scholarly journals Aortic Arch Calcification Predicts the Renal Function Progression in Patients with Stage 3 to 5 Chronic Kidney Disease

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Lung-Chih Li ◽  
Yueh-Ting Lee ◽  
Yi-Wei Lee ◽  
Chia-An Chou ◽  
Chien-Te Lee
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Function ◽  
Kidney Disease ◽  
Aortic Arch ◽  
Estimated Glomerular Filtration Rate ◽  
X Ray ◽  
Chest X Ray ◽  
Independent Determinant ◽  
Egfr Decline ◽  
Aortic Arch Calcification

Introduction. The presence of aortic arch calcification (AoAC) and cardiomegaly on chest radiography has been demonstrated as important risk factors for cardiovascular mortality in patients with chronic kidney disease (CKD). However, the interrelationship among AoAC, cardiomegaly, and renal function progression remains unclear. The aim of this study is to assess whether AoAC and cardiomegaly are independently associated with the renal function progression in patients with stages 3–5 CKD.Methods. We retrospectively determined AoAC and cardiomegaly by chest X-ray in 237 patients, followed up for at least three years without entering dialysis and classified into 4 groups according to the presence or absence of AoAC and cardiomegaly. The change in renal function was measured by the slope of estimated glomerular filtration rate (eGFR).Results. Of the 237 patients, the rate of eGFR decline was significantly higher in the group with coexistence of AoAC and cardiomegaly than any other groups. Baseline AoAC and proteinuria were independently associated with eGFR decline. AoAC were independently determined by age, eGFR slope, and cardiomegaly.Conclusions. The coexistence of AoAC and cardiomegaly is associated with faster eGFR decline. AoAC is an independent determinant of renal outcomes in patients with CKD stages 3–5.

scholarly journals Renal function trajectories in hepatitis C infection: differences between renal healthy and chronic kidney disease individuals

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Cheng-Kai Hsu ◽  
Tai-Shuan Lai ◽  
Yih-Ting Chen ◽  
Yi-Ju Tseng ◽  
Chin-Chan Lee ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Function ◽  
Hepatitis C ◽  
Kidney Disease ◽  
Normal Renal Function ◽  
Elderly Women ◽  
Hcv Infection ◽  
Diabetic Patients ◽  
Subgroup Analyses ◽  
Egfr Decline

AbstractAssociations between hepatitis C virus (HCV) and chronic kidney disease (CKD) have been reported; however, differences of renal progression between general and CKD population remain to be elucidated in prospective studies. A total of 1179 participants, who have tested for anti-HCV antibody, were enrolled and prospectively followed for 3 years. The risks associated with HCV infection, in terms of incidence of CKD, annual estimated glomerular filtration rate (eGFR) changes and 50% decline of eGFR at 3-year from baseline, were compared between normal renal function subjects and CKD patients. Overall, 111 of 233 (47.6%) CKD patients and 167 of 946 (17.7%) non-CKD subjects had HCV infection. The crude incidence rates of CKD were 226.9 per 1000 person-years and 14.8 per 1000 person-years in in HCV and non-HCV infected patients, respectively. The adjusted hazard ratio of HCV infection for incident CKD was 7.9 (95% CI 5–12.7). The HCV-infected normal renal function subjects were independently associated with increased risks of eGFR decline in the 1-year, 2-year and 3-year, respectively. The risk associations remained significant in 50% decline of eGFR at 3 years models and in different subgroup analyses. The increases of risks of eGFR decline were also notorious among overall HCV-infected CKD patients. However, the risk associations were less prominent in subgroup analyses (elderly, women and diabetic patients). The findings highlighted the importance of viral diagnosis with not only prognostic but also public health implications for preserving kidney function.

scholarly journals MO463EVIDENCE OF MICROALBUMINURIA AND ESTIMATED GLOMERULAR FILTRATION RATE DECLINE AS CHRONIC KIDNEY DISEASE RISKS IN NON-ALCOHOLIC FATTY LIVER DISEASE PATIENTS: META-ANALYSIS OF COHORT STUDIES

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Boby Pratama Putra ◽  
Felix Nugraha Putra
Keyword(s):  
Chronic Kidney Disease ◽  
Glomerular Filtration Rate ◽  
Kidney Disease ◽  
Cohort Studies ◽  
Fatty Liver ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Cochrane Library ◽  
Egfr Decline

Abstract Background and Aims Recent evidences showed an association between NAFLD and extrahepatic manifestations such as chronic kidney disease (CKD) although the result is still inconclusive. This study aims to measure the association of microalbuminuria and estimated glomerular filtration rate (eGFR) decline as CKD risks in NAFLD patients. Method Comprehensive searching using predefined queries was done through online databases Pubmed, EMBASE, ScienceDirect, and The Cochrane Library to include all relevant literature until November 2020. We included all cohort studies of NAFLD patients diagnosed by ultrasonography (USG), commutated tomography (CT), or scoring system fatty liver index (FLI) that reports microalbuminuria and eGFR decline below 60 ml/min/1.73m2. Bias risk was assessed by The Newcastle-Ottawa Scale for cohort studies. Analysis of this study was performed to provide pooled hazard ratio (HR) with 95% confidence interval (CI) using random-effect heterogeneity test. Results We included 10 cohort studies met our criteria. Analysis of 6 NAFLD cohort studies diagnosed by USG is significantly associated with eGFR decline (pooled HR = 1.54, 95% CI 1.13 to 2.11, p=0.006, I2=88%), while NAFLD patients diagnosed by FLI also showed significant association with eGFR decline (pooled HR = 1.58, 95% CI 1.52 to 1.64, p<0.0001, I2=0%), thus overall analysis combined with CT diagnostic modalities showed significant association between NAFLD and eGFR decline (pooled HR=1.53 95%CI 1.29-1.80 p<0.00001 I2=82%). Microalbuminuria risk is significantly increased in NAFLD patients (pooled HR = 1.93, 95% CI 1.39 to 2.67, p<0.0001, I2=0%). Surprisingly, NAFLD patients whose increased gamma-glutamyltransferase (GGT) has higher eGFR decline risk (pooled HR = 1.73, 95% CI 1.02 to 2.92, p=0.04, I2=78%). Conclusion Microalbuminuria and eGFR decline are associated as CKD risks in NAFLD patients. However, further studies are still needed to establish the causality.

scholarly journals Markers of Atherosclerosis in Hypertensive Patients with Less Advanced Chronic Kidney Disease

2019 ◽  
Vol 65 (3) ◽  
pp. 91-96
Author(s):  
Claudia Floriana Suciu ◽  
Andreea Varga ◽  
Corneliu Florin Buicu ◽  
Ioan Tilea
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Aortic Arch ◽  
Laboratory Data ◽  
Hypertensive Heart Disease ◽  
Neutrophil To Lymphocyte Ratio ◽  
Advanced Chronic Kidney Disease ◽  
Hypertensive Patients ◽  
Lymphocyte Ratio ◽  
Aortic Arch Calcification

AbstractObjective: Our study aimed to validate the neutrophil-to-lymphocyte ratio (NLR) as a marker for aortic arch calcification in hypertensive patients with less advanced chronic kidney disease (CKD).Methods: A number of forty-four hypertensive patients with chronic kidney disease (categories G3a and G3b – 2012 KDIGO nomenclature) were included in the study. Considering the presence of aortic arch calcification (AAC) on chest X-ray, the study population was divided into two groups: 27 patients AAC present and seventeen without aortic arch calcification. Laboratory data were collected for each patient and NLR was computed. Comorbidities were also recorded: stable coronary artery disease, lower extremity arterial disease and hypertensive heart disease.Results: A positive correlation between neutrophil-to-lymphocyte ratio and aortic arch calcification in hypertensive CKD patients was identified. Furthermore, advanced age, increased alkaline phosphatase and increased erythrocyte sedimentation rate had a positive association with aortic arch calcification. We found no statistical correlation between neutrophil-to-lymphocyte ratio and other laboratory features in both groups of patients.Conclusions: Neutrophil-to-lymphocyte ratio may be viewed as a potential risk factor for vascular calcification in patients with moderate chronic kidney disease; nevertheless, future extensive studies are necessary. In the management of hypertensive patients, general medicine might particularly benefit of this simple, readily available inflammatory marker.

scholarly journals Vascular Calcification as a Novel Risk Factor for Kidney Function Deterioration in the Nonelderly

2021 ◽  
Author(s):  
Samel Park ◽  
Nam‐Jun Cho ◽  
Nam Hun Heo ◽  
Eun‐Jung Rhee ◽  
Hyowook Gil ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Function ◽  
Glomerular Filtration Rate ◽  
Kidney Disease ◽  
Glomerular Filtration ◽  
Kidney Function ◽  
Vascular Calcification ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Tertiary Teaching

Background The relationship between vascular calcification and chronic kidney disease is well known. However, whether vascular calcification affects renal function deterioration remains unclear. We investigated whether kidney function deteriorated more rapidly in individuals with higher vascular calcification indicated by the coronary artery calcium score (CACS). Methods and Results Individuals with a normal estimated glomerular filtration rate (>60 mL/min per 1.73 m 2 ) who underwent cardiac computed tomography in our institution (a tertiary teaching hospital in Cheonan, Korea) from January 2010 to July 2012 were retrospectively reviewed. All participants were aged 20 to 65 years. Among 739 patients, 447, 175, and 117 had CACSs of 0, 1 to 99, and ≥100 units, respectively. The participants were followed for 7.8 (interquartile range, 5.5–8.8) years. The adjusted annual estimated glomerular filtration rates declined more rapidly in patients in the CACS ≥100 group compared with those in the CACS 0 group (adjusted‐β, −0.40; 95% CI, −0.80 to −0.03) when estimated using a linear mixed model. The adjusted hazard ratio in the CACS ≥100 group for Kidney Disease: Improving Global Outcomes criteria (a drop in estimated glomerular filtration rate category accompanied by a 25% or greater drop in estimated glomerular filtration rate) was 2.52 (1.13–5.61). After propensity score matching, more prevalent renal outcomes (13.2%) were observed in patients with a CACS of ≥100 compared with those with a CACS of 0 (1.9%), with statistical significance ( P =0.004). Conclusions Our results showed that renal function declined more rapidly in patients with higher CACSs, suggesting that vascular calcification might be associated with chronic kidney disease progression.

scholarly journals P0717EPIGENETIC REGULATION OF CHRONIC KIDNEY DISEASE ACCELERATED-ATHEROSCLEROSIS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Nuria Doladé ◽  
Sandra Rayego-Mateos ◽  
Alicia García-Carrasco ◽  
Aurora Pérez-Gomez ◽  
Maria Crespo-Masip ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Function ◽  
Kidney Disease ◽  
Aortic Arch ◽  
Atherosclerotic Plaque ◽  
Plaque Size ◽  
Total Blood ◽  
Blood Samples ◽  
Expression Levels ◽  
Accelerated Atherosclerosis

Abstract Background and Aims Atherosclerosis and its related clinical complications are the leading causes of death in western countries. Multiple processes are involved in atherosclerosis like endothelial dysfunction, inflammation, vascular proliferation, neovascularization, oxidative stress, apoptosis, extracellular matrix degradation and thrombosis. Moreover atherosclerosis could be accelerated in some diseases like chronic kidney disease (CKD). In this regard, miRNAs have been elucidated as important factors in the regulation of different cellular and molecular processes involved in atherosclerosis development. Our aim is to identify specific miRNAs that could be involved in chronic kidney disease (CKD) accelerated-atherosclerosis. Method A CKD accelerated-atherosclerosis mouse model was developed by subtotal nephrectomy (5/6 nephrectomy) in APOE-/- mice fed on a high fat diet (HFD) during 10 weeks and compared to mice with normal renal function. Urine and blood samples were collected every week. Western-blot, RT-PCR, immunohistochemistry and confocal microscopy analysis were performed. In previous studies mir23a-3p and miR652-3p have been suggested as possible regulators of the atherosclerotic process. Therefore the expression levels of these miRNAs and its possible target genes (FER and BTLA) were analyzed in mice total blood. Results APOE-/-+ERC+HFD mouse showed a progressive decrease in renal function and an increase of renal damage markers such as KIM-1. These animals showed structural glomerular damage characterized by de-cellularization, mesangial cell expansion and podocyte (WT1+,podocalixin+), endothelial (CD31+) and mesangial (GATA3+) loss. Lipid profile modifications were also observed in APOE-/-+ERC+HFD mice with an increase in plasma total cholesterol levels. Moreover atherosclerotic plaque size was also increased in APOE-/-+ERC+HFD animals in comparison with atherosclerotic plaque size of APOE-/-+HFD mice. CKD mice showed lower fibrosis (sirius red staining) and higher inflammatory markers in its atherosclerotic plaques. The presence of macrophages (CD68+) and T lymphocytes (CD3+) was increased in APOE-/-+ERC+HFD group in contrast with APOE-/-+HFD animals. Moreover, in samples from the aortic arch of APOE-/-+ERC+HFD mice, ICAM1 protein levels were increased. Finally we found decreased levels of mir23a-3p and mir652-3p gene in total blood samples of APOE-/-+ ERC+ HFD mice. On the other hand, in aortic arc and descendent aorta tissues, mir23a-3p and mir652-3p expression levels were similar between groups. The expression levels of mRNAs of potential targets of this miRNAs (FER and BTLA) were increased in total blood and aortic arch samples. In addition, we observed that BTLA and FER expression were localized in vascular smooth muscle cells and endothelial cells respectively. Conclusion Levels of mir23a-3p, mir652-3p and its related mRNA (FER and BTLA) are altered in CKD and may be a potential therapeutic target for CKD-accelerated atherosclerosis treatment.

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