scholarly journals Artherosclerotic Renovascular Disease: A KDIGO (Kidney Disease: Improving Global Outcomes) Controversies Conference

2021 ◽  
Author(s):  
Caitlin W. Hicks ◽  
Timothy W.I. Clark ◽  
Christopher J. Cooper ◽  
Áine M. de Bhailis ◽  
Marco De Carlo ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Renovascular Disease

Detection of Occult Renovascular Disease in Unexplained Chronic Kidney Disease

2005 ◽  
Vol 37 (4) ◽  
pp. 793-796 ◽  
Author(s):  
Tushar J. Vachharajani ◽  
Janet E. Dacie ◽  
Magadi M. Yaqoob ◽  
Anthony E. G. Raine ◽  
Laurence R. I. Baker
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Renovascular Disease

Association of novel biomarkers with major clinical outcomes in a cohort of patients with atherosclerotic renovascular disease

2019 ◽  
Vol 56 (4) ◽  
pp. 488-501
Author(s):  
Diana Vassallo ◽  
Helen Alderson ◽  
Nicolas Vuilleumier ◽  
James Ritchie ◽  
Darren Green ◽  
...  
Keyword(s):  
Risk Factors ◽  
Kidney Disease ◽  
Patient Selection ◽  
End Stage Kidney Disease ◽  
Renovascular Disease ◽  
Novel Biomarkers ◽  
Selection For ◽  
Traditional Risk Factors ◽  
End Stage ◽  
Atherosclerotic Renovascular Disease

Introduction In this study, we investigate whether the addition of biomarkers to a model based on traditional risk factors improves risk prediction and patient selection for revascularization in atherosclerotic renovascular disease. Methods Patients in the Salford Renovascular Study who had the following biomarkers analysed on a baseline sample were included in this study: FGF-23, Cystatin C, kidney injury molecule-1, myeloperoxidase, neutrophil gelatinase-associated lipocalin, N-terminal prohormone of brain natriuretic peptide (NT-proBNP), high-sensitivity Troponin T and anti-apolipoprotein A1 IgG. Cox proportional hazards models and net reclassification index were used to study the effects of either individual or a panel of biomarkers on predicting death, end-stage kidney disease and cardiovascular events. Results A total of 112 patients were followed up for a median 59.9 months (IQR 33.6–86.9). In total, 75 patients died, 21 reached end-stage kidney disease and 36 suffered a cardiovascular event. Only NT-proBNP maintained a statistically significant association with all end-points (death: HR 1.62 [95% CI 1.26–2.10], P < 0.0005; end-stage kidney disease: HR 1.51 [95% 1.19–1.91], P = 0.001; cardiovascular event: HR 1.56 [95% CI 1.23–1.97], P < 0.0005). Risk reclassification improved with addition of all biomarkers as a panel to the base model. Only patients with NT-proBNP concentrations above 300 ng/L gained benefit from revascularization with regard to all adverse end-points compared with medically managed patients. Conclusions NT-proBNP is independently associated with increased risk for all adverse events in atherosclerotic renovascular disease. Novel biomarkers may have an incremental risk predictive value when used in combination with traditional risk factors, and NT-proBNP may have value in patient selection for revascularization. Given the small size of this study, larger multicentre studies are required to validate these findings.

Atherosclerotic renovascular disease

2010 ◽  
pp. 4078-4078
Author(s):  
P A Kalra ◽  
J D Firth
Keyword(s):  
Heart Failure ◽  
Kidney Disease ◽  
Cardiovascular Events ◽  
Uncontrolled Hypertension ◽  
Rapid Decline ◽  
Renovascular Disease ◽  
Vascular Beds ◽  
End Stage ◽  
Parenchymal Injury ◽  
Atherosclerotic Renovascular Disease

Atherosclerotic renovascular disease (ARVD) refers to atheromatous narrowing of one or both renal arteries and frequently co-exists with atherosclerotic disease in other vascular beds. Patients with this condition are at high risk of adverse cardiovascular events, with mortality around 8% per year. Many patients with ARVD have chronic kidney disease, but only a minority progress to end-stage kidney disease (ESKD), suggesting that pre-existing hypertensive and/or ischaemic renal parenchymal injury is the usual cause of renal dysfunction. Many patients with ARVD are asymptomatic, but there can be important complications such as uncontrolled hypertension, rapid decline in kidney function and recurrent acute heart failure (flash pulmonary oedema)....

Atherosclerotic renovascular disease

2020 ◽  
pp. 5044-5048
Author(s):  
Philip A. Kalra ◽  
Diana Vassallo
Keyword(s):  
Kidney Disease ◽  
Angiotensin Receptor Blockers ◽  
Controlled Trial ◽  
Antihypertensive Agents ◽  
Antiplatelet Agents ◽  
Uncontrolled Hypertension ◽  
Rapid Decline ◽  
Renovascular Disease ◽  
Converting Enzyme Inhibitors ◽  
Atherosclerotic Renovascular Disease

Atherosclerotic renovascular disease (ARVD) refers to atheromatous narrowing of one or both renal arteries and frequently coexists with atherosclerotic disease in other vascular beds. Patients with this condition are at high risk of adverse cardiovascular events, with mortality around 8% per year. Many patients with ARVD have chronic kidney disease, but only a minority progress to endstage kidney disease, suggesting that pre-existing hypertensive and/or ischaemic renal parenchymal injury is the usual cause of renal dysfunction. Many patients with ARVD are asymptomatic, but there can be important complications such as uncontrolled hypertension, rapid decline in kidney function, and recurrent acute heart failure (flash pulmonary oedema). Management—patients with ARVD should receive medical vascular protective therapy just like other patients with atheromatous disease. This involves antiplatelet agents such as aspirin, statins, antihypertensive agents (angiotensin-converting enzyme inhibitors or angiotensin receptor blockers are the drugs of choice), optimization of glycaemic control in diabetic patients, and advice/help to stop smoking. On the basis of randomized controlled trial data, they should not be offered revascularization by angioplasty/stenting for the purpose of improving blood pressure control or stabilizing/improving renal function. However, there is evidence that a subgroup of patients with specific complications of ARVD (as previously mentioned) may benefit from revascularization.

scholarly journals Mesenchymal stromal cell-based therapy in kidney diseases and transplantation

2019 ◽  
Vol 13 (1) ◽  
pp. 3-14
Author(s):  
Federica Casiraghi ◽  
Giuseppe Remuzzi
Keyword(s):  
Acute Kidney Injury ◽  
Kidney Transplantation ◽  
Kidney Disease ◽  
Mesenchymal Stromal Cell ◽  
Stromal Cell ◽  
Kidney Diseases ◽  
Kidney Injury ◽  
Inflammatory Cells ◽  
Renovascular Disease ◽  
Cell Based Therapy

Intense investigation in pre-clinical models of kidney disease and transplantation showed that mesenchymal stromal cell (MSC) therapy acts on renal and inflammatory cells in multiple, complex and integrated ways, resulting in cell repair and regeneration, in the inhibition of inflammatory cells, and in the development of cells endowed with their own anti-inflammatory and immuneregulatory properties. These encouraging data paved the way for exploring the use of MSC in clinics as innovative therapeutic tools for patients with renal diseases and transplantation. In this review, we describe the available results of clinical studies of MSC in patients with post-cardiac surgery, acute kidney injury, chronic kidney diseases - including diabetes, renovascular disease and lupus nephritis - and in kidney transplant recipients, with a particular focus on our experience with MSC therapy as a pro-tolerogenic strategy in kidney transplantation. The available studies, mainly phase 1, indicated that MSC therapy is safe and feasible and not associated with adverse events, at least in the short- and mid-term. Encouraging results have been reported in renovascular disease and kidney transplantation, while studies in acute kidney injury and chronic kidney disease had contrasting outcomes. The relevant issues and the knowledge gap that still limit the translation of MSC cell therapy into clinical practice are discussed briefly.

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