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Direct oral anticoagulants in chronic kidney disease: an update
Purpose of review Direct oral anticoagulants (DOACs) are variably eliminated by the kidneys rendering their use potentially problematic in patients with chronic kidney disease (CKD) or necessitating appropriate dose adjustment. Recent findings Both observational and limited randomized trial data for DOACs compared with no treatment or with warfarin for patients with atrial fibrillation on maintenance dialysis were recently published. In a randomized trial in patients on hemodialysis, there was no significant difference in vascular calcification between patients who received rivaroxaban with or without vitamin K2 or vi...
Source: Current Opinion in Nephrology and Hypertension - August 1, 2020 Category: Urology & Nephrology Tags: PHARMACOLOGY AND THERAPEUTICS: Edited by Sankar D. Navaneethan Source Type: research

Autophagy in diabetic nephropathy: a review
AbstractDiabetes mellitus (DM) is the leading cause of end stage renal disease. 40% of the patients worldwide will require replacement therapy after 20  years of DM worldwide. Early-stage diabetic nephropathy is characterized by hyperfiltration related to hypeglycemia-induced afferent artery vasodilatation with micro-and macroalbuminuria. Later on, proteinuria with arterial hypertension may appear, culminating in glomerular filtration rate (GFR) d ecline and end stage renal disease. Forty percent of diabetic patients develop microvascular and macrovascular complications, with increased risk among patients with genetic pre...
Source: International Urology and Nephrology - July 12, 2020 Category: Urology & Nephrology Source Type: research

Free 25-Vitamin D Is Correlated with Cardiovascular Events in Prevalent Hemodialysis Patients but Not with Markers of Renal Mineral Bone Disease
In conclusion, our study shows that free vitamin D serum concentrations are independently associated with major cardiovascular events in chronic kidney disease patients on dialysis.Kidney Blood Press Res
Source: Kidney and Blood Pressure Research - June 14, 2019 Category: Urology & Nephrology Source Type: research

Recent evidence for direct oral anticoagulants in chronic kidney disease
Purpose of review The direct oral anticoagulants (DOACs) have emerged as an effective and safe alternative to vitamin K antagonists (VKAs) for stroke and venous thromboembolism (VTE) prevention. However, patients with chronic kidney disease (CKD) experience an increase in the risk of both thromboembolism and bleeding, and the risk–benefit profile of DOACs, particularly in advanced CKD remains a source of ongoing debate. This review summarizes the recent evidence on the effects of DOACs in CKD across a range of clinical indications including newly emerging indications. Recent findings Data on early-to-moderate stage ...
Source: Current Opinion in Nephrology and Hypertension - April 4, 2019 Category: Urology & Nephrology Tags: EPIDEMIOLOGY AND PREVENTION: Edited by Navdeep Tangri Source Type: research

Which anticoagulants should be used for stroke prevention in non-valvular atrial fibrillation and severe chronic kidney disease?
Purpose of review Non-valvular atrial fibrillation is common in patients with severe chronic kidney disease (CKD) and historically patients have been treated with vitamin K antagonists (VKA). However, these agents have questionable efficacy and are associated with increased bleeding risk. Non-vitamin K oral anticoagulants (NOAC) have advantages over VKA in early stage CKD. In this review, we sought to establish evidence for best practice in patients with severe CKD (creatinine clearance
Source: Current Opinion in Nephrology and Hypertension - October 5, 2018 Category: Urology & Nephrology Tags: DIAGNOSTICS AND TECHNIQUES: Edited by Maarten W. Taal Source Type: research

Novel oral anticoagulants in chronic kidney disease: ready for prime time?
Purpose of review Patients with chronic kidney disease (CKD) are at increased risk of atrial fibrillation, stroke, and bleeding posing unique clinical challenges. Novel oral anticoagulants (NOACs) including dabigatran, rivaroxaban, and apixaban have become recognized as alternative therapy to Vitamin K Antagonists (VKA) regarding the prevention of venous thromboembolism (VTE) and reduce the risk of stroke in atrial fibrillation. However, the understanding of NOACs in CKD is still underdeveloped. This review summarizes recent literature on the efficacy and safety of NOACs in patients with CKD. Recent findings Studies f...
Source: Current Opinion in Nephrology and Hypertension - April 5, 2018 Category: Urology & Nephrology Tags: EPIDEMIOLOGY AND PREVENTION: Edited by Navdeep Tangri Source Type: research

Nutrient intake and urinary incontinence in Korean women: A propensity score ‐matched analysis from the Korea National Health and Nutrition Examination Survey data
ConclusionHigh carbohydrate intake seems to be significantly related to female urinary incontinence in the Korean population.
Source: International Journal of Urology - August 28, 2017 Category: Urology & Nephrology Authors: Jun Ho Lee, Hyo Serk Lee Tags: Original Article Source Type: research

Folic acid supplementation and chronic kidney disease progression
In contrast to prior studies demonstrating no benefit or even increased harm from B vitamin supplementation in patients with chronic kidney disease, a large randomized trial from China recently demonstrated small but statistically significant reductions in the risk of first stroke and chronic kidney disease progression with the addition of folic acid to enalapril in adults with hypertension. Differences in the study population and study intervention may explain these discordant results.
Source: Kidney International - November 21, 2016 Category: Urology & Nephrology Authors: Christina M. Wyatt, J. David Spence Tags: Nephrology Digest Source Type: research

Epidemiologic insights on the role of fibroblast growth factor 23 in cardiovascular disease
Purpose of review: Fibroblast growth factor 23 (FGF23) regulates phosphate and vitamin D homeostasis and rises as kidney function declines. Animal studies have demonstrated direct and indirect effects of FGF23 that may promote heart disease. Herein, we review the recent epidemiologic literature evaluating the relationship between FGF23 and cardiovascular disease. Recent findings: In observational prospective studies, higher FGF23 associates with a greater risk of incident cardiovascular disease including ischemic heart disease, stroke, heart failure, and atrial fibrillation. These studies establish a temporal sequence of e...
Source: Current Opinion in Nephrology and Hypertension - April 14, 2015 Category: Urology & Nephrology Tags: EPIDEMIOLOGY AND PREVENTION: Edited by Navdeep Tangri Source Type: research

Effect of lower sodium intake on health: systematic review and meta-analyses
This is another article that supports the literature for reduction in salt intake for overall population health. This systematic further shows that not only does salt lower blood pressure, but there are no adverse effects on lipids, catecholamine levels of renal function. Furthermore, it is associated with lower risk of stroke and fatal coronary heart disease in adults. : Effect of increased potassium intake on cardiovascular risk factors and disease: systematic review and meta-analyses Benefits and harms of erythropoiesis-stimulating agents for anemia related to cancer: a meta-analysis. Systematic Review: Vitamin D and C...
Source: Nephrology Now - July 15, 2013 Category: Urology & Nephrology Authors: Nephrology Now editors Tags: General Nephrology Hypertension Source Type: research