Lipid-lowering agents for the treatment of hyperlipidemia in patients with chronic kidney disease and end-stage renal disease on dialysis: a review
AbstractCardiovascular disease (CVD) continues to be the leading cause of death in Western civilizations, and hyperlipidemia is a well-established independent risk factor for the development of atherosclerosis and CVD progression. Many chronic kidney disease (CKD) and dialysis patients have the traditional CVD risk factors (age, obesity, hypertension, diabetes mellitus, and hyperlipidemia); however, CKD and dialysis predispose patients to several non-traditional risk factors, including myocardial remodeling, hyperparathyroidism, malnutrition, bone and mineral disorders, anemia, albuminuria, inflammation, and endothelial dysfunction. Interestingly, as both cardiovascular morbidity and mortality increase and renal function declines, the therapeutic benefits of lipid-lowering agents decrease significantly. However, their recognized reduction in cardiovascular events and excellent tolerability contribute to the frequent use of lipid-lowering agents. Statins are the most commonly prescribed agents for the treatment of hyperlipidemia. Recent post hoc analyses of the lipid lowering in patients with CKD indicate that lowering low-density lipoprotein cholesterol may provide long-term cardiovascular protection in patients with CKD stages I –IV. However, questions remain regarding the optimal role of lipid-lowering agents for primary prevention in patients on dialysis. Statins remain the preferred first-line pharmacologic therapy, but non-statin add-on therapies can be used to dec...
ConclusionsIP cefepime monotherapy was noninferior to conventional combination therapy for resolution of CAPD-associated peritonitis at day 10 and may be a reasonable alternative first-line treatment.FundingThis study is supported by The Kidney Foundation of Thailand (R5879), Thailand; Rachadaphiseksompotch Fund (RA56/006) and Rachadaphicseksompotch Endorsement Fund (CU-GRS_61_06_30_01), Chulalongkorn University, Thailand; National Research Council of Thailand (156/2560), Thailand; and Thailand Research Foundation (IRG5780017), Thailand.Trial RegistrationRegistered at ClinicalTrials.gov with study number NCT02872038.
ConclusionsRemission of type 2 diabetes 5 years after bariatric surgery was associated with improvements in albuminuria and stabilized prognostic risk for CKD, but not with eGFR. Lower kidney function and greater prognostic risk at the time of bariatric surgery was linked to a lower likelihood of diabetes remission. These results highlight the need to identify the mechanisms through which bariatric surgery may delay the long-term progression of CKD in type 2 diabetes.
ConclusionVascular surgery in TA cases becomes an option when the patient does not improve clinically after administration of medical treatment. Although endovascular management has fewer complications, the rate of restenosis is higher. Patients at risk of restenosis and who have increased perioperative vascular risk can benefit from open surgical procedures. Surgical management should be tailored to the patient’s needs.
ConclusionThese cases are reported because of their rare location and presentation since few cases of bilateral cholesterol granuloma have been reported in the literature.
Publication date: Available online 19 July 2019Source: European Journal of RadiologyAuthor(s): Claire Boudinaud, Armand Abergel, Juliette Joubert-Zakeyh, Mikael Fontarensky, Bruno Pereira, Benoit Chauveau, Jean Marc Garcier, Pascal Chabrot, Louis Boyer, Benoît MagninAbstractPurposeGiven the growing prevalence of obesity and metabolic syndrome, the management of hepatic steatosis, especially its quantification, is a major issue. We assessed the quantification of liver steatosis using four different MR methods, in order to determine the one that is best correlated with the reference method which consists of histologica...
CONCLUSIONS: Steroid receptor coactivators are critical regulators of human metabolism with pleiotropic and tissue-specific actions. We believe that our study will contribute to the better understanding of the complex multi-tissue interactions that are disrupted in obesity and can therefore lead in numerous cardiometabolic diseases. Further on, present findings suggest that SRC-3/AIB-1 could constitute possible future drug targets. PMID: 31322077 [PubMed - as supplied by publisher]
Authors: Hamouda L, Miliani M, Hadjidj Z, Messali R, Aribi M Abstract BACKGROUND: Monocytes are the main blood innate mononuclear phagocyte and one of the most important effector cells expressing Fcγ receptor, which is critical for the interaction with Fc domain of antibodies. OBJECTIVE: To evaluate the effect of Rituximab (RTX, a chimeric human anti-CD20 monoclonal antibody) on the functional activities of Monocytes (MOs) at the onset of human Type 1 Diabetes (T1D). METHODS: MOs were isolated from peripheral blood mononuclear cells (PBMCs) obtained from volunteer patients with recent-onset T1D and he...
Authors: Wykretowicz M, Katulska K, Zwanzig M, Krauze T, Piskorski J, Guzik P, Wykretowicz A Abstract OBJECTIVES: Left atrial fibrosis represents a substrate for atrial fibrillation (AF) and cardioembolic events. White matter hyperintensities (WMH) are commonly found on magnetic resonance imaging (MRI) and are regarded, at least partly as ischemic brain lesions. Aortic excess pressure (excessPTI) represents an extra work performed by the left ventricle and is a new risk metric associated with cardiovascular complications. The aim of our study was to assessed whether there is a correlation between the degree of LA f...
Publication date: August 2019Source: Nutrition, Metabolism and Cardiovascular Diseases, Volume 29, Issue 8Author(s): Ada Di Gregorio, Silvia Migliaccio, Carmela Legorano, Gennaro Argentino, Domenico Russo, Luca Scalfi
Publication date: August 2019Source: Nutrition, Metabolism and Cardiovascular Diseases, Volume 29, Issue 8Author(s): Marialaura Bonaccio, Augusto Di Castelnuovo, Simona Costanzo, Mariarosaria Persichillo, Amalia De Curtis, Chiara Cerletti, Maria Benedetta Donati, Giovanni De Gaetano, Licia Iacoviello
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