Clinical Impact of Left Ventricular Diastolic Dysfunction in Chronic Kidney Disease.

Clinical Impact of Left Ventricular Diastolic Dysfunction in Chronic Kidney Disease. Contrib Nephrol. 2018;195:81-91 Authors: Ogawa T, Nitta K Abstract Left ventricular diastolic dysfunction (LVDD) frequently occurs in chronic kidney disease (CKD) and is associated with heart failure and higher mortality. LVDD is observed in patients with early stages of CKD and is associated with cardiovascular events, in patients undergoing incident hemodialysis in the absence of systolic function. The pathogenesis of CKD includes abnormal ventricular filling in diastole and a higher LV filling pressure (LVFP) because of LV hypertrophy (LVH), in addition to myocardial interstitial fibrosis. Therefore, LV dysfunction tends to cause pulmonary congestion. In patients with CKD, the mechanism of LVDD is complicated and mainly involves LVH, which is a physiological response to pressure and volume overload. Other factors related to CKD, including LVH, neurohumoral alterations, inflammation, anemia, and mineral disorders, might cause the development of LVDD. Echocardiography is frequently used for noninvasive evaluation of diastolic function and for estimating LVFP. Echocardiographic quantification of LVFP is based on the E/e' ratio, where E is the early mitral flow velocity on transmitral Doppler and e' is the early mitral annulus velocity obtained from tissue Doppler. An E/e' ratio 15 is considered to mirror the increase in LVFP. The main strategy for treating LVDD is to mini...
Source: Contributions to Nephrology - Category: Urology & Nephrology Tags: Contrib Nephrol Source Type: research

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Conclusion: Patients with CKD had more often permanent type of AF. Percutaneous interventions of the left main coronary artery, the only elective procedures influencing patients ’ prognosis, were done more frequently in CKD patients with AF. In-hospital mortality was significantly higher in patients with severe renal impairment. Despite the higher risk of ischaemic stroke in CKD group the use of oral anticoagulation therapy was significantly less frequent and the patients were deprived of the confirmed benefits of such treatment.Kidney Blood Press Res 2018;43:1796 –1805
Source: Kidney and Blood Pressure Research - Category: Urology & Nephrology Source Type: research
Introduction: MGUS is generally an incidental finding in the diagnostic work-up for clinical signs and symptoms suggestive of lymphoplasmacytic malignancies (multiple myeloma, light chain amyloidosis, and Waldenström macroglobulinemia), which are relatively rare (
Source: Blood - Category: Hematology Authors: Tags: 901. Health Services Research-Non-Malignant Conditions: Poster I Source Type: research
IntroductionIron deficiency anemia (IDA) is the leading cause of anemia in the United States. Although oral iron formulations can correct IDA, they are generally poorly tolerated due to gastrointestinal side effects and may require long term use to maintain normal hemoglobin. Intravenous iron is an alternative to oral iron especially in adults who cannot tolerate or absorb oral iron. Intravenous iron preparations avoid problems of malabsorption and can quickly correct IDA but little data exists on the safety or efficacy in patients without chronic kidney disease (CKD) with or without dialysis, heart failure, uterine bleedi...
Source: Blood - Category: Hematology Authors: Tags: 901. Health Services Research-Non-Malignant Conditions Source Type: research
The objective of this analysis was to assess the importance of parenteral iron dosing on serum hemoglobin (Hgb) level normalization in real world clinical practice.MethodsData was obtained from the Decision Resources Group (DRG) Real World Evidence Data Repository US database, which includes medical and pharmacy claims, and electronic health record data representing more than 300 million patient lives. Adult patients (≥18 years of age) who were treated with parenteral iron between 3/1/2015 and 2/28/2017 were included in the analysis. Eligible patients were required to have their most recent baseline Hgb level below normal (Hgb
Source: Blood - Category: Hematology Authors: Tags: 903. Outcomes Research-Non-Malignant Hematology: Poster I Source Type: research
ConclusionsRecurrent AKI is a common occurrence after a hospitalization complicated by AKI. Based on routinely available patient characteristics, our findings could facilitate identification of the subgroup of patients with AKI who may benefit from more intensive follow-up to potentially avoid recurrent AKI episodes.
Source: American Journal of Kidney Diseases - Category: Urology & Nephrology Source Type: research
This study performed a retrospective outcome analyses of a large cohort of mixed ejection fraction patients admitted for acute heart failure (HF), whose inpatient care was guided by individual quantitative blood volume analysis (BVA) results.BackgroundDecongestion strategies in patients hospitalized for HF are based on clinical assessment of volume and have not integrated a quantitative intravascular volume metric.MethodsPropensity score control matching analysis was performed in 245 consecutive HF admissions to a community hospital (September 2007 to April 2014; 78 ± 10 years of age; 50% with HF with reduced e...
Source: JACC: Heart Failure - Category: Cardiology Source Type: research
Heart Failure (HF) is a leading cause of hospitalization, 30 day readmissions and a health care burden. Preventing readmissions is priority. Although immediate management and counseling of patients occurs routinely, several comorbid factors may not receive recognition or be adequately addressed.
Source: Journal of Cardiac Failure - Category: Cardiology Authors: Tags: 218 Source Type: research
Iron-deficiency anemia (IDA) is undertreated in patients with chronic inflammatory conditions including chronic kidney disease (CKD) and heart failure (HF). Progressive inflammation and reduced iron transport associated with CKD and HF may reduce the efficacy of oral iron therapy. Oral ferric citrate improves anemia markers in CKD, but its effects in patients with CKD and concomitant HF have not been described. Patients with CKD not on dialysis and IDA from a phase 2 and 3 trial were treated with ferric citrate (n  = 190) or placebo (n = 188); patients with HF were identified from medical histories.
Source: The American Journal of Cardiology - Category: Cardiology Authors: Source Type: research
H Suresh, BS Arun, V Moger, PB Vijayalaxmi, K. T. K Murali MohanIndian Journal of Nephrology 2018 28(2):127-134 Pulmonary hypertension (PH) is a recently recognized complication of chronic kidney disease (CKD), especially in end-stage renal disease. It has prevalence estimates of 30%–50% and is an independent predictor of increased mortality in CKD patients. The aim of this study is to analyze the prevalence of PH in patients with CKD, its severity in different stages of CKD, and risk factors for it. One hundred and eight patients with CKD treated at Karnataka Institute of Medical Sciences, Hubli, Karnataka,...
Source: Indian Journal of Nephrology - Category: Urology & Nephrology Authors: Source Type: research
e;o L Abstract Iron Deficiency (ID) is increasingly recognized as a prevalent comorbid condition in Heart Failure (HF). Despite this, the pathophysiological mechanisms for progressive ID in either chronic or acute HF are still poorly understood. Beyond the traditional factors for iron deficit in the general population, we ought to review the specificities of such paucity in the HF patient, particularly focusing on the interplay between heightened inflammation, overactivity of the sympathetic nervous system and the so-called cardio-renal-anaemia-ID syndrome. Currently, ID constitutes not only an independent prognos...
Source: European Journal of Internal Medicine - Category: Internal Medicine Authors: Tags: Eur J Intern Med Source Type: research
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