scholarly journals Atorvastatin treatment does not abolish inflammatory mediated cardiovascular risk in subjects with chronic kidney disease

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Renate M. Hoogeveen ◽  
Simone L. Verweij ◽  
Yannick Kaiser ◽  
Jeffrey Kroon ◽  
Hein J. Verberne ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Chronic Kidney Disease ◽  
Cardiovascular Risk ◽  
Kidney Disease ◽  
Arterial Wall ◽  
Ldl Cholesterol ◽  
Statin Treatment ◽  
Receptor Expression ◽  
Disease Stage ◽  
Cellular Inflammation

AbstractIndividuals with chronic kidney disease are at an increased risk for cardiovascular disease. This risk may partially be explained by a chronic inflammatory state in these patients, reflected by increased arterial wall and cellular inflammation. Statin treatment decreases cardiovascular risk and arterial inflammation in non-CKD subjects. In patients with declining kidney function, cardiovascular benefit resulting from statin therapy is attenuated, possibly due to persisting inflammation. In the current study, we assessed the effect of statin treatment on arterial wall and cellular inflammation. Fourteen patients with chronic kidney disease stage 3 or 4, defined by an estimated Glomerular Filtration Rate between 15 and 60 mL/min/1.73 m2, without cardiovascular disease were included in a single center, open label study to assess the effect of atorvastatin 40 mg once daily for 12 weeks (NTR6896). At baseline and at 12 weeks of treatment, we assessed arterial wall inflammation by 18F-fluoro-deoxyglucose positron-emission tomography computed tomography (18F-FDG PET/CT) and the phenotype of circulating monocytes were assessed. Treatment with atorvastatin resulted in a 46% reduction in LDL-cholesterol, but this was not accompanied by an attenuation in arterial wall inflammation in the aorta or carotid arteries, nor with changes in chemokine receptor expression of circulating monocytes. Statin treatment does not abolish arterial wall or cellular inflammation in subjects with mild to moderate chronic kidney disease. These results imply that CKD-associated inflammatory activity is mediated by factors beyond LDL-cholesterol and specific anti-inflammatory interventions might be necessary to further dampen the inflammatory driven CV risk in these subjects.

scholarly journals A Step Closer to the “Fourth 90”: A Practical Narrative Review of Diagnosis and Management of Nutritional Issues of People Living with HIV

Diagnostics ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. 2047
Author(s):  
Davide Fiore Bavaro ◽  
Paola Laghetti ◽  
Mariacristina Poliseno ◽  
Nicolò De Gennaro ◽  
Francesco Di Gennaro ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Cardiovascular Risk ◽  
Kidney Disease ◽  
Current Knowledge ◽  
Disease Stage ◽  
Oral Glucose ◽  
People Living With Hiv ◽  
Diagnosis And Management ◽  
Increased Risk ◽  
Living With Hiv

The quality of life of people living with HIV (PLWH) has remarkably increased thanks to the introduction of combined antiretroviral therapy. Still, PLWH are exposed to an increased risk of cardiovascular diseases, diabetes, chronic kidney disease, and liver disease. Hence, the purpose of this review is to summarize the current knowledge about diagnosis and nutritional management with specific indication of macro and micronutrients intake for the main comorbidities of PLWH. In fact, a prompt diagnosis and management of lifestyle behaviors are fundamental steps to reach the “fourth 90”. To achieve an early diagnosis of these comorbidities, clinicians have at their disposal algorithms such as the Framingham Score to assess cardiovascular risk; transient elastography and liver biopsy to detect NAFLD and NASH; and markers such as the oral glucose tolerance test and GFR to identify glucose impairment and renal failure, respectively. Furthermore, maintenance of ideal body weight is the goal for reducing cardiovascular risk and to improve diabetes, steatosis and fibrosis; while Mediterranean and low-carbohydrate diets are the dietetic approaches proposed for cardioprotective effects and for glycemic control, respectively. Conversely, diet management of chronic kidney disease requires different nutritional assessment, especially regarding protein intake, according to disease stage and eventually concomitant diabetes.

scholarly journals Cardiovascular Risk in Chronic Kidney Disease: Role of the Sympathetic Nervous System

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Jeanie Park
Keyword(s):  
Cardiovascular Disease ◽  
Chronic Kidney Disease ◽  
Renal Failure ◽  
Nervous System ◽  
Cardiovascular Risk ◽  
Kidney Disease ◽  
Sympathetic Nervous System ◽  
Renal Disease ◽  
Left Ventricular ◽  
Sympathetic Nervous

Patients with chronic kidney disease are at significantly increased risk for cardiovascular disease and sudden cardiac death. One mechanism underlying increased cardiovascular risk in patients with renal failure includes overactivation of the sympathetic nervous system (SNS). Multiple human and animal studies have shown that central sympathetic outflow is chronically elevated in patients with both end-stage renal disease (ESRD) and chronic kidney disease (CKD). SNS overactivation, in turn, increases the risk of cardiovascular disease and sudden death by increasing arterial blood pressure, arrythmogenicity, left ventricular hypertrophy, and coronary vasoconstriction and contributes to the progression renal disease. This paper will examine the evidence for SNS overactivation in renal failure from both human and experimental studies and discuss mechanisms of SNS overactivity in CKD and therapeutic implications.

scholarly journals Cardiovascular Risk Factors and Chronic Kidney Disease—FGF23: A Key Molecule in the Cardiovascular Disease

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Rika Jimbo ◽  
Tatsuo Shimosawa
Keyword(s):  
Cardiovascular Disease ◽  
Chronic Kidney Disease ◽  
Cardiovascular Risk ◽  
Kidney Disease ◽  
Fibroblast Growth Factor 23 ◽  
Left Ventricular ◽  
Cardiovascular Risks ◽  
Mineral And Bone Disorder ◽  
Promising Target ◽  
Increased Risk

Patients with chronic kidney disease (CKD) are at increased risk of mortality, mainly from cardiovascular disease. Moreover, abnormal mineral and bone metabolism, the so-called CKD-mineral and bone disorder (MBD), occurs from early stages of CKD. This CKD-MBD presents a strong cardiovascular risk for CKD patients. Discovery of fibroblast growth factor 23 (FGF23) has altered our understanding of CKD-MBD and has revealed more complex cross-talk and endocrine feedback loops between the kidney, parathyroid gland, intestines, and bone. During the past decade, reports of clinical studies have described the association between FGF23 and cardiovascular risks, left ventricular hypertrophy, and vascular calcification. Recent translational reports have described the existence of FGF23-Klotho axis in the vasculature and the causative effect of FGF23 on cardiovascular disease. These findings suggest FGF23 as a promising target for novel therapeutic approaches to improve clinical outcomes of CKD patients.

Socio-Economic Disparities in the Distribution of Cardiovascular Risk in Chronic Kidney Disease Stage 3

2012 ◽  
Vol 122 (1-2) ◽  
pp. 58-65 ◽  
Author(s):  
Simon D.S. Fraser ◽  
Paul J. Roderick ◽  
Natasha J. McIntyre ◽  
Scott Harris ◽  
Christopher W. McIntyre ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Cardiovascular Risk ◽  
Kidney Disease ◽  
Chronic Kidney Disease Stage ◽  
Disease Stage ◽  
Economic Disparities

Diabetes, Cardiovascular Disease, and Cardiovascular Risk in Patients with Chronic Kidney Disease

2021 ◽  
Vol 28 (2) ◽  
pp. 159-165
Author(s):  
Jose J. G. De Lima ◽  
Luis Henrique W. Gowdak ◽  
Elias David-Neto ◽  
Luiz A. Bortolotto
Keyword(s):  
Cardiovascular Disease ◽  
Chronic Kidney Disease ◽  
Cardiovascular Risk ◽  
Kidney Disease

scholarly journals Carotid plaque thickness is increased in chronic kidney disease and associated with carotid and coronary calcification

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0260417
Author(s):  
Sasha S. Bjergfelt ◽  
Ida M. H. Sørensen ◽  
Henrik Ø. Hjortkjær ◽  
Nino Landler ◽  
Ellen L. F. Ballegaard ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Coronary Arteries ◽  
Carotid Plaque ◽  
Chronic Kidney Disease Stage ◽  
Disease Stage ◽  
Arterial Calcification ◽  
Carotid Plaques ◽  
Computed Tomography Scanning

Background Chronic kidney disease accelerates both atherosclerosis and arterial calcification. The aim of the present study was to explore whether maximal carotid plaque thickness (cPTmax) was increased in patients with chronic kidney disease compared to controls and associated with cardiovascular disease and severity of calcification in the carotid and coronary arteries. Methods The study group consisted of 200 patients with chronic kidney disease stage 3 from the Copenhagen Chronic Kidney Disease Cohort and 121 age- and sex-matched controls. cPTmax was assessed by ultrasound and arterial calcification by computed tomography scanning. Results Carotid plaques were present in 58% of patients (n = 115) compared with 40% of controls (n = 48), p = 0.002. Among participants with plaques, cPTmax (median, interquartile range) was significantly higher in patients compared with controls (1.9 (1.4–2.3) versus 1.5 (1.2–1.8) mm), p = 0.001. Cardiovascular disease was present in 9% of patients without plaques (n = 85), 23% of patients with cPTmax 1.0–1.9 mm (n = 69) and 35% of patients with cPTmax >1.9 mm (n = 46), p = 0.001. Carotid and coronary calcium scores >400 were present in 0% and 4%, respectively, of patients with no carotid plaques, in 19% and 24% of patients with cPTmax 1.0–1.9 mm, and in 48% and 53% of patients with cPTmax >1.9 mm, p<0.001. Conclusions This is the first study showing that cPTmax is increased in patients with chronic kidney disease stage 3 compared to controls and closely associated with prevalent cardiovascular disease and severity of calcification in both the carotid and coronary arteries.

scholarly journals Higher Fibrinogen Levels Among Patient With End-Stage Kidney Disease Post Initiation Of Peritoneal Dialysis: Cardiovascular Risk Attenuation

2020 ◽  
Vol 6 (4) ◽  
pp. 1-10
Author(s):  
Issa Al Salmi ◽  
Keyword(s):  
Cardiovascular Disease ◽  
Chronic Kidney Disease ◽  
Peritoneal Dialysis ◽  
Cardiovascular Risk ◽  
Kidney Disease ◽  
End Stage Kidney Disease ◽  
End Stage

Defects in both coagulation initiation and fibrinolysis have been identified in Chronic Kidney Disease (CKD) patients and patients on dialysis may have higher rates of Cardiovascular Disease (CVD) events.

scholarly journals Endocan level in patients with chronic kidney disease

2021 ◽  
Vol 11-12 (221-222) ◽  
pp. 35-42
Author(s):  
Togzhan Abdikalikova ◽  
◽  
Lyudmila Turgunova ◽  
Botagoz Baidildina ◽  
Zhanar Mursalova ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Chronic Kidney Disease ◽  
Glomerular Filtration Rate ◽  
Cardiovascular Risk ◽  
Kidney Disease ◽  
Total Cholesterol ◽  
Filtration Rate ◽  
Active Smoking

The relevance of the work is due to the high prevalence of chronic kidney disease (CKD) among the population and high mortality from cardiovascular disease (CVD) in this population. In this connection, it is necessary to search for new biomarkers in order to early identify individuals with cardiovascular risk in patients with CKD. The purpose of this study to assess the endocan level in patients with CKD depending on the glomerular filtration rate (GFR), to study the relationship between the endocan level and other cardiovascular risk factors in patients with CKD. Material and methods. 153 respondents with various stages of CKD were examined. The study included socio-demographic, anthropometric data, blood pressure measurements, cholesterol, high density lipoprotein (HDL), triglycerides (TG), glucose and endocan. Data analysis was performed using the statistical software package SPSS 22. Results and discussion. The respondents in the groups did not differ in such indicators as gender, age, marital status, frequency of active smoking, diabetes, body mass index (BMI). Significant differences were found in the level of education (p=0.04), income (p=0.008), systolic pressure (SBP) (p=0.0001) and diastolic blood pressure (DBP) (p=0.0001). Levels of total cholesterol (cholesterol), (p=0.0001), uric acid (p=0.0001), cystatin C (p=0.0001) and endocan (p=0.0001) also had significant differences depending on GFR. Conclusion. A comparative analysis of the frequency of “traditional” cardiovascular risk factors among patients with various stages of CKD showed the absence of differences in the frequency of active smoking, diabetes mellitus, obesity and the presence of significant differences in blood pressure and total cholesterol (p = 0.0001). Evaluation of the endocan level depending on the stage of CKD showed that with the progression of CKD, the endocan level increases significantly (p = 0.0001), which may indicate the progression of endothelial dysfunction with impaired renal function. Further studies are needed to determine the prognostic value of endocan in the development of cardiovascular events in patients with CKD. Keywords: chronic kidney disease, cardiovascular disease, glomerular filtration rate, biomarkers, endocan.

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