ISCHEMIA Trial: A Hope or a Hype for Patients with Stable Coronary Artery Disease?
The current session of American Heart Association in Philadelphia (November 16-18, 2019) was marked by considerable buzz around the presentation of International Study of Comparative Health Effectiveness With Medical and Invasive Approaches (ISCHEMIA) trial and its sub studies including quality of life and chronic kidney disease patients. The slides are available for review on ischemiatrial.org albeit the full text of the publication is awaited. The excitement around the trial is understandable; the data surrounding revcascularization in stable coronary artery disease is derived from historical studies, some of which were publish ed over 20 years ago1.
CONCLUSIONS AND CLINICAL RELEVANCE: Transcription of genes involved in profibrotic pathways remained altered in both kidneys 6 months after transient renal ischemia. This suggested that a single unilateral renal insult can have lasting effects on both kidneys. PMID: 31985291 [PubMed - in process]
ConclusionOur findings indicated that A&P protected kidney from inhibiting inflammation through down-regulating of Mincle pathway in macrophage in AKI. It provides a potential medicine compound for the treatment of AKI.Graphical abstract
Estimating CKD prevalence is difficult. Information on CKD prevalence is rather scanty in Italy and available figures come from surveys in selected geographical areas. Administrative data have been already dem...
Conclusion: The evaluation of QOL in CKD patients undergoing hemodialysis showed that it was relatively compromised. Because the patients had a chronic, progressive irreversible disease, the most affected was physical domain. Age, education, employment, and marital status were found to affect one or more domains of QOL. Age and education are significant independent variables; as the age increases, QOL decreases, and higher the education better the QOL.
Patients with chronic kidney disease (CKD) are at a high risk of future autonomic dysfunction and cardiovascular disease. The aim of this study was to examine the effects of a 12-month lifestyle intervention (LI) involving regular aerobic exercise on cardiac autonomic function in CKD patients.
Publication date: Available online 25 January 2020Source: Nutrition, Metabolism and Cardiovascular DiseasesAuthor(s): Jiadela Teliewubai, Ximin Fan, Hongwei Ji, Rusitanmujiang Maimaitiaili, Jiamin Tang, Song Zhao, Shikai Yu, Chen Chi, Yawei Xu, Yi ZhangAbstractBackground and AimsMetabolic unhealthiness and obesity are both associated with an increased risk of cardiovascular disease. We aimed to investigate the significance of metabolic unhealthiness and obesity in organ damages in a community-based elderly cohort.Methods and results3325 elderly participants (>65 years old) were recruited in northern Shanghai. Associatio...
Conclusion: The SBP at 7:00 AM, in addition to the 24-hour mSBP, is also associated with eGFR deterioration in patients with diabetic CKD, particularly in those with CKD stage 3-5. PMID: 31969922 [PubMed]
Among seriously ill patients, those with advanced chronic kidney disease (CKD) and end-stage kidney disease (ESKD) arguably receive among the worst end-of-life care. These patients frequently die in the hospital, often after an intensive procedure like cardiopulmonary resuscitation, and with a low referral rate to hospice. There is now a concerted effort in the nephrology and palliative care communities to integrate palliative care into the treatment of these seriously ill patients. The Pathways Project is a national demonstration, funded by the Gordon and Betty Moore Foundation, to develop scalable innovations in kidney supportive care.
Guidelines recommend advance care planning (ACP) as essential to quality chronic kidney disease (CKD) management, but the nephrology community has yet to incorporate ACP upstream of the dialysis decision. Others have attempted to improve ACP for dialysis patients, but many patients report wishing they had been engaged in ACP earlier. This project tested integration of ACP coaching in the upstream setting of nephrology offices.
Authors: Kovesdy CP, Gosmanova EO, Woods SD, Fogli JJ, Rowan CG, Hansen JL, Sauer BC Abstract Objective: Patiromer is a sodium-free, non-absorbed, potassium (K+) binder approved for the treatment of hyperkalemia (HK). Among US Veterans with HK, this retrospective, observational cohort study evaluated patiromer utilization, RAASi continuation, and K+ concentration change following patiromer initiation.Methods: Using data from the Veterans Affairs Corporate Data Warehouse, Veterans with HK (K+ ≥5.1 mmol/L) were included upon patiromer initiation (index date) during the study period (1/2016-8/2018). All patien...