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Chronic kidney disease and cardiovascular disease

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By Gabi Djab Nephrologist
Ana Luísa Pinheiro da Silva, Manuel Joaquim Vaz da Silva
The Acute Dialysis Quality Initiative consensus conference proposed a classification of cardiorenal syndrome (CRS), aiming for a better delineation of each subtype. Although the exact pathophysiology of type 4 CRS is not completely understood, the mechanisms involved are probably multifactorial. There is growing evidence that oxidative stress is a major connector in the development and progression of type 4 CRS. Giving its complexity, poor prognosis and increasing incidence, type 4 CRS is becoming a significant public health problem...
October 3, 2016: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
Maryam Afkarian, Leila R Zelnick, Yoshio N Hall, Patrick J Heagerty, Katherine Tuttle, Noel S Weiss, Ian H de Boer
IMPORTANCE: Diabetic kidney disease is the leading cause of chronic and end-stage kidney disease in the United States and worldwide. Changes in demographics and treatments may affect the prevalence and clinical manifestations of diabetic kidney disease. OBJECTIVE: To characterize the clinical manifestations of kidney disease among US adults with diabetes over time. DESIGN, SETTING, AND PARTICIPANTS: Serial cross-sectional studies of adults aged 20 years or older with diabetes mellitus participating in National Health and Nutrition Examination Surveys from 1988 through 2014...
August 9, 2016: JAMA: the Journal of the American Medical Association
Stein I Hallan, Marius A Øvrehus, Solfrid Romundstad, Dena Rifkin, Arnulf Langhammer, Paul E Stevens, Joachim H Ix
Surveillance of chronic kidney disease (CKD) prevalence over time and information on how changing risk factors influence this trend are needed to evaluate the effects of general practice and public health interventions. Because very few studies addressed this, we studied the total adult population of a demographically stable county representative of Norway using cross-sectional studies 10 years apart (Nord-Trøndelag Health Study (HUNT)2 and Nord-Trøndelag Health Study (HUNT)3, 65,237 and 50,586 participants, respectively)...
September 2016: Kidney International
Jerry Fan, Hasan Salameh
BACKGROUND: Chronic kidney disease (CKD) accounts for a significant proportion of the morbidity and mortality in the United States. CKD is defined as glomerular filtration rate (GFR) <60ml/min/1.73m2 or clear evidence of renal damage from biopsy. All-cause cardiovascular risk increases with decreasing GFR. Clinically, detection of CKD is through changes in creatinine clearance which estimates GFR, an indicator of kidney function. We reviewed conventional and nonconventional cardiovascular risk factors associated with CKD...
July 22, 2016: Current Vascular Pharmacology
Alan S Go
Chronic kidney disease, defined as reduced glomerular filtration rate (estimated using serum creatinine- and/or serum cystatin C-based equations) or excess urinary protein excretion, affects approximately 13% of adult Americans and is linked to a variety of clinical complications. Although persons with end-stage renal disease requiring chronic dialysis therapy experience a substantially high cardiovascular burden, whether mild-to-moderate chronic kidney disease is an independent risk factor for fatal and nonfatal cardiovascular events has been more controversial...
July 2016: Seminars in Nephrology
Philip Masson, Sradha Kotwal, Patrick J Kelly, Jonathan C Craig, Richard I Lindley, Martin Gallagher, Alan Cass, Angela C Webster
BACKGROUND: It is unclear how traditional cardiovascular risk factors and different treatment modalities for end-stage kidney disease (ESKD) affect stroke risk in people with ESKD. We aimed to identify the risk factors for stroke (ischemic and hemorrhagic) in people with ESKD. METHODS: We conducted a retrospective cohort study using data linkage between the Australian and New Zealand Dialysis and Transplant Registry, clinical and administrative datasets. Using Cox proportional hazards models, we estimated the magnitudes of risk of hospitalization with different subtypes of strokes associated with traditional cardiovascular risk factors and ESKD treatment modalities (hemodialysis (HD), peritoneal dialysis (PD) and kidney transplantation)...
August 10, 2016: Cerebrovascular Diseases
Jieli Lu, Yiming Mu, Qing Su, Lixin Shi, Chao Liu, Jiajun Zhao, Lulu Chen, Qiang Li, Tao Yang, Li Yan, Qin Wan, Shengli Wu, Yan Liu, Guixia Wang, Zuojie Luo, Xulei Tang, Gang Chen, Yanan Huo, Zhengnan Gao, Zhen Ye, Youmin Wang, Guijun Qin, Huacong Deng, Xuefeng Yu, Feixia Shen, Li Chen, Liebin Zhao, Jichao Sun, Wanwan Sun, Tiange Wang, Rui Du, Lin Lin, Meng Dai, Yu Xu, Min Xu, Yufang Bi, Shenghan Lai, Donghui Li, Weiqing Wang, Guang Ning
BACKGROUND: Chronic kidney disease (CKD) increases cardiovascular disease (CVD) risk. However, the association of mildly reduced kidney function with CVD risk is unclear. METHODS AND RESULTS: This study investigated the association of estimated glomerular filtration rate (eGFR) with prevalent CVDs, 10-year Framingham risk for coronary heart disease (CHD), and 10-year risk of atherosclerotic cardiovascular diseases (ASCVD) in 239 832 participants from the baseline of the Risk Evaluation of cAncers in Chinese diabeTic Individuals: a lONgitudinal study...
2016: Journal of the American Heart Association
Jing Chen, Emile R Mohler, Pranav S Garimella, L Lee Hamm, Dawei Xie, Stephen Kimmel, Raymond R Townsend, Matthew Budoff, Qiang Pan, Lisa Nessel, Susan Steigerwalt, Jackson T Wright, Jiang He
BACKGROUND: The clinical implications of ankle-brachial index (ABI) cutpoints are not well defined in patients with chronic kidney disease (CKD) despite increased prevalence of high ABI attributed to arterial stiffness. We examined the relationship of ABI with cardiovascular disease (CVD) and all-cause mortality among CKD patients. METHODS AND RESULTS: Three thousand six hundred twenty-seven participants without clinical peripheral artery disease (PAD) at baseline from the Chronic Renal Insufficiency Cohort Study were included...
June 2016: Journal of the American Heart Association
Patrick S Parfrey, Tilman B Drüeke, Geoffrey A Block, Ricardo Correa-Rotter, Jürgen Floege, Charles A Herzog, Gerard M London, Kenneth W Mahaffey, Sharon M Moe, David C Wheeler, Yumi Kubo, Bastian Dehmel, William G Goodman, Glenn M Chertow
BACKGROUND AND OBJECTIVES: The calcimimetic cinacalcet reduced the risk of death or cardiovascular (CV) events in older, but not younger, patients with moderate to severe secondary hyperparathyroidism (HPT) who were receiving hemodialysis. To determine whether the lower risk in younger patients might be due to lower baseline CV risk and more frequent use of cointerventions that reduce parathyroid hormone (kidney transplantation, parathyroidectomy, and commercial cinacalcet use), this study examined the effects of cinacalcet in older (≥65 years, n=1005) and younger (<65 years, n=2878) patients...
May 7, 2015: Clinical Journal of the American Society of Nephrology: CJASN
Casey M Rebholz, Cheryl A M Anderson, Morgan E Grams, Lydia A Bazzano, Deidra C Crews, Alex R Chang, Josef Coresh, Lawrence J Appel
BACKGROUND: As part of its 2020 Impact Goals, the American Heart Association developed the Life's Simple 7 metric for cardiovascular health promotion. The relationship between the Life's Simple 7 metric and incident chronic kidney disease (CKD) is unknown. METHODS AND RESULTS: We estimated the association between Life's Simple 7 and incident CKD in 14 832 Atherosclerosis Risk in Communities study participants. Ideal levels of Life's Simple 7 health factors were the following: nonsmoker or quit >1 year ago; body mass index <25 kg/m(2); ≥150 minutes/week of physical activity; healthy dietary pattern (high in fruits and vegetables, fish, and fiber-rich whole grains; low in sodium and sugar-sweetened beverages); total cholesterol <200 mg/dL; blood pressure <120/80 mm Hg; and fasting blood glucose <100 mg/dL...
April 2016: Journal of the American Heart Association
Teodora Vichova, Jiri Knot, Jaroslav Ulman, Marek Maly, Zuzana Motovska
BACKGROUND: Patients with diabetes mellitus (DM) or chronic kidney disease (CKD) have a high risk of acute myocardial infarction and recurrent cardiovascular events. According to the previous studies, the combination of the two conditions may have a synergistic impact on prognosis. The aim of this study was to assess the impact of stage of CKD on the outcomes of patients with DM and ST-elevation myocardial infarction (STEMI) treated with percutaneous coronary intervention (PCI). METHODS: Study population consisted of 946 consecutive patients with STEMI who underwent PCI from January 2009 to December 2012 and were followed up until the end of 2013...
July 2016: International Urology and Nephrology
Bogdan Ene-Iordache, Norberto Perico, Boris Bikbov, Sergio Carminati, Andrea Remuzzi, Annalisa Perna, Nazmul Islam, Rodolfo Flores Bravo, Mirna Aleckovic-Halilovic, Hequn Zou, Luxia Zhang, Zaghloul Gouda, Irma Tchokhonelidze, Georgi Abraham, Mitra Mahdavi-Mazdeh, Maurizio Gallieni, Igor Codreanu, Ariunaa Togtokh, Sanjib Kumar Sharma, Puru Koirala, Samyog Uprety, Ifeoma Ulasi, Giuseppe Remuzzi
BACKGROUND: Chronic kidney disease is an important cause of global mortality and morbidity. Data for epidemiological features of chronic kidney disease and its risk factors are limited for low-income and middle-income countries. The International Society of Nephrology's Kidney Disease Data Center (ISN-KDDC) aimed to assess the prevalence and awareness of chronic kidney disease and its risk factors, and to investigate the risk of cardiovascular disease, in countries of low and middle income...
May 2016: Lancet Global Health
Maleeka Ladhani, Jonathan C Craig, Michelle Irving, Philip A Clayton, Germaine Wong
BACKGROUND: Obesity is a risk factor for cardiovascular disease and death in people without chronic kidney disease (CKD), but the effect of obesity in people with CKD is uncertain. METHODS: Medline and Embase (from inception to January 2015) were searched for cohort studies measuring obesity by body mass index (BMI), waist:hip ratio (WHR) and/or waist circumference (WC) and all-cause and cardiovascular mortality or events in patients with any stage of CKD. Data were summarized using random effects models...
May 4, 2016: Nephrology, Dialysis, Transplantation
L Di Lullo, R Rivera, V Barbera, A Bellasi, M Cozzolino, D Russo, A De Pascalis, D Banerjee, F Floccari, C Ronco
Chronic kidney disease (CKD) patients demonstrate higher rates of cardiovascular mortality and morbidity; and increased incidence of sudden cardiac death (SCD) with declining kidney failure. Coronary artery disease (CAD) associated risk factors are the major determinants of SCD in the general population. However, current evidence suggests that in CKD patients, traditional cardiovascular risk factors may play a lesser role. Complex relationships between CKD-specific risk factors, structural heart disease, and ventricular arrhythmias (VA) contribute to the high risk of SCD...
August 15, 2016: International Journal of Cardiology
Oluseyi A Adejumo, Enajite I Okaka, George Madumezia, Chimezie G Okwuonu, Louis I Ojogwu
BACKGROUND: Cardiovascular risk factors are responsible for cardiovascular disease and rapid progression of chronic kidney disease (CKD) to end-stage renal disease. Prompt evaluation, modification, and treatment of these factors in predialysis patients will reduce morbidity and mortality. This study assessed some cardiovascular risk factors in predialysis CKD patients in a tertiary hospital in Southern Nigeria. PATIENTS AND METHODS: This was a case-control study that involved 76 consecutive predialysis CKD patients and 38 age-and sex-matched controls without CKD over 1 year period...
November 2015: Nigerian Medical Journal: Journal of the Nigeria Medical Association
Natalie Ebert, Olga Jakob, Jens Gaedeke, Markus van der Giet, Martin K Kuhlmann, Peter Martus, Nina Mielke, Mirjam Schuchardt, Markus Tölle, Volker Wenning, Elke S Schaeffner
BACKGROUND: Although CKD is said to increase among older adults, epidemiologic data on kidney function in people ≥70 years of age are scarce. The Berlin Initiative Study (BIS) aims to fill this gap by evaluating the CKD burden in older adults. METHODS: The BIS is a prospective population-based cohort study whose participants are members of Germany's biggest insurance company. This cross-sectional analysis (i) gives a detailed baseline characterization of the participants, (ii) analyses the representativeness of the cohort's disease profile, (iii) assesses GFR and albuminuria levels across age categories, (iv) associates cardiovascular risk factors with GFR as well as albuminuria and (v) compares means of GFR values according to different estimating equations with measured GFR...
May 9, 2016: Nephrology, Dialysis, Transplantation
Dean Campbell, Matthew R Weir
Chronic kidney disease (CKD) is prevalent in more than 20 million people in the United States. The majority of care provided to patients with this disease comes from primary care physicians, although it is often poorly understood. After an extensive literature review, it is clear that it can be difficult to classify and there are many barriers to care. Risk factors for both incident CKD and disease progression include hypertension, poor glycemic control, sociodemographic factors, acute kidney injury, metabolic acidosis, and possibly hyperuricemia and dietary factors...
July 2015: Journal of Clinical Hypertension
Marwa A Sabe, Brian Claggett, Emmanuel A Burdmann, Akshay S Desai, Peter Ivanovich, Reshma Kewalramani, Eldrin F Lewis, John J V McMurray, Kurt A Olson, Patrick Parfrey, Scott D Solomon, Marc A Pfeffer
BACKGROUND: Although clear evidence shows that chronic kidney disease is a predictor of cardiovascular events, death, and accelerated coronary artery disease (CAD) progression, it remains unknown whether CAD is a predictor of progression of chronic kidney disease to end-stage renal disease. We sought to assess whether CAD adds prognostic information to established predictors of progression to dialysis in patients with chronic kidney disease, diabetes, and anemia. METHODS AND RESULTS: Using the previously described Trial to Reduce Cardiovascular Events With Aranesp Therapy (TREAT) population, we compared baseline characteristics of patients with and without CAD...
April 2016: Journal of the American Heart Association
Yuanjie Pang, Yingying Sang, Shoshana H Ballew, Morgan E Grams, Gerardo Heiss, Josef Coresh, Kunihiro Matsushita
BACKGROUND AND OBJECTIVES: Carotid intima-media thickness has been reported to predict kidney function decline. However, whether carotid intima-media thickness is associated with a hard kidney end point, ESRD, has not been investigated. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We studied 13,197 Atherosclerosis Risk in Communities participants at visit 1 (1987-1989) without history of cardiovascular disease, including coronary heart disease, stroke, and heart failure, at baseline and assessed whether carotid intima-media thickness measured by B-mode ultrasound is associated with ESRD risk using Cox proportional hazards models...
July 7, 2016: Clinical Journal of the American Society of Nephrology: CJASN
Márcio G Kiuchi, Decio Mion
Several studies have shown a strong independent association between chronic kidney disease (CKD) and cardiovascular events, including death, heart failure, and myocardial infarction. Recent clinical trials extend this range of adverse cardiovascular events, also including ventricular arrhythmias and sudden cardiac death. Furthermore, other studies suggest structural remodeling of the heart and electrophysiological alterations in this population. These processes may explain the increased risk of arrhythmia in kidney disease and help to identify patients who are at increased risk of sudden cardiac death...
March 2016: Kidney Research and Clinical Practice
2016-04-16 15:56:28
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