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Dialysis cardiac disease

Nazem Akoum, Leila R Zelnick, Ian H de Boer, Irl B Hirsch, Dace Trence, Connor Henry, Nicole Robinson, Nisha Bansal
BACKGROUND AND OBJECTIVES: Cardiac arrhythmias increase mortality and morbidity in CKD. We evaluated the rates of subclinical arrhythmias in a population with type 2 diabetes and patients with moderate to severe CKD who were not on dialysis. DESIGN, SETTING, PARTICIPANTS & MEASUREMENTS: This is a prospective observational study, using continuous ambulatory cardiac monitors to determine the rate of atrial and ventricular arrhythmias, as well as conduction abnormalities in this group...
March 19, 2019: Clinical Journal of the American Society of Nephrology: CJASN
Magdalene M Assimon, M Alan Brookhart, Jennifer E Flythe
BACKGROUND: Individuals receiving maintenance hemodialysis may be particularly susceptible to the lethal cardiac consequences of drug-induced QT prolongation because they have a substantial cardiovascular disease burden and high level of polypharmacy, as well as recurrent exposure to electrolyte shifts during dialysis. Electrophysiologic data indicate that among the selective serotonin reuptake inhibitors (SSRIs), citalopram and escitalopram prolong the QT interval to the greatest extent...
March 18, 2019: Journal of the American Society of Nephrology: JASN
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
Guillaume Bayer, Florent von Tokarski, Benjamin Thoreau, Adeline Bauvois, Christelle Barbet, Sylvie Cloarec, Elodie Mérieau, Sébastien Lachot, Denis Garot, Louis Bernard, Emmanuel Gyan, Franck Perrotin, Claire Pouplard, François Maillot, Philippe Gatault, Bénédicte Sautenet, Emmanuel Rusch, Matthias Buchler, Cécile Vigneau, Fadi Fakhouri, Jean-Michel Halimi
BACKGROUND AND OBJECTIVES: Thrombotic microangiopathies constitute a diagnostic and therapeutic challenge. Secondary thrombotic microangiopathies are less characterized than primary thrombotic microangiopathies (thrombotic thrombocytopenic purpura and atypical hemolytic and uremic syndrome). The relative frequencies and outcomes of secondary and primary thrombotic microangiopathies are unknown. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We conducted a retrospective study in a four-hospital institution in 564 consecutive patients with adjudicated thrombotic microangiopathies during the 2009-2016 period...
March 12, 2019: Clinical Journal of the American Society of Nephrology: CJASN
Page Axley, Zunirah Ahmed, Sumant Arora, Allen Haas, Yong-Fang Kuo, Patrick S Kamath, Ashwani K Singal
BACKGROUND & AIMS: Acute on chronic liver failure (ACLF) among patients with cirrhosis is characterized by multiple organ failure (OF) with high short-term mortality. There is lack of population based data on trends on ACLF related morbidity and disease burden based on liver disease etiology. METHODS: National Inpatient Sample (2006-2014) was queried using the ICD-09 codes for admissions with cirrhosis and ACLF (defined with ≥2 extrahepatic organ failures)...
March 12, 2019: Liver Transplantation
Anahita Dua, Kara A Rothenberg, Karthik Mikkineni, Michael D Sgroi, Ehab Sorial, Manuel Garcia Toca
OBJECTIVE: The number of patients with end-stage renal disease who require implantable cardiac devices is increasing. Rates of secondary interventions or fistula failure are not well studied in patients who have arteriovenous fistula (AVF) access placed on the ipsilateral side as a pacemaker. This study aimed to compare central vein-related interventions and failure rates of arteriovenous access in patients with pacemakers placed on the ipsilateral vs contralateral side. METHODS: A retrospective review of a prospectively collected database at a single high-volume dialysis institution was performed; all patients 18 years or older who had both arteriovenous access and a pacemaker were included...
March 5, 2019: Journal of Vascular Surgery
Panyun Wu, Fei Luo, Zhenfei Fang
BACKGROUND: Early revascularization can lead to better prognosis in multivessel coronary artery disease (CAD) patients with chronic kidney disease (CKD). However, whether coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI) is better remains unknown. METHODS: We searched PubMed and the Cochrane Library database from inception until December 9, 2017, for articles that compare outcomes of CABG and PCI in multivessel CAD patients with CKD...
March 7, 2019: Cardiorenal Medicine
Diana Cimpoesu, Mihaela Corlade-Andrei, Tudor Ovidiu Popa, Gabriela Grigorasi, Catalin Bouros, Luciana Rotaru, Paul Lucian Nedelea
BACKGROUND: Cardiopulmonary resuscitation (CPR) in special circumstances includes the emergency intervention for special causes, special environments, and special patients. Special causes cover the potential reversible causes of cardiac arrest that must be identified or excluded during any resuscitation act. The special environments section includes recommendations for the treatment of cardiac arrest occurring in specific locations: cardiac surgery, catheterization laboratory, dialysis unit, dental surgery, commercial airplanes or air ambulances, playing field, difficult environment (eg, drowning, high altitude, avalanche, and electrical injuries) or mass casualty incident...
March 2019: American Journal of Therapeutics
Zubaid Rafique, Tahar Chouihed, Alexandre Mebazaa, W Frank Peacock
Hyperkalaemia is a common electrolyte abnormality and can cause life-threatening cardiac arrhythmia. Even though it is common in patients with diabetes, heart failure, and kidney disease, there is poor consensus over its definition and wide variability in its treatment. Medications used to treat hyperkalaemia in the emergent setting do not have robust efficacy and safety data to guide treatment leading to mismanagement due to poor choice of some agents or inappropriate dosing of others. Moreover, the medications used in the emergent setting are at best temporizing measures, with dialysis being the definitive treatment...
February 2019: European Heart Journal Supplements: Journal of the European Society of Cardiology
N Singh, N Pattanashetti, K Joshi, H S Kohli, K L Gupta, R Ramachandran
A 63-year-old diabetic gentleman with microvascular complications presented with advanced azotemia and anemia. He was stabilized with blood transfusion and hemodialysis. With the probable diagnosis of diabetic nephropathy-related end-stage renal disease, he underwent kidney transplantation. He had delayed graft function. Graft biopsy done on the 2nd postoperative day showed acute tubular necrosis. Graft biopsy repeated after 2 weeks for persistent graft dysfunction showed myeloma cast nephropathy (MCN) and light chain proximal tubulopathy...
January 2019: Indian Journal of Nephrology
Mario Pacilio, Silvio Borrelli, Giuseppe Conte, Roberto Minutolo, Antonino Musumeci, Giuliano Brunori, Patrizia Veniero, Vincenzo De Falco, Michele Provenzano, Luca De Nicola, Carlo Garofalo
The appropriate vascular access for hemodialysis in patients with cardiac implantable electronic devices (CIED) is undefined. We describe two cases of end-stage renal disease patients with CIED and tunneled central venous catheter (CVC) who developed venous cava stenosis: (1) a 70-year-old man with sinus node disease and pacemaker in 2013, CVC, and a Brescia-Cimino forearm fistula in 2015; (2) a 75-year-old woman with previous ventricular arrhythmia with implanted defibrillator in 2014 and CVC in 2016. In either case, after about 1 year from CVC insertion, patients developed superior vena cava (SVC) syndrome due to stenosis diagnosed by axial computerized tomography...
February 27, 2019: Cardiorenal Medicine
Varunsiri Atti, Nileshkumar J Patel, Varun Kumar, Byomesh Tripathi, Mir B Basir, Michele Voeltz, Usman Baber, Annapoorna S Kini, Samin K Sharma, William W O'Neill, Deepak L Bhatt
BACKGROUND: Survival after percutaneous coronary intervention (PCI) in acute myocardial infarction complicated by cardiogenic shock (AMI-CS) has increased over the years. Short-term readmission rates in this high-risk population remain unknown. METHODS: We queried the United States (U.S.) Nationwide Readmission Database (NRD) from January 2010 to November 2014 using the International Classification of Diseases-Ninth edition, Clinical Modification (ICD-9 CM) codes to identify all patients ≥18 years readmitted within 30 days after surviving an index hospitalization for PCI in AMI-CS...
February 27, 2019: Catheterization and Cardiovascular Interventions
Mohamed A El-Gamasy, Wegdan H Mawlana
Cardiac disease is a significant cause of morbidity and mortality in children with end-stage renal disease (ESRD). The aim of this work was to study the risk factors and prevalence of cardiac diseases in Egyptian pediatric patients with ESRD under regular hemodialysis (HD). Sixty-six children with ESRD on regular HD were included and subjected to history, clinical, laboratory, chest X-rays (CXR), ECG, and two-dimensional echocardiographic study to measure different echocardiographic parameters focusing on the left ventricular ejection fraction...
January 2019: Saudi Journal of Kidney Diseases and Transplantation
Vikas Srinivasan Sridhar, Michael Chen, Howard Gerson, Elizabeth MacNamara, Sharon J Nessim
Background: Cardiac troponins are the preferred biomarker to diagnose myocardial injury. Complicating the interpretation of serial troponins in patients with end-stage renal disease, it has been shown that the hemodialysis procedure results in a small but significant decline in high-sensitivity cardiac troponins (hs-cTnT). This raises the possibility that continuous renal replacement therapy (CRRT) might similarly alter cardiac troponin levels and affect their interpretation when cardiac ischemia is being considered...
2019: Canadian Journal of Kidney Health and Disease
Hatice Ayan, Rabia Akilli, Bulent Kaya, Saime Paydas, Ertan Kara, Asligul Cureoglu
OBJECTIVES: In patients with advanced-stage chronic kidney disease, renal insufficiency, arterial stiffness, and vascular calcification are strong predictors of cardiovascular risk. Signal peptide-CUB-EGF-like protein-1 (SCUBE1) levels increase during platelet activation and acute ischemic events. Here, we evaluated associations between SCUBE1 levels and electrocardiographic/echocardiographic findings, epicardial adipose tissue thickness, and carotid intimamedia thickness in patients with chronic kidney disease...
January 2019: Experimental and Clinical Transplantation
David M Shahian, David F Torchiana, Daniel T Engelman, Thoralf M Sundt, Richard S D'Agostino, Ann F Lovett, Matthew J Cioffi, James D Rawn, Vladimir Birjiniuk, Robert H Habib, Sharon-Lise T Normand
OBJECTIVES: Beginning in 2002, all 14 Massachusetts nonfederal cardiac surgery programs submitted Society of Thoracic Surgeons (STS) National Database data to the Massachusetts Data Analysis Center for mandatory state-based analysis and reporting, and to STS for nationally benchmarked analyses. We sought to determine whether longitudinal prevalences and trends in risk factors and observed and expected mortality differed between Massachusetts and the nation. METHODS: We analyzed 2003 to 2014 expected (STS predicted risk of operative [in-hospital + 30-day] mortality), observed, and risk-standardized isolated coronary artery bypass graft mortality using Massachusetts STS data (N = 39,400 cases) and national STS data (N = 1,815,234 cases)...
December 31, 2018: Journal of Thoracic and Cardiovascular Surgery
Vaka Kristin Sigurjonsdottir, Paul Charles Grimm
PURPOSE OF REVIEW: Kidney transplantation is the preferred treatment modality for children with end-stage renal disease. In this review, we discuss the factors affecting the selection of the appropriate donor to ensure the best possible short and long-term outcomes. RECENT FINDINGS: Outcomes of pediatric renal transplantation from living donors are superior to those obtained from deceased donors. Despite this, the rate of living donor kidney transplantation has declined over the last decade...
February 11, 2019: Current Opinion in Pediatrics
Bo Yang, Elizabeth L Norton, Reilly Hobbs, Linda Farhat, Xiaoting Wu, Whitney E Hornsby, Karen M Kim, Himanshu J Patel, G Michael Deeb
OBJECTIVE: The study objective was to evaluate the perioperative and long-term outcomes of aortic root repair and aortic root replacement and provide evidence for root management in acute type A aortic dissection. METHODS: From 1996 to 2017, 491 patients underwent aortic root repair (n = 307) or aortic root replacement (n = 184) (62% bioprosthesis) for acute type A aortic dissection. Indications for aortic root replacement were intimal tear at the aortic root, root measuring 4...
December 21, 2018: Journal of Thoracic and Cardiovascular Surgery
Amrita Ayer, Claire Mills, Catherine Donovan, Robert H Christenson, Peter Ganz, Ruth F Dubin
INTRODUCTION: Patients with end-stage renal disease (ESRD) have reduced endothelial function, but whether macro- and microvascular endothelial function correlate with baseline risk factors and cardiovascular outcomes in this population is not well understood. METHODS: Among 146 participants of the Cardiac, Endothelial Function and Arterial Stiffness in ESRD (CERES) study, we evaluated macro- and microvascular endothelial dysfunction as flow-mediated dilation (FMD) and velocity time integral (VTI), respectively...
February 6, 2019: Hemodialysis International
Tushar Kotecha, Ana Martinez-Naharro, Suree Yoowannakul, Tabitha Lambe, Tamer Rezk, Daniel S Knight, Philip N Hawkins, James C Moon, Vivek Muthurangu, Peter Kellman, Roby D Rakhit, Julian D Gillmore, Paramjit Jeetley, Andrew Davenport, Marianna Fontana
In patients with chronic kidney disease (CKD), reverse left ventricular (LV) remodelling, including reduction in LV mass, can be observed following long-term haemodialysis (HD) and has been attributed to regression of LV hypertrophy. However, LV mass can vary in response to changes in myocyte volume, edema, or fibrosis. The aims of this study were to investigate the acute changes in structural (myocardial mass and biventricular volumes) and tissue characterization parameters (native T1 and T2) following HD using cardiovascular magnetic resonance (CMR)...
February 4, 2019: Scientific Reports
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