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Defibrillators May Not Help Kidney Patients With Bad Hearts

WEDNESDAY, Feb. 7, 2018 -- People with chronic kidney disease often develop heart failure, leading to their having a heart defibrillator implanted to control an irregular heartbeat. But that's not without risk, a new study has found. The chances...
Source: Drugs.com - Daily MedNews - Category: General Medicine Source Type: news

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Authors: Pitt B, Garza D Abstract INTRODUCTION: Hyperkalemia (HK) occurs often among patients with chronic kidney disease (CKD) and heart failure (HF) and those treated with renin-angiotensin-aldosterone system inhibitors (RAASI). Even small deviations from normal potassium levels carry increased risk of mortality. Patiromer is approved for treatment of HK and has been shown in clinical trials to reduce serum potassium among patients with HK and comorbid conditions. Areas covered: We review pooled data from two clinical trials of patiromer in patients with CKD and HK, safety of patiromer in special populations, dru...
Source: Expert Opinion on Drug Safety - Category: Drugs & Pharmacology Tags: Expert Opin Drug Saf Source Type: research
Implantable cardioverter defibrillators in chronic kidney disease, Published online: 12 April 2018; doi:10.1038/s41581-018-0007-5A recent observational study reports that implantable cardioverter defibrillators were not associated with improved survival in patients with heart failure, reduced left ventricular ejection fraction and chronic kidney disease. Further studies are needed to identify which of these high-risk patients are most likely to benefit from this potentially life-saving therapy.
Source: Nature Reviews Nephrology - Category: Urology & Nephrology Authors: Source Type: research
In conclusion, repeated oral dosing with RDX7675 over 4 days reduced potassium absorption in healthy volunteers; the results support QD dosing of RDX7675 in future clinical studies. PMID: 29645278 [PubMed - as supplied by publisher]
Source: The Journal of Clinical Pharmacology - Category: Drugs & Pharmacology Authors: Tags: J Clin Pharmacol Source Type: research
Conclusions Compared with enalapril, sacubitril/valsartan led to a slower rate of decrease in the eGFR and improved cardiovascular outcomes, even in patients with chronic kidney disease, despite causing a modest increase in UACR. Graphical abstract
Source: JACC: Heart Failure - Category: Cardiology Source Type: research
Patients with severely decreased glomerular filtration rate (GFR) (i.e., chronic kidney disease [CKD] G4+) are at increased risk for kidney failure, cardiovascular disease (CVD) events (including heart failure), and death. However, little is known about the variability of outcomes and optimal therapeutic strategies, including initiation of kidney replacement therapy (KRT). Kidney Disease: Improving Global Outcomes (KDIGO) organized a Controversies Conference with an international expert group in December 2016 to address this gap in knowledge.
Source: Kidney International - Category: Urology & Nephrology Authors: Tags: KDIGO Executive Conclusions Source Type: research
Background: The rate of cardiovascular implantable electronic device infection (CIEDI) has increased, despite the use of preoperative antibiotics at the time of device placement or revision. Cefazolin, a beta-lactam antibiotic, is used as standard preoperative prophylaxis in the bulk of patients. Vancomycin is used in the small minority of patients who have IgE-mediated allergies to beta-lactams or have a history of colonization/infection with MRSA. As compared to cefazolin, vancomycin is less effective against methicillin-susceptible Staphylococcus aureus, has no gram-negative coverage, and has nephrotoxicity risk.Methods...
Source: Circulation: Cardiovascular Quality and Outcomes - Category: Cardiology Authors: Tags: Session Title: Poster Session PM Source Type: research
Conclusion: In our patients admitted with heart failure, 8 to 13-day index admission was associated with the longest readmission interval. It is possible that shorter index admission may not allow for sufficient medical optimization. This conclusion requires further study. While patients with prolonged index admission are more likely to have IDDM and CKD, these co-morbidities do not appear to result in shorter readmission intervals. There may be additional, currently not well investigated factors affecting readmission interval. Further research is needed to define optimal LOS and discharge criteria in patients admitted wit...
Source: Circulation: Cardiovascular Quality and Outcomes - Category: Cardiology Authors: Tags: Session Title: Poster Session PM Source Type: research
Background: Transcatheter aortic valve replacement (TAVR) is an alternative form of treatment for patients with aortic valve disease who are otherwise considered a high risk candidate for surgical aortic valve replacement (SAVR). Chronic kidney disease (CKD) is known to adversely affect the outcomes of cardiac surgery including SAVR. We aimed to determine the outcomes of TAVR in patients with CKD, which has not been widely reported.Methods: A retrospective observational study was conducted on 241 consecutive TAVR patients (81.6 +/- 8.1 years old, 58% females (140 of 241)) treated between January 2011 and April 2015 at a si...
Source: Circulation: Cardiovascular Quality and Outcomes - Category: Cardiology Authors: Tags: Session Title: Poster Session AM Source Type: research
We examined A1c and treatment data in adults ≥75 years with type 2 diabetes from 151 US outpatient sites in DCR. Patients were categorized as poor control (A1c>9%), moderate control (A1c>8-9%), conservative control (A1c 7-8%), tight control/low-risk agents (A1c
Source: Circulation: Cardiovascular Quality and Outcomes - Category: Cardiology Authors: Tags: Session Title: Poster Session AM Source Type: research
Background: The PARADIGM-HF clinical trial showed a significant reduction in heart failure (HF) hospitalizations and cardiovascular (CV) death in patients with heart failure and reduced ejection fraction (HFrEF) and treated with S/V compared to enalapril. The impact of S/V on real-world outcomes is not well studied.Objective: To assess the association of hospitalization and therapy with S/V vs. ACEI/ARB in patients with HFrEF in the US.Methods: Adult patients with ≥1 claim for S/V or ACEI/ARB from 7/7/2015-5/31/2016 were selected from the MarketScan databases. Patients with S/V were assumed to have HFrEF based on its pr...
Source: Circulation: Cardiovascular Quality and Outcomes - Category: Cardiology Authors: Tags: Session Title: Poster Session PM Source Type: research
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