The effect of dialysis modality (PD and HD) on cardiac morphology and functions in chronic kidney disease patients at very high cardiovascular risk

Background and aims The aim of this study was to develop an integrated central blood pressure–aortic stiffness (ICPS) risk score to predict cardiovascular events. Methods It was a retrospective cohort study. A total of 100 chronic kidney disease (CKD) patients on conservative therapy were included. Pulse wave velocity (PWV), central systolic blood pressure (cSBP), and central pulse pressure (cPP) were measured. A score was assigned to tertiles of PWV (0–2), cPP (0–2), and cSBP (0 to the first and second and 1 to the third tertile) based on each parameter’s ability to individually predict cardiovascular outcome. The sum of these scores and three ICPS risk categories as predictors were studied. Finally, we compared discrimination of the ICPS risk categories with PWV, cSBP, and cPP. Results Adjusted for age and sex, patients in high and very high ICPS risk categories had increased cardiovascular risk (HR: 3.52, 95% CI: 1.65–7.49; HR: 7.56, 95% CI: 3.20–17.85, respectively). High and very high ICPS risk categories remained independent predictors in a model adjusted for multiple CV risk factors (HR: 4.58, 95% CI: 1.65–7.49; HR: 8.56, 95% CI: 3.09–23.76, respectively). ICPS risk categories (Harrell’s C: 0.723, 95% CI: 0.652–0.795) showed better discrimination than PWV (Harrell’s C: 0.659, 95% CI: 0.586–0.732, p = 0.028) and cSBP (Harrell’s C: 0.660, 95% CI: 0.584–0.735, p = 0.008) and there has been a tendency of significance in case of cPP (Harrell’s C: 0.691, 95% CI: 0.621–0.761, p = 0.170). Conclusion The ICPS score may clinically importantly improve the identification of CKD patients with elevated cardiovascular risk.

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Reference Renal Artery Diameter Is a Stronger Predictor of Contrast-Induced Nephropathy than Chronic Kidney Disease in Patients with High Cardiovascular Risk

Nephron Extra ◽

10.1159/000329895 ◽

2011 ◽

Vol 1 (1) ◽

pp. 38-44 ◽

Cited By ~ 2

Author(s):

Luca Zanoli ◽

Stefania Rastelli ◽

Carmelita Marcantoni ◽

Julien Blanco ◽

Davide Capodanno ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Cardiovascular Risk ◽

Kidney Disease ◽

Renal Artery ◽

High Cardiovascular Risk ◽

Contrast Induced Nephropathy

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Phenotypic Fitness of Primary Endothelial Cells Cultured from Patients with High Cardiovascular Risk or Chronic Kidney Disease for Vascular Tissue Engineering

Tissue Engineering Part A ◽

10.1089/ten.tea.2013.0163 ◽

2014 ◽

Vol 20 (5-6) ◽

pp. 1049-1059

Author(s):

Irma L. Geenen ◽

Sanne Verbruggen ◽

Daniel G. Molin ◽

Henri M. Spronk ◽

Jos G. Maessen ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Tissue Engineering ◽

Endothelial Cells ◽

Cardiovascular Risk ◽

Kidney Disease ◽

Vascular Tissue ◽

Vascular Tissue Engineering ◽

High Cardiovascular Risk ◽

Phenotypic Fitness ◽

Cells Cultured

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Rationale of screening for early kidney damage in patients with high cardiovascular risk: nephrologist’s point of view

Seminars in Cardiovascular Medicine ◽

10.2478/semcard-2013-0001 ◽

2013 ◽

Vol 19 (1) ◽

pp. 1-8

Author(s):

Laurynas Rimševičius ◽

Diana Aksionova ◽

Marius Miglinas ◽

Jolita Badarienė ◽

Ligita Ryliškytė ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Glomerular Filtration Rate ◽

Cardiovascular Risk ◽

Kidney Disease ◽

Glomerular Filtration ◽

Filtration Rate ◽

Risk Groups ◽

Kidney Damage ◽

High Cardiovascular Risk ◽

Family History Of Diabetes

SummaryIncreased awareness of chronic kidney disease stimulates an interest towards early detection and prevention. The true prevalence of kidney injury varies from 10 to 40%, mostly depending on the methodology of the study and the population enrolled. A screening strategy targeting the highest risk groups, those with diabetes or hypertension, family history of diabetes, hypertension, or kidney disease, is likely to be most efficient and cost effective. Quantification for albuminuria should be performed using laboratorymethods or albumin to creatinine ratio and should be monitored at regular intervals. The most correct equations calculating glomerular filtration rate differ in separate populations, and the most accurate equations in patients with high cardiovascular risk are MDRD and CKD-EPI. Markers of early kidney damage have association with other target organs damage, even in subclinical or preclinical mode. Individuals at stage 4 and 5 chronic kidney disease, with higher levels of proteinuria, proteinuria together with haematuria, rapidly declining glomerular filtration rate, or poorly controlled hypertension should be referred to a nephrologist in order to identify the cause, provide recommendations, slow progression, or treat complications.

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Apolipoproteins: Good Markers for Cardiovacular Risk in Patients with Chronic Kidney Disease and Dyslipidemia

Romanian Journal of Diabetes Nutrition and Metabolic Diseases ◽

10.2478/rjdnmd-2014-0023 ◽

2014 ◽

Vol 21 (3) ◽

pp. 185-191 ◽

Cited By ~ 3

Author(s):

Mirela - Nicoleta Tudor ◽

Adina Mitrea ◽

Simona Georgiana Popa ◽

Sorin Zaharie ◽

Maria Moţa ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Cardiovascular Risk ◽

Kidney Disease ◽

Estimated Glomerular Filtration Rate ◽

Control Group ◽

C Reactive Protein ◽

High Cardiovascular Risk ◽

Apo B ◽

Reactive Protein ◽

And Control

AbstractBackground and aims. Dyslipidemia (DLP) is a common complication of chronic kidney disease (CKD) and may accelerate its progression. Circulating lipoproteins and their constituent proteins, apolipoproteins, are risk factors for CKD and cardiovascular diseases (CVD). The aim of the study was to determine whether there is a correlation between apolipoproteins and estimated glomerular filtration rate (eGFR) or between apolipoproteins and anthropometrical and laboratory parameters or between evaluated cardiovascular risk (CV) and dyslipidemia/CKD. Material and methods. We performed a study on 51 subjects from the Nephrology Department of Emergency Clinical County Hospital of Craiova, from November 2011 to July 2013. Results. We found statistically significant correlations between eGFR and Apo A1. Also we found a linear correlation between C-reactive protein (CRP) and Apo B. When we evaluated the CV risk using CRP, we found statistically significant differences between the groups (CKD and DLP, only CKD, only DLP and control group), patients with CKD and DLP showing the highest levels of CRP. Conclusions. Elevated levels of Apo A1 are associated with a low rate of CKD. DLP and chronic inflammation play an important role in the progression of CKD. Patients with CKD and DLP had a high cardiovascular risk.

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