GALECTIN-3 LEVELS IN PATIENTS WITH CONGESTIVE HEART FAILURE NYHA III-IV AND CHRONIC KIDNEY DISEASE

Background: Despite of considerable advances in its diagnosis and management, heart failure remains an unsettled problem and life threatening. Heart failure with a growing prevalence represents a burden to healthcare system, responsible for deterioration of patient’s daily activities. Galectin-3 is a new cardiac biomarker in prognosis for heart failure. Serum galectin-3 has some relation to heart failure NYHA classification, acute coronary syndrome and clinical outcome. Level of serum galectin-3 give information for prognosis and help risk stratifications in patient with heart failure, so intensive therapeutics can be approached to patients with high risk. Objective: To examine plasma galectin-3 level in hospitalized heart failure patients, investigate the relationship between galectin-3 level with associated diseases, clinical conditions and disease progression in hospital. Methodology: Cross sectional study. Result: 20 patients with severe heart failure as NYHA classification were diagnosed by The ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure (2012) and performed blood test for serum galectin-3 level. Increasing of serum galectin-3 level have seen in all patients, mean value is 36.5 (13.7 – 74.0), especially high level in patient with acute coronary syndrome and patients with severe chronic kidney disease. There are five patients dead. Conclusion: Serum galectin-3 level increase in patients with heart failure and has some relation to NYHA classification, acute coronary syndrome. However, level of serum galectin-3 can be affected by severe chronic kidney disease, more research is needed on this aspect Key words: Serum galectin-3, heart failure, ESC Guidelines, NYHA

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Abstract MP012: Plasma Galectin-3 Levels and Subsequent Risk of Incident Chronic Kidney Disease

Circulation ◽

10.1161/circ.135.suppl_1.mp012 ◽

2017 ◽

Vol 135 (suppl_1) ◽

Author(s):

Casey M Rebholz ◽

Elizabeth Selvin ◽

Menglu Liang ◽

Christie M Ballantyne ◽

Ron C Hoogeveen ◽

...

Keyword(s):

Heart Failure ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Proportional Hazards ◽

Disease Risk ◽

Positive Association ◽

Cox Proportional Hazards ◽

Diabetes Status ◽

Incident Chronic Kidney Disease ◽

Galectin 3

Introduction: Galectin-3 is a 35 kDa β-galactoside-binding lectin which has been proposed as a novel biomarker of heart failure primarily due to its involvement in myocardial fibrosis. Elevated levels of galectin-3 may be associated with fibrosis of other organs, such as the kidney, and increase the risk of developing kidney disease. Methods: Using Cox proportional hazards regression, we prospectively analyzed Atherosclerosis Risk in Communities (ARIC) study participants with measurements of plasma galectin-3 levels at baseline (visit 4, 1996-98) and without prevalent kidney disease or heart failure (N=9,647). Incident chronic kidney disease was defined as estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m 2 accompanied by 25% eGFR decline, chronic kidney disease-related hospitalization or death, or end-stage renal disease between baseline and December 31, 2013. Results: 2,105 participants (22%) developed incident chronic kidney disease over a median follow-up of 16 years. The mean (standard deviation) plasma level of galectin-3 was 14.7 (4.4) ng/mL. At baseline, galectin-3 was cross-sectionally associated with eGFR (r = -0.31) and urine albumin-to-creatinine ratio (UACR) (r = 0.19). After adjusting for demographics and kidney disease risk factors, there was a significant, graded, and positive association between galectin-3 and incident chronic kidney disease (quartile 4 vs. 1 HR: 1.84, 95% CI: 1.62, 2.09, p for trend <0.001). The association between galectin-3 and incident chronic kidney disease was attenuated but remained significant after accounting for eGFR and UACR (quartile 4 vs. 1 HR: 1.58, 95% CI: 1.39, 1.80, p for trend <0.001). The association was similar by diabetes status (p for interaction = 0.33) and stronger among those with hypertension (p for interaction = 0.004). Conclusion: In this community-based population, higher plasma galectin-3 levels were associated with elevated risk of developing incident chronic kidney disease, particularly among those with hypertension.

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O210 Risk factors for congestive heart failure in patients with chronic kidney disease: the CRIC study

Global Heart ◽

10.1016/j.gheart.2014.03.1415 ◽

2014 ◽

Vol 9 (1) ◽

pp. e58

Author(s):

Jiang He ◽

Wei Yang ◽

Amanda Anderson ◽

Harold Feldman ◽

John Kusek ◽

...

Keyword(s):

Risk Factors ◽

Heart Failure ◽

Chronic Kidney Disease ◽

Congestive Heart Failure ◽

Kidney Disease

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Acute kidney injury on chronic kidney disease: from congestive heart failure to light chain deposition disease and cast nephropathy in multiple myeloma

Journal of Community Hospital Internal Medicine Perspectives ◽

10.1080/20009666.2019.1624136 ◽

2019 ◽

Vol 9 (4) ◽

pp. 319-321

Author(s):

Sana Shaikh ◽

Christian Nwankwo ◽

Alexandre Lacasse ◽

Steven Cheng

Keyword(s):

Heart Failure ◽

Chronic Kidney Disease ◽

Multiple Myeloma ◽

Congestive Heart Failure ◽

Acute Kidney Injury ◽

Kidney Disease ◽

Kidney Injury ◽

Light Chain Deposition Disease ◽

Cast Nephropathy ◽

Light Chain Deposition

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Diuretics in critical illness

10.1093/med/9780199600830.003.0058 ◽

2016 ◽

Author(s):

Marlies Ostermann ◽

Ruth Y. Y. Wan

Keyword(s):

Heart Failure ◽

Chronic Kidney Disease ◽

Congestive Heart Failure ◽

Renal Function ◽

Liver Disease ◽

Kidney Disease ◽

Chronic Liver Disease ◽

Fluid Overload ◽

Chronic Liver ◽

Risk Of Death

Fluid overload and chronic hypertension are the most common indications for diuretics. The diuretic response varies between different types and depends on underlying renal function. In patients with congestive heart failure, diuretics appear to reduce the risk of death and worsening heart failure compared with placebo, but their use in acute decompensated heart failure is questionable. Diuretics are also widely used in chronic kidney disease to prevent or control fluid overload, and treat hypertension. In acute kidney injury, there is no evidence that they improve renal function, speed up recovery, or change mortality. In patients with chronic liver disease and large volume ascites, paracentesis is more effective and associated with fewer adverse events than diuretic therapy, but maintenance treatment with diuretics is indicated to prevent recurrence of ascites. Mannitol has a role in liver patients with cerebral oedema and normal renal function. The use of diuretics in rhabdomyolysis is controversial and restricted to patients who are not fluid deplete. In conditions associated with resistant oedema (chronic kidney disease, congestive heart failure, chronic liver disease), combinations of diuretics with different modes of action may be necessary. Diuresis is easier to achieve with a continuous furosemide infusion compared with intermittent boluses, but there is no evidence of better outcomes. The role of combination therapy with albumin in patients with fluid overload and severe hypoalbuminaemia is uncertain with conflicting data.

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Association of Cardiac Biomarkers With the Kansas City Cardiomyopathy Questionnaire in Patients With Chronic Kidney Disease Without Heart Failure

Journal of the American Heart Association ◽

10.1161/jaha.119.014385 ◽

2020 ◽

Vol 9 (13) ◽

Cited By ~ 1

Author(s):

Sri Lekha Tummalapalli ◽

Leila R. Zelnick ◽

Amanda H. Andersen ◽

Robert H. Christenson ◽

Christopher R. deFilippi ◽

...

Keyword(s):

Heart Failure ◽

Chronic Kidney Disease ◽

Health Status ◽

Kidney Disease ◽

Kansas City ◽

Troponin T ◽

Cardiac Biomarkers ◽

Kansas City Cardiomyopathy Questionnaire ◽

Galectin 3 ◽

Multivariable Adjustment

Background The Kansas City Cardiomyopathy Questionnaire ( KCCQ ) is a measure of heart failure ( HF ) health status. Worse KCCQ scores are common in patients with chronic kidney disease ( CKD ), even without diagnosed heart failure ( HF ). Elevations in the cardiac biomarkers GDF‐15 (growth differentiation factor‐15), galectin‐3, sST2 (soluble suppression of tumorigenesis‐2), hsTnT (high‐sensitivity troponin T), and NT ‐pro BNP (N‐terminal pro‐B‐type natriuretic peptide) likely reflect subclinical HF in CKD . Whether cardiac biomarkers are associated with low KCCQ scores is not known. Methods and Results We studied participants with CKD without HF in the multicenter prospective CRIC (Chronic Renal Insufficiency Cohort) Study. Outcomes included (1) low KCCQ score <75 at year 1 and (2) incident decline in KCCQ score to <75. We used multivariable logistic regression and Cox regression models to evaluate the associations between baseline cardiac biomarkers and cross‐sectional and longitudinal KCCQ scores. Among 2873 participants, GDF‐15 (adjusted odds ratio 1.42 per SD ; 99% CI , 1.19–1.68) and galectin‐3 (1.28; 1.12–1.48) were significantly associated with KCCQ scores <75, whereas sST2, hsTnT, and NT ‐pro BNP were not significantly associated with KCCQ scores <75 after multivariable adjustment. Of the 2132 participants with KCCQ ≥75 at year 1, GDF‐15 (adjusted hazard ratio, 1.36 per SD ; 99% CI , 1.12–1.65), hsTnT (1.20; 1.01–1.44), and NT ‐pro BNP (1.30; 1.08–1.56) were associated with incident decline in KCCQ to <75 after multivariable adjustment, whereas galectin‐3 and sST2 did not have significant associations with KCCQ decline. Conclusions Among participants with CKD without clinical HF , GDF‐15, galectin‐3, NT ‐pro BNP , and hsTnT were associated with low KCCQ either at baseline or during follow‐up. Our findings show that elevations in cardiac biomarkers reflect early symptomatic changes in HF health status in CKD patients.

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Deep vein thrombosis in patients with chronic kidney disease

Thrombosis and Haemostasis ◽

10.1160/th08-02-0107 ◽

2008 ◽

Vol 99 (06) ◽

pp. 1035-1039 ◽

Cited By ~ 24

Author(s):

H. Daneschvar ◽

Ali Seddighzadeh ◽

Gregory Piazza ◽

Samuel Goldhaber

Keyword(s):

Heart Failure ◽

Chronic Kidney Disease ◽

Congestive Heart Failure ◽

Renal Function ◽

Deep Vein Thrombosis ◽

Kidney Disease ◽

Special Population ◽

Future Studies ◽

Vein Thrombosis ◽

Deep Vein

SummaryDeep vein thrombosis (DVT) is a poorly understood complication of chronic kidney disease (CKD). The objective of our analysis was to profile DVT patients with and without CKD. We defined CKD as patients requiring dialysis or patients having nephrotic syndrome.We compared 268 patients with CKD (184 patients with dialysis-dependent renal disease and 84 with nephrotic syndrome) to 4,307 patients with preserved renal function from a prospective United States multicenter deep venous thrombosis (DVT) registry. Compared with non-CKD patients, CKD patients with DVT were younger (median age 62 vs. 69 years, p<0.0001), more often African- American (p<0.0001), and more often Hispanic (p=0.0003). CKD patients underwent surgery more frequently in the three months prior to developing DVT (48.9% vs. 39.0%, p=0.001) and more often had concomitant congestive heart failure (20.9% vs. 14.6%, p=0.005). CKD patients suffered upper extremity DVT more frequently (30.0% vs. 10.8%, p<0.0001). Patients with CKD presented less often with typical DVT symptoms of extremity discomfort (42.9% vs. 52.4%, p=0.003) and difficulty ambulating (5.4% vs. 10.1%, p=0.01). Prophylaxis rates prior to DVT were similarly low in CKD and non-CKD patients (44.2% vs. 38.0%, p=0.06). Future studies of DVT in CKD patients should explore novel strategies for improving prophylaxis utilization and the detection of DVT in this special population.

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