
#12
Christopher Nilsson, Anders Christensson, Peter M Nilsson, Louise Bennet
BACKGROUND: Iraqi-born immigrants residing in Sweden are at high risk for type 2 diabetes, obesity and hyperlipidemia compared with native Swedes. Paradoxically, hypertension is less prevalent in this immigrant population. The aim of this study was to investigate differences in renal function and further if differences in blood pressure (BP) levels were associated with differences across ethnicities in renal function as a possible explanation to the paradox. METHODS: A population-based, cross-sectional study of men and women, born in Iraq or Sweden, aged 30-75 years was conducted in Malmö, Sweden, from 2010 to 2012...
July 20, 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28729248/end-stage-renal-disease-versus-death-in-a-portuguese-cohort-of-elderly-patients-an-approach-using-competing-event-analysis
#13
Josefina Santos, Isabel Fonseca, Jorge Malheiro, Idalina Beirao, Luisa Lobato, Pedro Oliveira, Antonio Cabrita
Chronic kidney disease (CKD) is higher in elderly, but mortality outweighs the risk of end-stage renal disease (ESRD). Our aim was to identify prognostic markers for ESRD or death in elderly CKD, within a competing-risk analysis. This is a longitudinal study of consecutive newly referred patients with CKD ages 65 years, followed until the time of the first event (ESRD or death), using a competing-risk analysis. A modified Charlson Comorbidity Index (mCCI) was subdivided into subgroups (0-2, 3-4, ≥5). Patients were followed for hospitalizations that occurred prior to the outcomes...
July 19, 2017: Journal of Investigative Medicine: the Official Publication of the American Federation for Clinical Research
https://www.readbyqxmd.com/read/28728756/circulating-soluble-urokinase-plasminogen-activator-receptor-levels-and-peripheral-arterial-disease-outcomes
#14
Ayman Samman Tahhan, Salim S Hayek, Pratik Sandesara, Jamal Hajjari, Muhammad Hammadah, Wesley T O'Neal, Heval M Kelli, Ayman Alkhoder, Nima Ghasemzadeh, Yi-An Ko, Hiroshi Aida, Mohamad Mazen Gafeer, Naser Abdelhadi, Kareem Hosny Mohammed, Keyur Patel, Shipra Arya, Jochen Reiser, Viola Vaccarino, Laurence Sperling, Arshed Quyyumi
BACKGROUND AND AIMS: Circulating soluble urokinase plasminogen activator receptor (suPAR) is a marker of immune activation associated with atherosclerosis. Whether suPAR levels are associated with prevalent peripheral arterial disease (PAD) and its adverse outcomes remains unknown and is the aim of the study. METHODS: SuPAR levels were measured in 5810 patients (mean age 63 years, 63% male, 77% with obstructive coronary artery disease [CAD]) undergoing cardiac catheterization...
June 8, 2017: Atherosclerosis
https://www.readbyqxmd.com/read/28726774/interleukin-22-ameliorated-renal-injury-and-fibrosis-in-diabetic-nephropathy-through-inhibition-of-nlrp3-inflammasome-activation
#15
Shaofei Wang, Yubin Li, Jiajun Fan, Xuyao Zhang, Jingyun Luan, Qi Bian, Tao Ding, Yichen Wang, Ziyu Wang, Ping Song, Daxiang Cui, Xiaobin Mei, Dianwen Ju
Diabetic nephropathy (DN) is one of the most lethal complications of diabetes mellitus with metabolic disorders and chronic inflammation. Although the cytokine IL-22 was initially implicated in the pathogenesis of chronic inflammatory diseases, recent studies suggested that IL-22 could suppress inflammatory responses and alleviate tissue injury. Herein, we examined the role of IL-22 in DN. We found that serum levels of IL-22 were significantly downregulated in both patients and mice with DN. The expression of IL-22 was further decreased with the progression of DN, whereas IL-22 gene therapy significantly ameliorated renal injury and mesangial matrix expansion in mice with established nephropathy...
July 20, 2017: Cell Death & Disease
https://www.readbyqxmd.com/read/28725317/prevalence-of-metabolic-syndrome-among-the-end-stage-renal-disease-patients-on-hemodialysis
#16
Khaled A Alswat, Awwadh Althobaiti, Khulod Alsaadi, Amaal Saeed Alkhaldi, Maryam Mutlaq Alharthi, Walaa Abduraheem Abuharba, Ahmed A Alzaidi
BACKGROUND: Patients with metabolic syndrome (MetS) have a 2.6-fold greater risk of incident chronic kidney disease (CKD). The primary goal of this study was to assess the prevalence of MetS in patients with end-stage renal disease (ESRD) who are on hemodialysis (HD) and the impact of MetS presence on HD-related outcomes. METHODS: This is a cross-sectional study conducted in the Dialysis Center, King Abdulaziz Specialist Hospital, Taif, Saudi Arabia. It was conducted among ESRD patients that attended the Dialysis Center between August 2013 and September 2016...
August 2017: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/28723880/prevalence-and-clinical-characteristics-of-white-coat-hypertension-based-on-different-definition-criteria-in-untreated-and-treated-patients
#17
Alejandro de la Sierra, Ernest Vinyoles, José R Banegas, Julián Segura, Manuel Gorostidi, Juan J de la Cruz, Luis M Ruilope
BACKGROUND AND AIM: The prevalence and associated risks of white-coat hypertension (WCH) are still a matter of debate. We aimed to assess differences in prevalence and associated conditions of WCH defined on the basis of the normality of all daytime, night-time, and 24-h blood pressure (BP), only daytime, or only 24-h BP. METHODS: We selected 115 708 patients (45 020 untreated and 70 688 treated) from the Spanish Ambulatory BP Monitoring Registry. WCH was estimated in patients with elevated office BP (≥140 and/or 90 mmHg) by using normal daytime (<135/85) BP, normal 24-h BP (<130/80), or normal daytime, night-time (<120/70) and 24-h BP...
July 18, 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28721687/practical-approach-to-initiating-sglt2-inhibitors-in-type-2-diabetes
#18
REVIEW
Fernando Gomez-Peralta, Cristina Abreu, Albert Lecube, Diego Bellido, Alfonso Soto, Cristóbal Morales, Miguel Brito-Sanfiel, Guillermo Umpierrez
Sodium-glucose co-transporter 2 (SGLT2) inhibitors are an attractive novel therapeutic option for the treatment of type 2 diabetes. They block the reabsorption of filtered glucose in kidneys, mainly in proximal renal tubules, resulting in increased urinary glucose excretion and correction of the diabetes-related hyperglycemia. Beyond improving glucose control, SGLT2 inhibitors offer potential benefits by reducing body weight and blood pressure. On the basis of the efficacy demonstrated in clinical trials, SGLT2 inhibitors are recommended as second- or third-line agents for the management of patients with type 2 diabetes...
July 18, 2017: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://www.readbyqxmd.com/read/28721497/normoalbuminuric-diabetic-kidney-disease
#19
REVIEW
Chao Chen, Chang Wang, Chun Hu, Yachun Han, Li Zhao, Xuejing Zhu, Li Xiao, Lin Sun
Diabetic kidney disease (DKD) is one of the primary causes of end-stage renal disease (ESRD). Early diagnosis is very important in preventing the development of DKD. Urinary albumin excretion rate (UAER) and glomerular filtration rate (GFR) are widely accepted as criteria for the diagnosis and clinical grading of DKD, and microalbuminuria has been recommended as the first clinical sign of DKD. The natural history of DKD has been divided into three stages: normoalbuminuria, microalbuminuria, and macroalbuminuria...
July 18, 2017: Frontiers of Medicine
https://www.readbyqxmd.com/read/28721320/detection-of-chronic-kidney-disease-by-using-different-equations-of-glomerular-filtration-rate-in-patients-with-type-2-diabetes-mellitus-a-cross-sectional-analysis
#20
Sojib Bin Zaman
Introduction Chronic kidney disease (CKD) is a global threat due to its high mortality. It is essential to know the actual magnitude of diabetic CKD to design a specific management program. However, there is limited knowledge regarding the most suitable equation to measure CKD in patients with Type 2 diabetes mellitus (T2DM). This paper aimed to analyze estimated glomerular filtration rate (eGFR) based on different equations to detect the CKD among T2DM.  Methods A hospital-based cross-sectional study was carried out, and a clinical registry was used to collect 4,042 T2DM patients from a large district hospital in Northeast Thailand...
June 14, 2017: Curēus
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