Mineralocorticoid Receptor Antagonist Use in Heart Failure With Reduced Ejection Fraction and End-Stage Renal Disease Patients on Dialysis: A Literature Review

This article will review the epidemiology of heart failure in ESRD, the pathophysiological derangements of the renin–angiotensin–aldosterone system in patients with kidney disease, and the results from case series and trials of the use of MRAs in ESRD with HFrEF. Although limited to several small trials using MRAs in peritoneal and hemodialysis patients with or without HFrEF, the current literature appears to show the potential for clinical benefits with little risk.
Source: Cardiology in Review - Category: Cardiology Tags: Review Articles Source Type: research

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Authors: Mu F, Betts KA, Woolley JM, Dua A, Wang Y, Zhong J, Wu EQ Abstract Objective: To estimate the prevalence and economic burden of hyperkalemia in the United States (US) Medicare population.Methods: Patients were selected from a 5% random sample of Medicare beneficiaries (01/01/2010-12/31/2014) to estimate the prevalence and economic burden of hyperkalemia. The prevalence for each calendar year was calculated as the number of patients with hyperkalemia divided by the total number of eligible patients per year. To estimate the economic burden of hyperkalemia, patients with hyperkalemia (cases) were matched 1:1...
Source: Current Medical Research and Opinion - Category: Research Tags: Curr Med Res Opin Source Type: research
Abstract Indoxyl sulfate (IS) is a protein-bound uremic toxin that can accumulate in patients with chronic kidney disease (CKD) or acute kidney injury (AKI) and cause kidney and cardiac dysfunction. Klotho is an anti-aging protein that has reno- and cardio-protective effects. We investigated whether Klotho could alleviate IS-induced heart failure and kidney damage by regulating macrophages, which play a key role in the inflammatory response in CKD and AKI. Treatment of THP-1-derived macrophages with IS induced the production of the pro-inflammatory cytokines TNFα, IL-6, and IL-1β, and stimulated M1 pola...
Source: Aging - Category: Biomedical Science Authors: Tags: Aging (Albany NY) Source Type: research
AbstractHeart failure (HF) and atrial fibrillation (AF) often coexist, being closely interrelated as the one increases the prevalence and incidence and worsens the prognosis of the other. Their frequent coexistence raises several challenges, including under-diagnosis of HF with preserved ejection fraction in AF and of AF in HF, characterization and diagnosis of atrial cardiomyopathy, target and impact of rate control therapy on outcomes, optimal rhythm control strategy in the era of catheter ablation, HF-related thromboembolic risk and management of anticoagulation in patients with comorbidities, such as chronic kidney dis...
Source: Heart Failure Reviews - Category: Cardiology Source Type: research
This study aimed to elucidate the influential parameter, acquired from the analyses of nasal capnography waveforms, for the elevated plasma brain natriuretic peptide (BNP) levels in patients (n = 34) with heart failure (HF). The capnography waveforms were analyzed to evaluate changes in end-tidal CO2 (ETCO2) values and expiratory and inspiratory durations. The relationship between these parameters, estimated from capnography analyses and plasma BNP, was then evaluated. Mean ETCO2 values and BNP levels showed a strong negative correlation (R2 = 0.6355,p
Source: Journal of Cardiovascular Translational Research - Category: Cardiology Source Type: research
Cardiac scintigraphy with 99mTc pyrophosphate (PYP) has a high diagnostic accuracy for transthyretin (ATTR) cardiac amyloidosis (CA) and is being increasingly used to diagnose this condition noninvasively.1-3 Multisocietal guidelines recommend performing 99mTc PYP scintigraphy in patients with heart failure and left ventricular (LV) hypertrophy on transthoracic echocardiography (TTE).1,2 Other features on TTE (increased interatrial septal thickness, pericardial effusion, and biatrial enlargement) and electrocardiography (low voltage, conduction abnormalities, and a pseudo-infarct pattern) may increase the suspicion for CA ...
Source: Journal of the American Society of Echocardiography - Category: Cardiology Authors: Tags: Letters to the Editor Source Type: research
AbstractAimsThe aim of this study was to investigate the diagnostic and prognostic utility of the QRS ‐T angle, an electrocardiogram (ECG) marker quantifying depolarization–repolarization heterogeneity, in patients with suspected acute decompensated heart failure (ADHF).Methods and resultsWe prospectively enrolled unselected patients presenting to the emergency department with symptoms suggestive of ADHF. The QRS ‐T angle was automatically derived from a standard 12‐lead ECG recorded at presentation. The primary diagnostic endpoint was a final adjudicated diagnosis of ADHF. The primary prognostic endpoint was a...
Source: ESC Heart Failure - Category: Cardiology Authors: Tags: Original Research Article Source Type: research
ConclusionsConsistent with the overall AMBER trial results, this pre ‐specified subgroup analysis in patients with HF, resistant hypertension and advanced chronic kidney disease demonstrated that patiromer enabled more persistent use of spironolactone by reducing the risk of hyperkalaemia.
Source: European Journal of Heart Failure - Category: Cardiology Authors: Tags: Research Article Source Type: research
This study aimed to clarify the association of post-percutaneous coronary intervention (PCI) acute heart failure (AHF) with all-cause long-term mortality in patients with chronic kidney disease (CKD).
Source: International Journal of Cardiology - Category: Cardiology Authors: 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
Could treatment with neprilysin inhibitors effectively reduce the risk of heart failure in patients with chronic kidney disease?Nephrology Dialysis Transplantation
Source: Medscape Today Headlines - Category: Consumer Health News Tags: Nephrology Journal Article Source Type: news
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