Review – current opinion in cardiology hypertension in chronic kidney disease

Purpose of review Hypertension is a major risk factor for cardiovascular disease, cerebrovascular events, and progression to end-stage kidney disease (ESKD). The kidneys play a causative role in hypertension, but they are also organs vulnerable to hypertensive injury. Thus far, goals for optimal blood pressure in chronic kidney disease (CKD) and ESKD patients are not fully elucidated. Herein, we critically review the existing evidence. Recent findings Large randomized controlled trials (RCTs) continue to be deemed as the best source of evidence to guide optimal blood pressure goals in CKD and ESKD patients. Despite recent advances, the growing body of literature does not permit drawing definitive conclusions. Few adequately powered RCTs have specifically assessed goals for treatment of hypertension in patients with CKD. The most recent large RCT in hypertension, the Systolic Blood Pressure Intervention Trial, included a subset of patients with CKD and provided some insights. For the ESKD population, trials to evaluate blood pressure goals are even more scarce. The Blood Pressure in Dialysis Trial was a relatively small pilot study that can be deemed as hypothesis generating. Summary Management of hypertension in CKD is essential for optimization of cardiovascular, cerebrovascular and renal outcomes. To date, the existing evidence does not fully clarify ideal targets for blood pressure control in this patient population.
Source: Current Opinion in Cardiology - Category: Cardiology Tags: HYPERTENSION: Edited by Hector O. Ventura and Carl J. Lavie Source Type: research

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Conclusion: Roxadustat increased and maintained Hb in ESA-na ïve, partially iron-depleted NDD-CKD patients with anemia.Nephron
Source: Nephron - Category: Urology & Nephrology Source Type: research
Controversy remains whether white coat hypertension (WCH) is associated with renal prognosis in patients with chronic kidney disease (CKD).
Source: Journal of Translational Medicine - Category: Research Authors: Tags: Research 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
uevas A, Carrero JJ Abstract BACKGROUND: In persons with CKD, adherence to plant-based diets is associated with lower risk of CKD progression and death, but underlying mechanisms are poorly characterized. We here explore associations between adherence to plant-based diets and measures of insulin sensitivity and inflammation in men with CKD stages 3-5. METHODS: Cross-sectional study including 418 men free from diabetes, aged 70-71 years and with cystatin-C estimated glomerular filtration rate (eGFR)
Source: Journal of Nephrology - Category: Urology & Nephrology Authors: Tags: J Nephrol Source Type: research
Purpose of review Hypoxia-inducible factor prolyl hydroxylase inhibitors (HIF-PHIs) are orally active small molecules and are launched as novel therapeutic agents for anemia in chronic kidney disease (CKD). In contrast to conventional exogenous erythropoietin (EPO) administration, HIF-PHIs stimulate endogenous EPO production and improve iron metabolism via stabilization of hypoxia-inducible factor (HIF). This review summarizes the mechanism of action, the results of clinical trials, and future perspectives of HIF-PHIs. Recent findings Six HIF-PHIs are currently under phase III studies, some of which have been already ...
Source: Current Opinion in Nephrology and Hypertension - Category: Urology & Nephrology Tags: RENAL PATHOPHYSIOLOGY: Edited by Orson W. Moe and Susan E. Quaggin Source Type: research
One of the worst symptoms of any plague is uncertainty—who it will strike, when it will end, why it began. Merely understanding a pandemic does not stop it, but an informed public can help curb its impact and slow its spread. It can also provide a certain ease of mind in a decidedly uneasy time. Here are some of the most frequently asked questions about the COVID-19 pandemic from TIME’s readers, along with the best and most current answers science can provide. A note about our sourcing: While there are many, many studies underway investigating COVID-19 and SARS-CoV-19, the novel coronavirus that causes the illn...
Source: TIME: Health - Category: Consumer Health News Authors: Tags: Uncategorized COVID-19 Explainer Source Type: news
Abstract The increased prevalence of chronic kidney disease (CKD) in elderly patients recognizes, as main cause, the long-term exposure to atherosclerosis and hypertension. Chronic ischemic damage due to critical renal arterial stenosis induces oxidative stress and intra-renal inflammation, resulting in fibrosis and microvascular remodelling, that is the histological picture of atherosclerotic renal vascular disease (ARVD). The concomitant presence of a long history of hypertension may generate intimal thickening and luminal narrowing of renal arteries and arterioles, glomerulosclerosis, interstitial fibrosis and ...
Source: Journal of Nephrology - Category: Urology & Nephrology Authors: Tags: J Nephrol Source Type: research
Purpose of review Chronic kidney disease (CKD) is a pervasive and growing health concern that has a significant impact on mortality and morbidity, putting stress on global healthcare systems. CKD affects ∼14% of general populations and ∼36% of high-risk populations and is projected to rise in the coming decade due to increasing rates of diabetes and hypertension. Recent findings Screen, triage, and treat programs aim to detect early stage disease with the intention of promoting medical and lifestyle interventions in line with a patient's level of risk that may slow disease progression and reduce morbidity and ...
Source: Current Opinion in Nephrology and Hypertension - Category: Urology & Nephrology Tags: EPIDEMIOLOGY AND PREVENTION: Edited by Navdeep Tangri Source Type: research
Purpose of review We will examine the current and future options in management of anemia in dialysis patients focusing on recent trials in iron supplementation and alternatives to erythropoietin-stimulating agents (ESAs). Recent findings We review the literature on Erythropoietin (EPO)-stimulating agents, focusing on the risk benefits of various options available. We review the recent practice changing trial in iron supplementation in dialysis patients with chronic kidney disease and movements in the research on alternatives to EPO-stimulating agents primarily hypoxia-inducible factor prolyl hydroxylase inhibitors (HI...
Source: Current Opinion in Nephrology and Hypertension - Category: Urology & Nephrology Tags: EPIDEMIOLOGY AND PREVENTION: Edited by Navdeep Tangri Source Type: research
We report the first US case of a 56-year-old nondiabetic male with ESRD secondary to IgA nephropathy undergoing thrice-weekly maintenance hemodialysis for 3 years, who developed COVID-19 infection. He has hypertension controlled with angiotensin receptor blocker losartan 100 mg/day and coronary artery disease status-post stent placement. During the first 5 days of his febrile disease, he presented to an urgent care, 3 emergency rooms, 1 cardiology clinic, and 2 dialysis centers in California and Utah. During this interval, he reported nausea, vomiting, diarrhea, and low-grade fevers but was not suspected of COVID-19 infect...
Source: American Journal of Nephrology - Category: Urology & Nephrology Authors: Tags: Am J Nephrol Source Type: research
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