Nondipping heart rate and associated factors in patients with chronic kidney disease

AbstractBackgroundNondipping heart rate (NHR) is a condition reported to be associated with cardiovascular events and cardiovascular mortality recently. We aimed to search whether there is difference among hypertensive patients with and without chronic kidney disease (CKD) in terms of NHR pattern and the factors associated with NHR in patients with CKD.MethodsThe study included 133 hypertensive patients with normal kidney functions, 97 hypertensive patients with predialysis CKD, and 31 hypertensive hemodialysis patients. Heart rate, blood pressure and pulse wave velocity (PWV) were measured by 24-h ambulatory blood pressure monitorization. NHR was defined as a decrease of less than 10% at night mean heart rate when compared with daytime values.ResultsNHR pattern was established as 26.3% in non-CKD hypertensive group, 43.3% in predialysis group and 77.4% in dialysis group. Among patients with CKD, when NHR group was compared with dipper heart rate group, it was seen that they were at older age, there were higher prevalence of diabetes mellitus and more female sex, and while the value of urea, creatinine, phosphorus, intact parathyroid hormone, and PWV were significantly higher, the value of hemoglobin, albumin and calcium were significantly lower. By multivariate analysis, hemoglobin [odds ratio (OR) 0.661; 95% CI 0.541 –0.806;p 
Source: Clinical and Experimental Nephrology - Category: Urology & Nephrology Source Type: research

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A 78-year-old woman with a history of type 2 diabetes mellitus, chronic kidney disease stage 4, hypertension, atrial fibrillation, grade 1 follicular lymphoma, gastroesophageal reflux disease, and iron deficiency anemia presented with several months of transfusion-dependent anemia. Medications included oral ferrous sulfate, insulin, spironolactone, clonidine, metoprolol, simvastatin, omeprazole, and apixaban. In the past several months, she had been receiving weekly darbepoetin alfa injections and requiring 4 blood transfusions a month.
Source: Mayo Clinic Proceedings - Category: Internal Medicine Authors: Tags: Medical image Source Type: research
In conclusion, careful monitoring of patients in the early stages of CKD would result in lower morbidity and mortality. These objectives can be achieved by implementing screening programs and early interventions. PMID: 32509001 [PubMed]
Source: Experimental and Therapeutic Medicine - Category: General Medicine Tags: Exp Ther Med Source Type: research
In conclusion, the evidence for state‐of‐the‐art heart failure treatments with regard to exercise capacity and quality of life is limited and appears not robust enough to permit recommendations for heart failure. The treatment of co‐morbidities may be important fo r these patient‐related outcomes. Additional studies on functional capacity and quality of life in heart failure are required.
Source: European Journal of Heart Failure - Category: Cardiology Authors: Tags: Review Source Type: research
In conclusion, the concept of an epigenetic clock is compelling, but caution should be taken in interpreting associations with age acceleration. Association tests of age acceleration should include age as a covariate. A Discussion of Recent Work on Allotopic Expression of Mitochondrial Genes at the SENS Research Foundation https://www.fightaging.org/archives/2020/02/a-discussion-of-recent-work-on-allotopic-expression-of-mitochondrial-genes-at-the-sens-research-foundation/ A paper published last month outlines recent progress on allotopic expression of mitochondrial genes carried out by the SENS Research ...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
This study enrolled consecutive 615 hospitalized patients with heart failure. We investigated the associations between circulating acetoacetate and clinical characteristics or prognosis in HF patients.ResultsWe divided the patients into two groups based on circulating acetoacetate levels (high group: acetoacetate ≥35 µmoL/L, n = 313; and low group: acetoacetate
Source: IJC Heart and Vasculature - Category: Cardiology Source Type: research
Chronic kidney disease (CKD), defined by low estimated glomerular filtration rate (eGFR), is common and a risk factor for cardiovascular disease (CVD). The risk rises with decline in eGFR and is maximal (around 20 times that of the general population) in patients with end-stage kidney disease (ESKD) requiring dialysis. Conventional factors such as diabetes mellitus, hypertension, smoking and hyperlipidaemia contribute to the risk of progressive CKD and CVD. Other factors including proteinuria, left ventricular hypertrophy, impaired calcium –phosphate homeostasis (PTH, FGF-23), anaemia and inflammation, contribute to ...
Source: Medicine - Category: Internal Medicine Authors: Tags: Chronic kidney disease Source Type: research
Authors: Wee YH, Anpalahan M Abstract BACKGROUND: Older age has a significant association with anaemia. However, this has not been adequately investigated in the context of specific comorbidities such as type 2 diabetes mellitus(T2DM). OBJECTIVES: To investigate the role of age in normocytic anaemia(NCA) and the adverse outcomes of NCA in T2DM. METHODS: Patients with NCA, either unexplained or related to chronic kidney disease(CKD), were recruited from a diabetic clinic over six months. Anaemia was defined as a haemoglobin(Hb)
Source: Current Aging Science - Category: Geriatrics Tags: Curr Aging Sci Source Type: research
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 dy...
Source: Drugs and Therapy Perspectives - Category: Drugs & Pharmacology Source Type: research
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
Conclusion: Almost half of the CKD participants were anemic, and the odds of anemia did not increase linearly with increasing severity of CKD. There was a marked ethnic disparity in anemia prevalence. Our study highlights the need for risk-based management of anemia among CKD patients. PMID: 30858723 [PubMed]
Source: International Journal of Nephrology and Renovascular Disease - Category: Urology & Nephrology Tags: Int J Nephrol Renovasc Dis Source Type: research
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