Guidelines for CKD: Defining, Staging, and Managing Guidelines for CKD: Defining, Staging, and Managing
Get up-to-date on the most recent guidelines for identifying and managing patients with chronic kidney disease.Journal for Nurse Practitioners
Am J Nephrol 2017;46:257-259
Background: Cigarette smoking exacerbates the estimated glomerular filtration rate (eGFR) decline in nondiabetic chronic kidney disease (CKD) despite the kidney protection that is achieved by angiotensin converting enzyme inhibition (ACEI). Whether smoking cessation restores ACEI-related kidney protection is not known.Methods: This 5-year, prospective, prevention trial recruited 108 smokers and 108 nonsmokers with stage-2 nondiabetic CKD with primary hypertension and urine albumin-to-creatinine ratio (Ualb)>200 mg/g. All smokers underwent smoking cessation intervention programs. Blood pressure was reduced in all partici...
Since the proposal of cardio-renal syndrome, which describes diseases that involve both heart failure (HF) and acute or chronic kidney disease (CKD), kidney damage has become a topic of discussion in patients with acute HF (AHF). However, the mechanisms and pathophysiology of acute kidney injury (AKI) in AHF patients are multi-factorial and still poorly understood. We first reported AKI on admission in patients with AHF. AKI was found to be already involved in approximately 30% of patients with AHF, with the rate increasing to around 70% over the course of hospitalization.
Chronic kidney disease (CKD) is a major cardiovascular risk factor because of elevated tissue renin-angiotensin system activity in the heart. Although the (pro)renin receptor ((P)RR), specific receptor for renin and (pro)renin, is expressed in the cardiovascular system, its precise function in CKD heart has not yet been elucidated. We investigated the role of (P)RR and underlying molecular mechanism in CKD-associated heart failure using subtotal nephrectomy (STN, 5/6 kidney resection) mice and age-matched control mice treated with handle region peptide (HRP; a peptide which blocks (P)RR).
Background: While anemia can occur concomitantly with chronic kidney disease (CKD), the adverse cardiovascular effects of anemia, including heart failure (HF), remain unclear. Thus, the direct effects of anemia on the left ventricular ejection fraction (LVEF), as a marker of systolic function, and the plasma B-type natriuretic peptide (BNP) level, as a marker of cardiac overload, were investigated. Methods: Covariance structure analyses were proposed for 1536 inpatients to examine the interactions among the estimated glomerular filtration rate, hemoglobin (Hb), LVEF, and LogBNP.
In this study, we assessed intestinal iron transporters in chronic kidney disease (CKD) model rats to investigate the association of intestinal iron transporters in the mechanism of cardio-renal anemia syndrome. Methods and Results: CKD was induced by 5/6 nephrectomy in Sprague-Dawley rats.
Introduction: Chronic kidney disease (CKD) is associated with poor outcome in patients with heart failure (HF), but little is known about the prognostic value of urine results in these patients. We therefore investigated the relationship between urine results and the prognosis of hospitalized patients with HF. Methods: We retrospectively reviewed the database of the Cardiovascular Center of Toranomon Hospital, Japan and enrolled 128 consecutive patients who admitted with their first presentation of acute decompensated HF.
Introduction: Recently, a simple screening test that can identify sarcopenia using three variables (age, grip strength and calf circumference) has been developed. However, clinical utility of sarcopenia score for predicting future cardiovascular events in patients with kidney disease remains unclear. Methods and Results: We calculated sarcopenia score of 265 chronic kidney disease (CKD) patients, and followed the patients for cardiovascular events. The endpoint of this study was a composite of total mortality and cardiovascular hospitalization, including heart failure decompensation.
It is difficult that chronic heart failure (CHF) with CS 5 and preserved ejection fraction (HFpEF) are under control especially in the elder. In addition, chronic kidney disease (CKD) and severe tricuspid regurgitation (TR) complicates furthermore CHF in the elder. We experienced that three elderly CHF patients with CS5, CKD and severe TR could become stable by active introduction of hemodialysis (HD). The present cases consisted of 2 males and 1 female with averaged 78y.o. Their basic heart diseases were two operated congenital heart diseases and one ischemic heart disease.
We examined the change of such parameters as estimated glomerular filtration rates, BNP levels, serum sodium concentration levels, and loop diuretic doses before and six months after the initiation of tolvaptan therapy in nine patients with chronic heart failure and chronic kidney disease.