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Chronic kidney disease cardiovascular

Alexandru Burlacu, Simonetta Genovesi, Alberto Ortiz, Christian Combe, Carlo Basile, Daniel Schneditz, Frank van der Sande, Grigore T Popa, Cornel Morosanu, Adrian Covic
Dialysis patients manifest both an increased thrombotic risk and a haemorrhagic tendency. A great number of patients with chronic kidney disease requiring dialysis have cardiovascular comorbidities (coronary artery disease, atrial fibrillation or venous thromboembolism) and different indications for treatment with antithrombotics (primary or secondary prevention). Unfortunately, few randomized controlled trials deal with antiplatelet and/or anticoagulant therapy in dialysis. Therefore cardiology and nephrology guidelines offer ambiguous recommendations and often exclude or ignore these patients...
March 16, 2019: Nephrology, Dialysis, Transplantation
Maaz Syed-Ahmed, Mohanram Narayanan
Cardiovascular disease and infections are directly or indirectly associated with an altered immune response, which leads to a high incidence of morbidity and mortality, and together, they account for up to 70% of all deaths among patients with chronic kidney dysfunction. Impairment of the normal reaction of the innate and adaptive immune systems in chronic kidney disease predisposes patients to an increased risk of infections, virus-associated cancers, and a diminished vaccine response. On the other hand, an abnormal, exaggerated reaction of the immune systems can also occur in this group of patients, resulting in increased production and decreased clearance of proinflammatory cytokines, which can lead to inflammation and its sequelae (eg, atherosclerotic cardiovascular disease)...
January 2019: Advances in Chronic Kidney Disease
Snigdha Reddy, Chandrika Chitturi, Jerry Yee
Infections after cardiovascular disease are the second most common cause of death in the chronic kidney disease population. Vaccination is an important component of maintaining health and wellness in patients with kidney disease. There is a changing epidemiologic landscape for several vaccine-preventable illnesses from childhood to adulthood and unfounded public perception of safety concerns. Several mechanisms have been proposed to cause inadequate vaccine protection in this high-risk group with chronic kidney disease...
January 2019: Advances in Chronic Kidney Disease
Qiongjing Yuan, Jinwei Wang, Zhangzhe Peng, Qiaoling Zhou, Xiangcheng Xiao, Yanyun Xie, Wei Wang, Ling Huang, Wenbin Tang, Danni Sun, Luxia Zhang, Fang Wang, Ming-Hui Zhao, Lijian Tao, Kevin He, Hui Xu
BACKGROUND: Chronic kidney disease (CKD) leads to end-stage renal failure and cardiovascular events. An attribute to these progressions is abnormalities in inflammation, which can be evaluated using the neutrophil-to-lymphocyte ratio (NLR). We aimed to investigate the association of NLR with the progression of end stage of renal disease (ESRD), cardiovascular disease (CVD) and all-cause mortality in Chinese patients with stages 1-4 CKD. METHODS: Patients with stages 1-4 CKD (18-74 years of age) were recruited at 39 centers in 28 cities across 22 provinces in China since 2011...
March 15, 2019: Journal of Translational Medicine
Silvia Lai, Maurizio Muscaritoli, Paola Andreozzi, Alessandro Sgreccia, Sabrina De Leo, Sandro Mazzaferro, Anna Paola Mitterhofer, Marzia Pasquali, Paolo Protopapa, Alessandra Spagnoli, Maria Ida Amabile, Alessio Molfino
OBJECTIVE: Chronic kidney disease (CKD) is a condition with high cardiovascular mortality associated with emerging risk factors, including sarcopenia. Several mechanisms can affect muscle mass, such as vitamin D deficiency, low protein intake, physical inactivity, metabolic acidosis, and inflammation leading to a worsening of cardiovascular outcomes and cognitive function. We aimed to evaluate the prevalence of sarcopenia in CKD patients on conservative and replacement therapy and the associations between sarcopenia and markers of atherosclerosis, endothelial dysfunction, psychological and cognitive function...
December 11, 2018: Nutrition
Chang Kyu Lee, Sun Kyu Choi, Dong Ah Shin, Seong Yi, Yoon Ha, Keung Nyun Kim, Insoo Kim
PURPOSE: To evaluate the relationship between comorbidities, medical cost, and surgical outcome in patients with lumbar spinal stenosis (LSS) and diabetes mellitus (DM). METHODS: Data on patients with LSS (n = 14,298) were collected from the Korean National Health Insurance Service database from 2005 to 2007. After 8 years of follow-up, a "DM group" (n = 3,478) and a "non-DM group" (n = 10,820) were compared according to outcome measures. Cox proportional hazard regressions were performed to examine the relationship between DM, hypertension (HTN), cardiovascular disease (CVD), chronic kidney disease (CKD), cerebrovascular disease (CbVD), and surgery for LSS...
2019: PloS One
Dimitrios Poulikakos, Katerina Hnatkova, Sofia Skampardoni, Darren Green, Philip Kalra, Marek Malik
Sudden Cardiac Death (SCD) is the leading cause of cardiovascular death in dialysis patients. This review discusses potential underlying arrhythmic mechanisms of SCD in the dialysis population. It examines recent evidence from studies using implantable loop recorders and from electrophysiological studies in experimental animal models of chronic kidney disease. The review summarizes advances in the field of non-invasive electrophysiology for risk prediction in dialysis patients focusing on the predictive value of the QRS-T angle and of the assessments of autonomic imbalance by means of heart rate variability analysis...
2019: Frontiers in Physiology
Ophélie Fourdinier, Eva Schepers, Valérie Metzinger-Le Meuth, Griet Glorieux, Sophie Liabeuf, Francis Verbeke, Raymond Vanholder, Benjamin Brigant, Anneleen Pletinck, Momar Diouf, Stéphane Burtey, Gabriel Choukroun, Ziad A Massy, Laurent Metzinger
Several microRNAs (miRNAs) have been linked to chronic kidney disease (CKD) mortality, cardiovascular (CV) complications and kidney disease progression. However, their association with clinical outcomes remains poorly evaluated. We used real-time qPCR to measure serum levels of miR-126 and miR-223 in a large cohort of 601 CKD patients (CKD stage G1 to G5 patients or on renal replacement therapy - CKD G5D) from Ghent University Hospital and 31 healthy controls. All-cause mortality and cardiovascular and renal events were registered as endpoints over a 6 year follow-up period...
March 14, 2019: Scientific Reports
Vincent Brandenburg, Gunnar Heine
In patients with chronic cardio renal syndrome chronic heart disease coexists with chronic kidney disease and poses the patients to a specifically high risk for cardiovascular events and mortality. Treatment recommendations in this condition with a high level of evidence are sparse. Mainstay of therapy in cardiorenal syndrome is fluid metabolism control and stabilization of renal and cardiac function, which can basically been achieved by substances modifying the renin-angiotensin-aldosterone-system as well as diuretics...
March 2019: Deutsche Medizinische Wochenschrift
Neeraj Dhaun, David J Webb
Cardiovascular disease is a major contributor to global morbidity and mortality and is the common end point of many chronic diseases. The endothelins comprise three structurally similar peptides of 21 amino acids in length. Endothelin 1 (ET-1) and ET-2 activate two G protein-coupled receptors - endothelin receptor type A (ETA ) and endothelin receptor type B (ETB ) - with equal affinity, whereas ET-3 has a lower affinity for ETA . ET-1 is the most potent vasoconstrictor in the human cardiovascular system and has remarkably long-lasting actions...
March 13, 2019: Nature Reviews. Cardiology
Kathryn King-Shier, Hude Quan, M K Kapral, Ross Tsuyuki, Libin An, Suvro Banerjee, Danielle A Southern, Nadia Khan
OBJECTIVES: Successful treatment of acute coronary syndrome (ACS) relies on its rapid recognition. It is unclear whether the accepted presentation of chest pain applies to different ethnic groups. We thus examined potential ethnic variations in ACS symptoms and clinical care outcomes in white, South Asian and Chinese patients. DESIGN: Cross-sectional survey. SETTING: Participants were hospitalised at 1 of 12 Canadian centres across four provinces...
March 13, 2019: BMJ Open
Dragana Komnenov, Peter E Levanovich, Noreen F Rossi
Hypertension is a leading cause of cardiovascular and chronic renal disease. Despite multiple important strides that have been made in our understanding of the etiology of hypertension, the mechanisms remain complex due to multiple factors, including the environment, heredity and diet. This review focuses on dietary contributions, providing evidence for the involvement of elevated fructose and salt consumption that parallels the increased incidence of hypertension worldwide. High fructose loads potentiate salt reabsorption by the kidney, leading to elevation in blood pressure...
March 7, 2019: Nutrients
Takuji Toyama, Shu Kasama, Makito Sato, Hirokazu Sano, Tetsuya Ueda, Toyoshi Sasaki, Takehiro Nakahara, Tetsuya Higuchi, Yoshito Tsushima, Masahiko Kurabayashi
Patients with chronic kidney disease (CKD) have an increased risk of adverse cardiovascular/cerebrovascular events. The aim of this study is to clarify whether stress myocardial perfusion single-photon emission computed tomography (SPECT) could predict cardiovascular/cerebrovascular events. In the Gunma-CKD SPECT Study, a multicenter prospective cohort trial, 311 patients with CKD (estimated glomerular filtration rate < 60 min/mL/1.73 m2) including 50 patients on hemodialysis underwent stress 99mTc-tetrofosmin SPECT for suspected ischemic heart disease and were followed for 2 years...
March 13, 2019: Cardiology
Joan Valls, Serafí Cambray, Carles Pérez-Guallar, Milica Bozic, Marcelino Bermúdez-López, Elvira Fernández, Àngels Betriu, Isabel Rodríguez, José M Valdivielso
Chronic kidney disease (CKD) is a major risk factor for end-stage renal disease, cardiovascular disease and premature death. Despite classical clinical risk factors for CKD and some genetic risk factors have been identified, the residual risk observed in prediction models is still high. Therefore, new risk factors need to be identified in order to better predict the risk of CKD in the population. Here, we analyzed the genetic association of 79 SNPs of proteins associated with mineral metabolism disturbances with CKD in a cohort that includes 2,445 CKD cases and 559 controls...
2019: Frontiers in Genetics
Jean-Philippe Bastard, Camille Couffignal, Soraya Fellahi, Jean-Marie Bard, France Mentre, Dominique Salmon, Christine Katlama, François Raffi, Leport Catherine, Capeau Jacqueline
AIM: - Ageing HIV-infected patients controlled by antiretroviral therapy (ART) frequently present age-related comorbidities, such as cardiovascular (CV) events, diabetes, dyslipidaemia, hypertension and chronic kidney disease (CKD). The prevalence of these comorbidities was evaluated in a cohort of long-term-monitored ART-controlled HIV-infected patients, then followed by a search into whether oxidative stress, like inflammation, might be associated with metabolic parameters and/or comorbidities...
March 9, 2019: Diabetes & Metabolism
Yazan Ranneh, Abdah Md Akim, Hasiah Ab Hamid, Huzwah Khazaai, Abdulmannan Fadel, Ayman M Mahmoud
Background: Epidemiological and experimental studies have extensively indicated that chronic subclinical systemic inflammation (CSSI) and oxidative stress are risk factors for several chronic diseases, including cancer, arthritis, type 2 diabetes, and cardiovascular and neurodegenerative diseases. This study examined the protective effect of stingless bee honey (SBH) supplementation against lipopolysaccharide (LPS)-induced CSSI, pointing to the possible involvement of NF-κB, p38 MAPK and Nrf2 signaling...
2019: Nutrition & Metabolism
Gudrun Evén, Jonas Spaak, Magnus von Arbin, Åsa Franzén-Dahlin, Terese Stenfors
Introduction: Person-centered care (PCC) appears particularly suitable for patients with complex diseases and in multidisciplinary care. However, previous research tends to focus on each profession and condition separately. Purpose: We studied how health care professionals (HCPs) understand PCC, and whether their clinical practice is aligned with their theoretical understanding, when starting clinical practice at a novel multidisciplinary clinic. Methods: In total, 16 semi-structured interviews with HCPs and 31 non-participatory observations of outpatient meetings and other activities at the clinic such as team meetings were conducted at a multidisciplinary, integrated outpatient clinic in Sweden...
2019: Journal of Multidisciplinary Healthcare
Francesco Franchi, Stefan K James, Tatevik Ghukasyan Lakic, Andrzej J Budaj, Jan H Cornel, Hugo A Katus, Matyas Keltai, Frederic Kontny, Basil S Lewis, Robert F Storey, Anders Himmelmann, Lars Wallentin, Dominick J Angiolillo
Background There are limited data on how the combination of diabetes mellitus ( DM ) and chronic kidney disease ( CKD ) affects cardiovascular outcomes as well as response to different P2Y12 receptor antagonists, which represented the aim of the present investigation. Methods and Results In this post hoc analysis of the PLATO (Platelet Inhibition and Patient Outcomes) trial, which randomized acute coronary syndrome patients to ticagrelor versus clopidogrel, patients (n=15 108) with available DM and CKD status were classified into 4 groups: DM +/ CKD + (n=1058), DM +/ CKD - (n=2748), DM -/ CKD + (n=2160), and DM -/ CKD - (n=9142)...
March 19, 2019: Journal of the American Heart Association
Agnieszka Kuchta, Agnieszka Ćwiklińska, Monika Czaplińska, Ewa Wieczorek, Barbara Kortas-Stempak, Anna Gliwińska, Kamil Dąbkowski, Kornelia Sałaga-Zaleska, Agnieszka Mickiewicz, Alicja Dębska-Ślizień, Ewa Król, Maciej Jankowski
In chronic kidney disease (CKD), the level of high-density lipoprotein (HDL) decreases markedly, but there is no strong inverse relationship between HDL-cholesterol (HDL-C) and cardiovascular diseases. This indicates that not only the HDL-C level, but also the other quantitative changes in the HDL particles can influence the protective functionality of these particles, and can play a key role in the increase of cardiovascular risk in CKD patients. The aim of the present study was the evaluation of the parameters that may give additional information about the HDL particles in the course of progressing CKD...
March 9, 2019: International Journal of Molecular Sciences
Mette Louise Blouner Gram Kjærulff, Birgitte Schmidt Astrup
PURPOSE: To report a case in which autopsy findings and data from an insulin pump illustrate the course up to the death of a 31-year-old man with a history of type 1 diabetes mellitus who was found dead in his apartment with his insulin pump disassembled and placed in another room. METHODS: Autopsy findings including histological, toxicological and biochemical examination are presented. Postmortem download of data from the insulin pump gave the history of the pump, which included blood glucose, insulin bolus, carbohydrate intake and the time course in the days to death, and the pump settings were recorded...
February 26, 2019: Journal of Forensic and Legal Medicine
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