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: Our findings describe the most reported risk factors for preventability of oral anticoagulant-induced bleedings. These factors may be useful for targeting interventions to improve pharmacovigilance activities in our regional territory and to reduce the burden of medication errors and inappropriate prescription. Introduction Oral anticoagulant therapy is widely used for the prevention of stroke and systemic embolism in patients with atrial fibrillation, or for the prevention and treatment of deep vein thrombosis and pulmonary embolism (Raj et al., 1994; Monaco et al., 2017). Oral anticoagulants can be di...
Source: Frontiers in Pharmacology - Category: Drugs & Pharmacology Source Type: research
Fight Aging! provides a weekly digest of news and commentary for thousands of subscribers interested in the latest longevity science: progress towards the medical control of aging in order to prevent age-related frailty, suffering, and disease, as well as improvements in the present understanding of what works and what doesn't work when it comes to extending healthy life. Expect to see summaries of recent advances in medical research, news from the scientific community, advocacy and fundraising initiatives to help speed work on the repair and reversal of aging, links to online resources, and much more. This content is...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
Authors: Sakashita M, Tanaka T, Nangaku M Abstract BACKGROUND: Hypoxia-inducible factor (HIF) stabilizers, also known as inhibitors of HIF prolyl hydroxylase domain (PHD) inhibitors enzymes, are novel small-molecule agents to treat renal anemia. They increase endogenous erythropoietin (EPO) production by stabilizing HIF. This review focuses on the mechanisms by which PHD inhibitors ameliorate anemia in chronic kidney disease (CKD) and summarizes the current clinical experience with and prospects for these drugs. SUMMARY: Anemia is a serious complication of CKD and is an independent risk factor for congestive he...
Source: Contributions to Nephrology - Category: Urology & Nephrology Tags: Contrib Nephrol Source Type: research
We report the long-term effects of treatment with atrasentan on major renal outcomes.MethodsWe did this double-blind, randomised, placebo-controlled trial at 689 sites in 41 countries. We enrolled adults aged 18–85 years with type 2 diabetes, estimated glomerular filtration rate (eGFR) 25–75 mL/min per 1·73 m2 of body surface area, and a urine albumin-to-creatinine ratio (UACR) of 300–5000 mg/g who had received maximum labelled or tolerated renin–angiotensin system inhibition for at least 4 weeks. Participants were given atrasentan 0·75 mg orally daily during an enrichment period befor...
Source: The Lancet - Category: General Medicine Source Type: research
Discussion: Incomplete septal cirrhosis is an uncommon cause of non-cirrhotic portal hypertension. Its definition is not well known, morphological and pathophysiological. We have not found published cases of post-RT ascites secondary to this pathology, described as possibly associated with drugs, immune alterations, infections, hypercoagulability and genetic predisposition. PMID: 30897191 [PubMed - as supplied by publisher]
Source: Jornal Brasileiro de Nefrologia - Category: Urology & Nephrology Tags: J Bras Nefrol Source Type: research
Dr Thomas S. Huber (Gainesville, Fla). The authors have analyzed the impact of preoperative anemia on the perioperative outcomes of both open and endovascular repair for intact aneurysms using the Vascular Quality Initiative. They have reported that anemia is associated with increased 30-day mortality and adverse outcome for endovascular but not open repair in their multivariate analysis. They reported that the adverse outcomes associated with anemia were independent of chronic kidney disease and congestive heart failure.
Source: Journal of Vascular Surgery - Category: Surgery Source Type: research
(AI), also known as anemia of chronic disease (ACD), is regarded as the most frequent anemia in hospitalized and chronically ill patients. It is prevalent in patients with diseases that cause prolonged immune activation, including infection, autoimmune diseases, and cancer. More recently, the list has grown to include chronic kidney disease, congestive heart failure, chronic pulmonary diseases, and obesity. Inflammation-inducible cytokines and the master regulator of iron homeostasis, hepcidin, block intestinal iron absorption and cause iron retention in reticuloendothelial cells, resulting in iron-restricted erythropoies...
Source: Blood - Category: Hematology Authors: Tags: Red Cells, Iron, and Erythropoiesis, Review Articles, Review Series, Clinical Trials and Observations Source Type: research
Publication date: Available online 19 December 2018Source: American Journal of Kidney DiseasesAuthor(s): Finnian R. Mc Causland, Brian Claggett, Emmanuel A. Burdmann, Glenn M. Chertow, Mark E. Cooper, Kai-Uwe Eckardt, Peter Ivanovich, Andrew S. Levey, Eldrin F. Lewis, Janet B. McGill, John J.V. McMurray, Patrick Parfrey, Hans-Henrik Parving, Giuseppe Remuzzi, Ajay K. Singh, Scott D. Solomon, Robert D. Toto, Marc A. PfefferRationale &ObjectiveEvidence from clinical trials to guide patient preparation for maintenance dialysis therapy is limited. Although anemia is associated with mortality and cardiovascular (CV) disease...
Source: American Journal of Kidney Diseases - Category: Urology & Nephrology Source Type: research
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
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