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Novel approaches to hypoglycemia and burnt-out diabetes in chronic kidney disease
Purpose of review Diabetes mellitus is a leading cause of chronic kidney disease (CKD) that confers faster kidney disease progression, higher mortality, and various metabolic derangements including hypoglycemia. Recent findings Even in the absence of diabetes mellitus, growing research demonstrates that CKD patients are at heightened risk for hypoglycemia via multiple pathways. In CKD patients transitioning to end-stage renal disease (ESRD), spontaneous resolution of hyperglycemia and frequent hypoglycemia resulting in reduction and/or cessation of glucose-lowering medications are frequently observed in a phenom...
Source: Current Opinion in Nephrology and Hypertension - December 6, 2021 Category: Urology & Nephrology Tags: NOVEL THERAPEUTIC APPROACHES IN NEPHROLOGY AND HYPERTENSION: Edited by Ekamol Tantisattamo, Ramy M. Hanna and Kamyar Kalantar-Zadeh Source Type: research

MILLER Banding Procedure for Treatment of Dialysis Access-Related Steal Syndrome, Pulmonary Hypertension, and Heart Failure
Am Surg. 2021 Nov 18:31348211056259. doi: 10.1177/00031348211056259. Online ahead of print.ABSTRACTA Minimally Invasive Limited Ligation Endoluminal-assisted Revision (MILLER) banding procedure has been used for treating patients with dialysis access-related steal syndrome (DASS) and high-flow vascular access-related pulmonary hypertension (PHT) and heart failure (HF).We performed a retrospective analysis of patients undergoing the MILLER procedure performed for DASS, HF, and PHT from our Vascular Access Database from September 2017 to October 2019. Outcomes included primary patency of banding, primary assisted patency, an...
Source: The American Surgeon - November 19, 2021 Category: Surgery Authors: Ahmad Alqassieh Patrick B Dennis Veena Mehta June Shi Angello Lin Dave Taber Vinayak Rohan Source Type: research

Ankle-Brachial Index Is Independently Associated With Cardiovascular Outcomes and Foot Ulcers in Asian Patients With Type 2 Diabetes Mellitus
ConclusionsLow ABI was associated with cardiovascular events and diabetic foot ulcer independently in patients with type 2 DM.
Source: Frontiers in Endocrinology - November 18, 2021 Category: Endocrinology Source Type: research

Reducing the Risk of Stroke in Patients with Impaired Renal Function: Nutritional Issues
Patients with renal failure have extremely high cardiovascular risk; in dialysis patients the risk of stroke is increased approximately 10-fold over that in the general population. Reasons include not only a high prevalence of traditional risk factors such as diabetes, hypertension and dyslipidemia, but also the accumulation of toxic substances that are eliminated by the kidneys, so have very high levels in patients with renal failure. These include plasma total homocysteine, asymmetric dimethylarginine, thiocyanate, and toxic products of the intestinal microbiome (Gut-Derived Uremic Toxins; GDUT), which include trimethyla...
Source: Journal of Stroke and Cerebrovascular Diseases - November 17, 2020 Category: Neurology Authors: J. David Spence Tags: Review Article Source Type: research

Biosynthesis and characterization of a novel fibrinolytic alkaline serine protease from newly isolated Bacillus flexusBF12 for biomedical applications.
CONCLUSION: The Bacillus flexus BF12 fibrinolytic enzyme shows promising potentials in nutraceutical and food fortification applications. The application of fibrinolytic enzymes could prevent CVDs. PMID: 33208066 [PubMed - as supplied by publisher]
Source: Current Pharmaceutical Biotechnology - November 16, 2020 Category: Biotechnology Authors: Raj TS, Athimoolam S, Vijayaraghavan P Tags: Curr Pharm Biotechnol Source Type: research

New XARELTO ® (rivaroxaban) Peripheral Artery Disease (PAD) Data from EXPLORER Clinical Research Program to be Unveiled at American Heart Association (AHA) Scientific Sessions 2020
RARITAN, N.J., November 9, 2020 – The Janssen Pharmaceutical Companies of Johnson & Johnson today announced that 10 data presentations will be shared at the virtual American Heart Association (AHA) Scientific Sessions 2020 from November 13-17. Most notably, four new sub-analyses of XARELTO® (rivaroxaban) from the landmark VOYAGER PAD trial, part of the EXPLORER global cardiovascular research program, will be presented, including two live, featured science oral presentations. “We're pleased VOYAGER PAD was selected to be front and center once again at a major medical congress, as there's an urgent need for data in ...
Source: Johnson and Johnson - November 9, 2020 Category: Pharmaceuticals Tags: Innovation Source Type: news

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

Torsades de Pointes in Coronavirus Disease 2019 Infection
A 73-YEAR-OLD MAN (weight 69 kg, height 175 cm) was transferred to the authors ’ critical care unit with respiratory and acute renal failure secondary to coronavirus disease 2019 (COVID-19) infection. His past medical history included hypertension, diabetes, and previous stroke, from which he had made a full recovery. The patient was treated with mechanical ventilation and p eritoneal dialysis. He was recruited into the hydroxychloroquine arm of the RECOVERY (Randomised Evaluation of COVID-19 Therapy) trial.
Source: Journal of Cardiothoracic and Vascular Anesthesia - July 31, 2020 Category: Anesthesiology Authors: Bagrat Lalabekyan, Gudrun Kunst, Vanessa A. Skelton Tags: Diagnostic Dilemma Source Type: research

Characteristics of patients at initiation of renal replacement therapy - experience of a hemodialysis center.
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 - June 9, 2020 Category: General Medicine Tags: Exp Ther Med Source Type: research

Association of Serum Uromodulin with Death, Cardiovascular Events, and Kidney Failure in CKD.
CONCLUSIONS: Higher serum uromodulin is independently associated with lower risk for mortality, cardiovascular events, and kidney failure in white patients with CKD. CLINICAL TRIAL REGISTRY NAME AND REGISTRATION NUMBER: Deutsches Register für Klinische Studien (DRKS; German national database of clinical studies), DRKS00003971. PMID: 32291270 [PubMed - as supplied by publisher]
Source: Clinical Journal of the American Society of Nephrology : CJASN - April 13, 2020 Category: Urology & Nephrology Authors: Steubl D, Schneider MP, Meiselbach H, Nadal J, Schmid MC, Saritas T, Krane V, Sommerer C, Baid-Agrawal S, Voelkl J, Kotsis F, Köttgen A, Eckardt KU, Scherberich JE, GCKD Study Investigators Tags: Clin J Am Soc Nephrol Source Type: research

Effects and outcomes of cardiac surgery in patients with cardiometabolic syndrome
ConclusionsPatients with CMS were more likely to present with increased comorbidities. Patients with CMS undergoing CABG were at risk for worse short ‐term secondary postoperative outcomes and reduced long‐term survival. The data supports the need for further investigation for risk reduction surrounding operative revascularization.
Source: Journal of Cardiac Surgery - February 17, 2020 Category: Cardiovascular & Thoracic Surgery Authors: David Zapata, Michael Halkos, Jose Binongo, John Puskas, Robert Guyton, Omar Lattouf Tags: ORIGINAL ARTICLE Source Type: research

Prevention and treatment of stroke in patients with chronic kidney disease: an overview of evidence and current guidelines
Chronic Kidney Disease (CKD) is strongly associated with an increased risk of stroke, small vessel disease, and vascular dementia. Common vascular factors for stroke, such as hypertension, diabetes, and atrial fibrillation, are more prevalent in CKD patients, accounting for this association. However, factors unique to these patients, such as uraemia, oxidative stress, mineral and bone abnormalities, as well as dialysis-related factors are also believed to contribute to risk. Despite improvements in stroke treatment and survival in the general population, the rate of improvement in patients with CKD, especially those who ar...
Source: Kidney International - October 17, 2019 Category: Urology & Nephrology Authors: Dearbhla M. Kelly, Peter M. Rothwell Tags: Review Source Type: research

Chronic disease burdens of incident U.S.  dialysis patients, 1996 - 2015
.
DISCUSSION: Mortality and cardiovascular disease burden have declined for dialysis patients in the United States despite an aging population that is increasingly hypertensive and diabetic. Comorbid disease burdens among HD and PD patients have diverged over time, with PD patients having fewer comorbid conditions.
. PMID: 31599226 [PubMed - as supplied by publisher]
Source: Clinical Nephrology - October 9, 2019 Category: Urology & Nephrology Authors: McGill RL, Bragg-Gresham JL, He K, Lacson EK, Miskulin DC, Saran R Tags: Clin Nephrol Source Type: research

Serum lipoprotein(a) and risk of hemorrhagic stroke among incident peritoneal dialysis patients: a large study from a single center in China.
Conclusions: Among patients with incident PD, a higher serum Lp(a) level may predict a lower risk of hemorrhagic stroke. PMID: 31498021 [PubMed - in process]
Source: Renal Failure - September 10, 2019 Category: Urology & Nephrology Tags: Ren Fail Source Type: research

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