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Hypertension in hemodialysis patients treated with atenolol or lisinopril: a randomized controlled trial
Conclusions Among maintenance dialysis patients with hypertension and left ventricular hypertrophy, atenolol-based antihypertensive therapy may be superior to lisinopril-based therapy in preventing cardiovascular morbidity and all-cause hospitalizations. (Funded by the National Institute of Diabetes and Digestive and Kidney Diseases; ClinicalTrials.gov number: NCT00582114)
Source: Nephrology Dialysis Transplantation - February 28, 2014 Category: Urology & Nephrology Authors: Agarwal, R., Sinha, A. D., Pappas, M. K., Abraham, T. N., Tegegne, G. G. Tags: Intra- and Extracorporeal Treatments of Kidney Failure Source Type: research

Home Blood Pressure Monitoring in CKD
Hypertension is common in patients with chronic kidney disease (CKD) and the prevalence increases with declining kidney function. Hypertension management is particularly important due to the increased risk of cardiovascular disease and stroke in the CKD population. Most clinical decisions for blood pressure (BP) management are based on BP readings in the office or dialysis unit. These BP readings often are inaccurate. Home BP monitoring provides more data than conventional clinic or dialysis-unit BP measurements and is relatively easy to accomplish, is cost-effective, and has been shown to have an increasing role in the ma...
Source: American Journal of Kidney Diseases - February 14, 2014 Category: Urology & Nephrology Authors: Debbie L. Cohen, Yonghong Huan, Raymond R. Townsend Tags: In Practice Source Type: research

Statins do not improve cardiovascular outcomes for dialysis patients
Commentary on: Palmer SC, Navaneethan SD, Craig JC, et al.. HMG CoA reductase inhibitors (statins) for dialysis patients: a systematic review and meta-analysis. Cochrane Database Syst Rev 2013;(9):CD004289. Context Chronic kidney disease affected nearly 19 million people in the USA, with incidence increasing globally at an annual rate of 8%, most of which were unrecognised or undiagnosed. Cardiovascular events are common among patients with chronic kidney disease and highest in dialysis patients. While dialysis patients experience a high prevalence of traditional risk factors for cardiovascular disease (CVD), such as hyper...
Source: Evidence-Based Medicine - May 19, 2014 Category: Internal Medicine Authors: Olyaei, A. Tags: Clinical trials (epidemiology), Epidemiologic studies, Drugs: cardiovascular system, Neuromuscular disease, Stroke, Hypertension, Obesity (nutrition), Ischaemic heart disease, Unwanted effects / adverse reactions, Renal medicine, Musculoskeletal syndromes Source Type: research

Cardiovascular Risk Assessment Before and After Kidney Transplantation
Cardiovascular disease (CVD) is the leading cause of death in dialysis patients and the most common cause of death and allograft loss among kidney transplant recipients. End-stage renal disease (ESRD) is associated with an increased incidence and prevalence of a wide range of CVDs including coronary artery disease, stroke, congestive heart failure, atrial fibrillation, sudden cardiac death, pulmonary hypertension, and valvular heart disease. CVD risk factors are very common in patients with ESRD, and most patients have multiple risk factors. Kidney transplantation is the treatment of choice for patients with ESRD, as a suc...
Source: Cardiology in Review - June 6, 2014 Category: Cardiology Tags: Review Articles Source Type: research

Therapy of anemia and iron deficiency in dialysis patients: An update.
Abstract The Kidney Disease Improving Global Outcomes (KDIGO)-2012 on the treatment of anemia emit suggestions (which differ from recommendations) based on a scientific evidence of low level. The first rule is no harm; physicians must take into account the profile of the patient and its associated morbidities and remember on the potential risks to begin a treatment by erythropoiesis stimulating agents (ESA) (thrombosis of arteriovenous fistula, hypertension, stroke). All correctable causes of anemia other than erythropoietin deficiency should be actively sought. It is necessary to individualize the treatment by ES...
Source: Nephrologie and Therapeutique - June 26, 2014 Category: Urology & Nephrology Authors: Rostoker G, Hummel A, Chantrel F, Ryckelynck JP Tags: Nephrol Ther Source Type: research

Cerebral microbleeds and cognitive decline in a hemodialysis patient: Case report and review of literature
We present an ESRD patient on chronic hemodialysis with a history of gradual cognitive decline and progressive CMBs. Through this case and literature review, we illustrate the need to develop detection and prediction models to treat this frequent development in ESRD patients.
Source: Hemodialysis International - July 1, 2014 Category: Hematology Authors: Lin Li, Mark Fisher, Wei‐Ling Lau, Hamid Moradi, Alexander Cheung, Gaby Thai, Jason Handwerker, Kamyar Kalantar‐Zadeh Tags: Case Report Source Type: research

Bidirectional relationship of hypertension with obstructive sleep apnea
Purpose of reviewHypertension (HTN) and obstructive sleep apnea (OSA) are coexistent in millions of people, and both have been associated with heart disease, stroke, and premature death. OSA is an important risk factor for HTN. However, the relationship between OSA and HTN may be bidirectional, with high blood pressure (BP) contributing to an increased risk and severity of OSA. The aim of this review is to summarize the current literature supporting a bidirectional relationship of sleep apnea and HTN. Recent findingsThe treatment of HTN to a lower BP target may improve sleep apnea by improving upper airway tone, by targeti...
Source: Current Opinion in Pulmonary Medicine - October 2, 2014 Category: Respiratory Medicine Tags: SLEEP AND RESPIRATORY NEUROBIOLOGY: Edited by Lee K. Brown and Adrian Williams Source Type: research

Effects of blood pressure lowering on outcome incidence in hypertension. 1. Overview, meta-analyses, and meta-regression analyses of randomized trials
Background:Antihypertensive treatment is based on randomized controlled trials (RCTs) started since 1966. Meta-analyses comprehensive of all RCTs but limited to RCTs investigating blood pressure (BP) lowering in hypertensive patients are lacking. Objectives:Two clinical questions were investigated: the extent of different outcome reductions by BP lowering in hypertensive patients, and the proportionality of outcome reductions to SBP, DBP, and pulse pressure (PP) reductions. Methods:PubMed between 1966 and December 2013 (any language), Cochrane Collaboration Library and previous overviews were used as data sources for ident...
Source: Journal of Hypertension - November 10, 2014 Category: Cardiology Tags: Reviews Source Type: research

Non Invasive Evaluation of Cardiac Hemodynamics in End Stage Renal Disease (ESRD)
Conclusions Blood pressure, cardiac morphology and function are significantly modified by acute volume depletion and such variations are strictly interrelated. SW and LVEDd/height2.7 may identify ESRD patients carrying an higher volume load.
Source: High Blood Pressure and Cardiovascular Prevention - November 19, 2014 Category: Cardiology Source Type: research

Early and mid-term clinical outcome in younger and elderly patients undergoing mitral valve repair with or without tricuspid valve repair
CONCLUSIONS Data demonstrate excellent postoperative mortality rates in older patients undergoing MV repair with or without TV repair. Consequently, even in older patients with numerous comorbidities, MV repair should be considered a suitable surgical method.
Source: Interactive CardioVascular and Thoracic Surgery - December 18, 2014 Category: Cardiovascular & Thoracic Surgery Authors: Renner, A., Zittermann, A., Aboud, A., Hakim-Meibodi, K., Borgermann, J., Gummert, J. F. Tags: Valve disease Adult Cardiac Source Type: research

Risk-based individualisation of target haemoglobin in haemodialysis patients with renal anaemia in the post-TREAT era: theoretical attitudes versus actual practice patterns (MONITOR-CKD5 study)
Conclusions Physicians’ theoretical attitudes to anaemia management in patients on haemodialysis appear to have been influenced by the results of the TREAT study, which involved patients not on dialysis. Physicians claim to use risk-based target Hb levels to guide renal anaemia care. However, there is discrepancy between these declared risk-based target Hb levels and actual target Hb levels for patients with variable risk factors.
Source: International Urology and Nephrology - April 17, 2015 Category: Urology & Nephrology Source Type: research

Ischemic brain injury in hemodialysis patients: which is more dangerous, hypertension or intradialytic hypotension?
Ischemic brain injury in hemodialysis patients: which is more dangerous, hypertension or intradialytic hypotension? Kidney International 87, 1109 (June 2015). doi:10.1038/ki.2015.62 Authors: Christopher W McIntyre & David J Goldsmith
Source: Kidney International - May 29, 2015 Category: Urology & Nephrology Authors: Christopher W McIntyreDavid J Goldsmith Tags: brain injury hemodialysis leukoaraiosis myocardial stunning stroke Source Type: research

Water and solute transport across the peritoneal membrane
Purpose of review: We review the molecular mechanisms of peritoneal transport and discuss how a better understanding of these mechanisms is relevant for dialysis therapy. Recent findings: Peritoneal dialysis involves diffusion and osmosis through the highly vascularized peritoneal membrane. Computer simulations, expression studies and functional analyses in Aqp1 knockout mice demonstrated the critical role of the water channel aquaporin-1 (AQP1) in water removal during peritoneal dialysis. Pharmacologic regulation of AQP1, either through increased expression or gating, is associated with increased water transport in rodent...
Source: Current Opinion in Nephrology and Hypertension - August 11, 2015 Category: Urology & Nephrology Tags: MOLECULAR CELL BIOLOGY AND PHYSIOLOGY OF SOLUTE TRANSPORT: Edited by Alan S.L. Yu Source Type: research

Hemodialysis with end-stage renal disease did not raise the risk of intracranial hemorrhage after a head injury
Conclusions: HD +ESRD did not increase the post-HI risk of ICH. Therefore, it may not be necessary to lower the threshold of head CT in HD +ESRD patients.
Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine - October 28, 2015 Category: Emergency Medicine Authors: Hsin-Hung ChenChien-Chin HsuShih-Feng WengHung-Jung LinJhi-Joung WangHow-Ran GuoShih-Bin SuChien-Cheng HuangJiann-Hwa Chen Source Type: research

Outcomes of Chopart Amputation in a Tertiary Referral Diabetic Foot Clinic: Data From a Consecutive Series of 83 Hospitalized Patients
The purpose of the present retrospective study was to evaluate the outcomes (ie, ulcer recurrence, major amputation, death) in diabetic patients undergoing Chopart amputation because of deep infection or gangrene extending to the midfoot. From 2009 to 2011, 83 patients, aged 71.4 ± 9.3 years, underwent a midtarsal amputation and were followed up until December 31, 2012 (mean follow-up 2.8 ± 0.8 years). Of the 83 patients, 26 were female, 61 required insulin, 47 had renal insufficiency, 19 underwent hemodialysis, 65 had hypertension, 34 had a history of cardiac disease, and 4 had a history of stroke.
Source: Journal of Foot and Ankle Surgery - November 24, 2015 Category: Orthopaedics Authors: Ezio Faglia, Giacomo Clerici, Robert Frykberg, Maurizio Caminiti, Vincenzo Curci, Francesco Cetta, Vincenzo Prisco, Rosaria Greco, Marco Prisco, Alberto Morabito Tags: Original Research Source Type: research

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