Prognostic value of silent myocardial infarction in patients with chronic kidney disease after kidney transplantation

Abstract Background Chronic kidney disease (CKD) are associated with acute myocardial infarction (AMI). High-sensitive cardiac troponin (hs-cTn) has been evidenced to enhance the early diagnostic accuracy of AMI, but hs-cTn levels are often chronically elevated in CKD patients, which reduces their diagnostic utility. The aim of this study was to derive optimal cutoff-values of hs-cTn levels in patients with CKD and suspected AMI. Methods In this retrospective paper, a total of 3295 patients with chest pain (2758 in AMI group and 537 in Non-AMI group) were recruited, of whom 23.1% were had an estimated glomerular filtration rate (eGFR) of < 60 mL min−1 (1.73 m2)−1. Hs-cTnI values were measured at presentation. Results AMI was diagnosed in 83.7% of all patients. The optimal value of hs-TnI in diagnosing AMI was 1.15 ng mL−1, which were higher in males than females comparing different cutoff-values of subgroups divided by age, gender and renal function, and which increased monotonically with decreasing of eGFR because in patients with CKD without AMI, the correlation between hs-cTnI and renal function is low but significant (r2 = 0.067, P < 0.001). Conclusions Different optimal cutoff-values of hs-cTnI in the diagnosis of AMI in patients with CKD were helpful to the clinical diagnosis of AMI in various populations and were higher in males than females, but which was needed to be validated by multicenter randomized controlled clinical studies in the future.

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Risk for recurrent cardiovascular disease events among patients with diabetes and chronic kidney disease

Cardiovascular Diabetology ◽

10.1186/s12933-021-01247-0 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Demetria Hubbard ◽

Lisandro D. Colantonio ◽

Robert S. Rosenson ◽

Todd M. Brown ◽

Elizabeth A. Jackson ◽

...

Keyword(s):

Myocardial Infarction ◽

Cardiovascular Disease ◽

Chronic Kidney Disease ◽

Health Insurance ◽

High Risk ◽

Kidney Disease ◽

Peripheral Artery ◽

Increased Risk ◽

Patients With Diabetes ◽

Very High

Abstract Background Adults who have experienced multiple cardiovascular disease (CVD) events have a very high risk for additional events. Diabetes and chronic kidney disease (CKD) are each associated with an increased risk for recurrent CVD events following a myocardial infarction (MI). Methods We compared the risk for recurrent CVD events among US adults with health insurance who were hospitalized for an MI between 2014 and 2017 and had (1) CVD prior to their MI but were free from diabetes or CKD (prior CVD), and those without CVD prior to their MI who had (2) diabetes only, (3) CKD only and (4) both diabetes and CKD. We followed patients from hospital discharge through December 31, 2018 for recurrent CVD events including coronary, stroke, and peripheral artery events. Results Among 162,730 patients, 55.2% had prior CVD, and 28.3%, 8.3%, and 8.2% had diabetes only, CKD only, and both diabetes and CKD, respectively. The rate for recurrent CVD events per 1000 person-years was 135 among patients with prior CVD and 110, 124 and 171 among those with diabetes only, CKD only and both diabetes and CKD, respectively. Compared to patients with prior CVD, the multivariable-adjusted hazard ratio for recurrent CVD events was 0.92 (95%CI 0.90–0.95), 0.89 (95%CI: 0.85–0.93), and 1.18 (95%CI: 1.14–1.22) among those with diabetes only, CKD only, and both diabetes and CKD, respectively. Conclusion Following MI, adults with both diabetes and CKD had a higher risk for recurrent CVD events compared to those with prior CVD without diabetes or CKD.

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Prognostic value of myocardial perfusion imaging in patients with chronic kidney disease: A systematic review and meta-analysis

Journal of Nuclear Cardiology ◽

10.1007/s12350-020-02449-x ◽

2021 ◽

Author(s):

Valeria Cantoni ◽

Roberta Green ◽

Wanda Acampa ◽

Roberta Assante ◽

Emilia Zampella ◽

...

Keyword(s):

Systematic Review ◽

Chronic Kidney Disease ◽

Myocardial Perfusion Imaging ◽

Kidney Disease ◽

Myocardial Perfusion ◽

Perfusion Imaging ◽

Prognostic Value ◽

Meta Analysis

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Kidney transplantation fails to provide adequate growth in children with chronic kidney disease born small for gestational age

Pediatric Nephrology ◽

10.1007/s00467-016-3503-5 ◽

2016 ◽

Vol 32 (3) ◽

pp. 511-519 ◽

Cited By ~ 3

Author(s):

Doris Franke ◽

Rena Steffens ◽

Lena Thomas ◽

Leo Pavičić ◽

Thurid Ahlenstiel ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Kidney Transplantation ◽

Kidney Disease ◽

Gestational Age ◽

Small For Gestational Age

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CLINICAL ASPECTS OF RENAL TRANSPLANTATION

Vestnik ◽

10.53065/kaznmu.2021.78.65.026 ◽

2021 ◽

pp. 136-142

Author(s):

Б.Г. Султанова ◽

И.Б. Мансурова ◽

С.Б. Бодесова ◽

Н.С. Джуманов ◽

Ш.А. Сарсенова ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Kidney Transplantation ◽

Renal Transplantation ◽

Kidney Disease ◽

Immunosuppressive Therapy ◽

Interdisciplinary Approach ◽

Clinical Aspects ◽

Graft Dysfunction ◽

Donor Kidney ◽

Donor Evaluation

В статье приведен литературный обзор, посвященный современным проблемам в трансплантологии почек. Нерешенными проблемами остаются оценка донора, низкая приверженность пациентов иммуносупрессивной терапии и развитие дисфункции трансплантата. Развивающиеся осложнения после трансплантации и иммуносупрессивной терапии требуют междисциплинарного подхода в лечении и наблюдении реципиентов донорской почки. Также необходимо широкое развитие трупного донорства для снижения числа потенциальных пациентов с хронической болезнью почек. The article presents a literature review of contemporary problems in kidney transplantation. Donor evaluation, low adherence of patients to immunosuppressive therapy and the development of graft dysfunction remain as unresolved problems. Developing complications after transplantation and immunosuppressive therapy require an interdisciplinary approach in the treatment and monitoring of recipients of donor kidney. It is also indispensable to the development of cadaveric donation to reduce the number of potential patients with chronic kidney disease.

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Racial Disparities in Invasive Management for Patients With Acute Myocardial Infarction With Chronic Kidney Disease

Circulation Cardiovascular Interventions ◽

10.1161/circinterventions.121.011171 ◽

2021 ◽

Author(s):

Jennifer A. Rymer ◽

Shuang Li ◽

Patrick H. Pun ◽

Laine Thomas ◽

Tracy Y. Wang

Keyword(s):

Myocardial Infarction ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Racial Disparities ◽

Odds Ratio ◽

Adjusted Odds Ratio ◽

Logistic Regression Models ◽

Black Patients ◽

Invasive Management ◽

White Patients

Background: Due to increased risks of contrast nephropathy, chronic kidney disease (CKD) can deter consideration of invasive management for patients with myocardial infarction (MI). Black patients have a higher prevalence of CKD. Whether racial disparities exist in the use of invasive MI management for patients with CKD presenting with MI is unknown. Methods: We examined 717 012 White and 99 882 Black patients with MI treated from 2008 to 2017 at 914 hospitals in the National Cardiovascular Data Registry Chest Pain—MI Registry. CKD status was defined as estimated glomerular filtration rate (eGFR) ≥90 mL/(min·1.73 m 2 ; no CKD), eGFR <90 but ≥60 (mild), eGFR <60 but ≥30 (moderate), and eGFR <30 or dialysis (severe). We used multivariable logistic regression models to examine the interaction of race and CKD severity in invasive MI management. Results: Among those with MI, Black patients were more likely than White patients to have CKD (eGFR <90; 61.4% versus 58.5%; P <0.001). Among those with MI and CKD, Black patients were more likely than White patients to have severe CKD (21.2% versus 12.4%; P <0.001). Patients with CKD were more likely than those without CKD to have diabetes or heart failure; Black patients with CKD were more likely to have these comorbidities when compared with White patients with CKD (all P <0.0001). Black race and CKD were associated with a lower likelihood of invasive management (adjusted odds ratio, 0.78 [95% CI, 0.75–0.81]; adjusted odds ratio, 0.72 [95% CI, 0.70–0.74]; P <0.001 for both). At eGFR levels ≥10, Black patients were significantly less likely than White patients to undergo invasive management. Conclusions: Black patients with MI and mild or moderate CKD were less likely to undergo invasive management compared with White patients with similar CKD severity. National efforts are needed to address racial disparities that may remain in the invasive management of MI.

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