scholarly journals Association of rs11780592 Polymorphism in the Human Soluble Epoxide Hydrolase Gene (EPHX2) with Oxidized LDL and Mortality in Patients with Diabetic Chronic Kidney Disease

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Stefanos Roumeliotis ◽  
Athanasios Roumeliotis ◽  
Aikaterini Stamou ◽  
Stylianos Panagoutsos ◽  
Vangelis G. Manolopoulos ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Epoxide Hydrolase ◽  
Cox Regression ◽  
Oxidized Ldl ◽  
Intima Media Thickness ◽  
Soluble Epoxide Hydrolase ◽  
Cox Regression Analysis ◽  
Functional Polymorphisms ◽  
All Cause Mortality

Soluble epoxide hydrolase 2 (EPHX2) is an enzyme promoting increased cellular apoptosis through induction of oxidative stress (OS) and inflammation. The EPHX2 gene which encodes soluble EPHX2 might be implicated in the pathogenesis and development of OS and atherosclerosis. We aimed to assess the possible association between two functional polymorphisms of the EPHX2 gene (rs2741335 and rs11780592) with oxidized LDL (ox-LDL), carotid atherosclerosis, mortality, and cardiovascular (CV) disease in 118 patients with diabetic chronic kidney disease (CKD). At baseline, ox-LDL and carotid intima-media thickness (cIMT) were evaluated and all patients were followed for seven years with outcomes all-cause mortality and CV events. rs11780592 EPHX2 polymorphism was associated with ox-LDL, cIMT, albuminuria, and hypertension. Compared to AG and GG, AA homozygotes had higher values of albuminuria, ox-LDL, and cIMT ( p = 0.046 , p = 0.003 , and p = 0.038 , respectively). These associations remained significant, even after grouping for the G allele. After the follow-up period, 42/118 patients died (30/60 with AA genotype, 11/42 with AG genotype, and 1/12 with GG genotype) and 49/118 experienced a new CV event (fatal or nonfatal). The Kaplan-Meier analysis revealed that patients with the AA genotype exhibited a significantly higher mortality risk, compared to patients with AG and GG genotypes ( p = 0.006 ). This association became even stronger, when AG and GG genotypes were grouped (AA vs. AG/GG, p = 0.002 ). AA homozygotes were strongly associated with all-cause mortality in both univariate (hazard ratio HR = 2.74 , confidence interval CI = 1.40 – 5.35 , p = 0.003 ) and multivariate Cox regression analysis ( HR = 2.61 , CI = 1.32 – 5.17 , p = 0.006 ). In conclusion, our study demonstrated that genetic variations of EPHX2 gene were associated with increased circulating ox-LDL, increased cIMT, and all-cause mortality in diabetic CKD. Since EPHX2 regulates the cholesterol efflux and the oxidation of LDL in foam cells and macrophages, our study suggests that a genetic basis to endothelial dysfunction and OS might be present in diabetic CKD.

CHA2DS2-VASc Score as a Predictor of Cardiovascular and All-Cause Mortality in Chronic Kidney Disease Patients

2021 ◽  
pp. 1-8
Author(s):  
Nina Vodošek Hojs ◽  
Robert Ekart ◽  
Sebastjan Bevc ◽  
Nejc Piko ◽  
Radovan Hojs
Keyword(s):  
Chronic Kidney Disease ◽  
Regression Analysis ◽  
Kidney Disease ◽  
Cox Regression ◽  
Smoking Status ◽  
High Sensitivity ◽  
Cox Regression Analysis ◽  
Reactive Protein ◽  
All Cause Mortality

<b><i>Introduction:</i></b> Chronic kidney disease (CKD) is a risk factor for cardiovascular and all-cause mortality. Recognition of high-risk patients is important and could lead to a different approach and better treatment. The CHA<sub>2</sub>DS<sub>2</sub>-VASc score was originally used to predict cerebral infarction in patients with atrial fibrillation (AF), but it is also a useful predictor of outcome in other cardiovascular conditions, independent of AF. Therefore, the aim of our research was to assess the role of CHA<sub>2</sub>DS<sub>2</sub>-VASc score in predicting cardiovascular and all-cause mortality in CKD patients. <b><i>Methods:</i></b> Stable nondialysis CKD patients were included. At the time of inclusion, medical history data and standard blood results were collected and CHA<sub>2</sub>DS<sub>2</sub>-VASc score was calculated. Patients were followed till the same end date, until kidney transplantation or until their death. <b><i>Results:</i></b> Eighty-seven CKD patients were included (60.3 ± 12.8 years, 66% male). Mean follow-up time was 1,696.5 ± 564.6 days. During the follow-up, 21 patients died and 11 because of cardiovascular reasons. Univariate Cox regression analysis showed that CHA<sub>2</sub>DS<sub>2</sub>-VASc score is a significant predictor of cardiovascular and all-cause mortality. In multivariate Cox regression analysis, in which CHA<sub>2</sub>DS<sub>2</sub>-VASc score, serum creatinine, urinary albumin/creatinine, hemoglobin, high-sensitivity C-reactive protein, and intact parathyroid hormone were included, CHA<sub>2</sub>DS<sub>2</sub>-VASc score was an independent predictor of cardiovascular (HR: 2.04, CI: 1.20–3.45, <i>p</i> = 0.008) and all-cause mortality (HR: 2.06, CI: 1.43–2.97, <i>p</i> = 0.001). The same was true after adding total cholesterol, triglycerides, and smoking status to both the analyses. <b><i>Conclusion:</i></b> The CHA<sub>2</sub>DS<sub>2</sub>-VASc score is a simple, practical, and quick way to identify the risk for cardiovascular and all-cause mortality in CKD patients.

scholarly journals Vascular and Cardiac Prognostic Determinants in Patients with Gynecological Cancers: A Six-Year Follow-up Study

2021 ◽  
Vol 11 (13) ◽  
pp. 6091
Author(s):  
Pietro Scicchitano ◽  
Marco Tucci ◽  
Gabriella Ricci ◽  
Michele Gesualdo ◽  
Santa Carbonara ◽  
...  
Keyword(s):  
Brachial Artery ◽  
Cox Regression ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Controlled Study ◽  
Gynecological Cancers ◽  
Roc Curve Analysis ◽  
Cox Regression Analysis ◽  
All Cause Mortality

Background: The aim of this study was to assess the role of cardiac and vascular parameters as all-cause mortality determinants in patients suffering from gynecological cancers. Methods: This was an observational, prospective, non-randomized, and non-controlled study. Forty-seven consecutive patients (mean age: 58 ± 13 years) were enrolled after cancer staging. All patients underwent evaluation of vascular (common carotid intima-media thickness (mean C-IMT), flow-mediated dilation of the brachial artery (FMD), and antero-posterior diameter of the infrarenal abdominal aorta (APAO)) and cardiac function and morphology before cancer-related interventions. A 6-year follow-up was carried out to assess the overall survival of the whole population. Results: Twenty patients (42%) died by the time of the 6-year follow-up. The brachial artery FMD values were higher in the survivors than the non-survivors (9.71 ± 3.53% vs. 6.13 ± 2.62%, p < 0.001), as well as the LVEF (60.8 ± 3.0% vs. 57.8 ± 4.4%, p = 0.009). There were no differences in the mean C-IMT, APAO, and other echocardiographic parameters. ROC curve analysis identified a baseline LVEF < 57% and FMD value < 5.8% as the best cut-offs. Kaplan–Meier evaluation showed that the LVEF, tricuspid annular plane systolic excursion, and FMD were the best predictors of all-cause mortality, although only the LVEF and FMD were confirmed in multivariate Cox regression analysis. Conclusions: The LVEF and brachial artery FMD are independent prognostic determinants in patients with gynecological cancers.

Bypass Grafting vs Endovascular Therapy in Patients With Non-Dialysis-Dependent Chronic Kidney Disease and Chronic Limb-Threatening Ischemia (CRITISCH Registry)

2020 ◽  
Vol 27 (4) ◽  
pp. 599-607
Author(s):  
Konstantinos Stavroulakis ◽  
Asimakis Gkremoutis ◽  
Matthias Borowski ◽  
Giovanni Torsello ◽  
Dittmar Böckler ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Chronic Kidney Disease ◽  
Overall Survival ◽  
Kidney Disease ◽  
Endovascular Therapy ◽  
Proportional Hazards ◽  
Cox Regression ◽  
Cox Proportional Hazards ◽  
Bypass Grafting ◽  
Cox Regression Analysis

Purpose: To report the outcomes of bypass grafting (BG) vs endovascular therapy (EVT) in patients with non-dialysis-dependent chronic kidney disease (CKD) and chronic limb-threatening ischemia (CLTI). Materials and Methods: The CRITISCH Registry is a prospective, national, interdisciplinary, multicenter registry evaluating the current practice of all available treatment options in 1200 consecutive CLTI patients. For the purposes of this analysis, only the 337 patients with non-dialysis-dependent CKD treated by either BG (n=86; median 78 years, 48 men) or EVT (n=251; median age 80 years, 135 men) were analyzed. The primary composite outcome was amputation-free survival (AFS); secondary outcomes were overall survival (OS) and amputation-free time (AFT). All outcomes were evaluated in Cox proportional hazards models; the results are reported as the hazard ratio (HR) and 95% confidence interval (CI). Results: The Cox regression analysis revealed a significantly greater hazard of amputation or death after BG (HR 1.78, 95% CI 1.05 to 3.03, p=0.028). The models for AFT and overall survival also suggested a higher hazard for BG, but the differences were not significant (AFT: HR 1.66, 95% CI 0.78 to 3.53, p=0.188; OS: HR 1.41, 95% CI 0.80 to 2.47, p=0.348). The absence of runoff vessels (HR 1.73, 95% CI 1.15 to 2.60, p=0.008) was associated with a decreased AFS. The likelihood of amputation was higher in male patients (HR 2.21, 95% CI 1.10 to 4.45, p=0.027) and was associated with a lack of runoff vessels (HR 1.95, 95% CI 0.96 to 3.95, p=0.065) and myocardial infarction (HR 3.74, 95% CI 1.23 to 11.35, p=0.020). Death was more likely in patients without runoff vessels (HR 1.76, 95% CI 1.11 to 2.80, p=0.016) and those with a higher risk score (HR 1.73, 95% CI 1.03 to 2.91, p=0.038). Conclusion: This analysis suggested that BG was associated with poorer AFS than EVT in patients with non-dialysis-dependent CKD and CLTI. Male sex, previous myocardial infarction, and the absence of runoff vessels were additionally identified as predictors of poorer outcomes.

Impact of the inhibition of soluble epoxide hydrolase on cardiovascular consequences of chronic kidney disease

2016 ◽  
Vol 12 (5) ◽  
pp. 412
Author(s):  
M. Hamzaoui ◽  
C. Roche ◽  
A. Lejeune ◽  
V. Brunel ◽  
V. Richard ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Epoxide Hydrolase ◽  
Soluble Epoxide Hydrolase

scholarly journals MO159CHA2DS2-VASC SCORE AS A PREDICTOR OF CARDIOVASCULAR MORTALITY IN CHRONIC KIDNEY DISEASE PATIENTS

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Nina Vodošek Hojs ◽  
Robert Ekart ◽  
Sebastjan Bevc ◽  
Nejc Piko ◽  
Radovan Hojs
Keyword(s):  
Chronic Kidney Disease ◽  
Regression Analysis ◽  
Cardiovascular Risk ◽  
Kidney Disease ◽  
Cardiovascular Mortality ◽  
Cox Regression ◽  
High Sensitivity ◽  
Cardiovascular Death ◽  
Cox Regression Analysis

Abstract Background and Aims Cardiovascular mortality is high in chronic kidney disease (CKD) patients. Recognizing patients with higher cardiovascular risk might help in their treatment. CHA2DS2-VASc score was originally used to predict cerebral infarction in patients with atrial fibrillation (AF). However, it is also useful in predicting outcome in different cardiovascular conditions, independent of the presence of AF. Therefore, the aim of our research was to assess the role of CHA2DS2-VASc score in cardiovascular mortality in CKD patients. Method Eighty-seven non-dialysis CKD patients from our outpatient clinic were included. At the time of inclusion, medical history data and standard blood results were collected and CHA2DS2-VASc score was calculated. Patients were followed for assigned time or until their death. Mean follow-up time was 1696.45±564.60 days. Results Descriptive statistics of our patients are presented in table 1. During follow-up 11 patients suffered from cardiovascular death. Univariate Cox regression analysis showed that CHA2DS2-VASc score is a significant predictor of cardiovascular mortality (HR: 2.19, CI: 1.42-3.37, p=0.001). In multivariate Cox regression analysis in which CHA2DS2-VASc score, serum creatinine, urinary albumin/creatinine, haemoglobin, high sensitivity CRP and intact PTH were included, CHA2DS2-VASc score was an independent predictor of cardiovascular mortality (HR: 2.04, CI: 1.20-3.45, p=0.008) (table 2). Conclusion CHA2DS2-VASc score is a simple and quick way to identify cardiovascular risk in CKD patients.

scholarly journals 0376 : Impact of the inhibition of soluble epoxide hydrolase on cardiovascular consequences of chronic kidney disease

2016 ◽  
Vol 8 (3) ◽  
pp. 233
Author(s):  
Mouad Hamzaoui ◽  
Clothilde Roche ◽  
Annie Lejeune ◽  
Valery Brunel ◽  
Vincent Richard ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Epoxide Hydrolase ◽  
Soluble Epoxide Hydrolase

Association between Extreme Values of Markers of Chronic Kidney Disease: Mineral and Bone Disorder and 5-Year Mortality among Prevalent Hemodialysis Patients

2017 ◽  
Vol 45 (1-3) ◽  
pp. 1-7 ◽  
Author(s):  
Jin-Gang Zhu ◽  
Jin-Bor Chen ◽  
Ben-Chung Cheng ◽  
Chih-Hsiung Lee ◽  
Gang Long ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Regression Models ◽  
Cox Regression ◽  
Extreme Values ◽  
Journal Club ◽  
Mineral And Bone Disorder ◽  
Increased Risk ◽  
Bone Disorder ◽  
All Cause Mortality

Background/Aims: We examined the association between markers of chronic kidney disease - mineral and bone disorder (CKD-MBD) and mortality in hemodialysis (HD) patients. Methods: We retrospectively reviewed the association between markers of CKD-MBD and mortality in 1,126 HD patients from 2009 to 2013 with baseline (B), time-average (TA), and time-dependent (TD) Cox regression models. Results: Hypercalcemia (10.9-11.9 mg/dL) indicated an increased risk of all-cause mortality (TA: hazard ratio [HR] 3.49; p = 0.01). Hypophosphatemia (2.0-2.5 mg/dL) was significantly associated with an increased risk of all-cause mortality (TA: HR 5.18; p = 0.01). Hypophosphatemia (<2.0 mg/dL) was significantly associated with an increased risk of cardiovascular mortality in all models. Intact parathyroid hormone levels <60 and >1,500 pg/mL indicated an increased risk of all-cause mortality (TA: HR 1.64; p = 0.02; TD: HR 2.26; p = 0.02). Conclusion: Extreme values of CKD-MBD markers are associated with mortality risk in HD patients. Video Journal Club ‘Cappuccino with Claudio Ronco' at http://www.karger.com/?doi=478972.

scholarly journals Dietary intakes of total polyphenol and its subclasses in relation to incidence of chronic kidney disease: a prospective population-based cohort study

2020 ◽  
Author(s):  
Parvin Mirmiran ◽  
Emad Yuzbashian ◽  
Pegah Rahbarinejad ◽  
Golaleh Asghari ◽  
Fereidoun Azizi
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Phenolic Acids ◽  
Cox Regression ◽  
Dietary Intakes ◽  
Total Polyphenols ◽  
Moderate Amount ◽  
Total Polyphenol ◽  
Cox Regression Analysis ◽  
Incidence Of Ckd

Abstract Background: Chronic kidney disease (CKD) is nowadays a public health challenge worldwide. Accordingly, this study is aiming to evaluate the association between long-term intake of total polyphenol and its subclasses, and the incidence of CKD. Methods: A sample of 3021 Iranian Adults (47% men) were selected from the Tehran Lipid and Glucose Study population. The participants aged 20-79 years and had no diagnosis of CKD at baseline. Total polyphenol intake and its major subclasses including flavonoids, phenolic acids, stilbenes, and lignans, was assessed by a validated and reliable food frequency questionnaire, and were categorized as flavonoids, phenolic acids, stilbenes, and lignans. CKD should be defined by either reduction in eGFR or by morphological abnormalities of the kidneys or by abnormalities in the urinalysis persistent for 3 months. Since GFR is generally accepted as the best overall index of kidney function, in current study CKD was exclusively defined as eGFR <60 mL/min/1.73m2. The Modification of Diet in Renal Disease Study equation was used to calculate the estimated glomerular filtration rate (eGFR).Hazard ratio and 95% confidence intervals of CKD by total polyphenols quartiles were assessed by Cox-regression analysis. Results: In this study, we documented 355 cases of diagnosed CKD over 11,058.464 person-years. The median [IQR] age of participants was 36 [27-46] years at baseline. After adjustment of the potential confounders, it was revealed that a moderate intake of lignans (≤6.8 mg) was negatively associated with the incidence of CKD, whereas there was no significant association between the higher amounts of lignan intake and CKD. No significant associations were observed between the consumption of total polyphenols and the incidence of CKD (HR: 0.97, 95% CI 0.67-1.40). Conclusions: Data of the current study suggest that in the case of lignan with protective properties, a moderate amount of lignan favorably reduced the incidence of CKD by approximately 32%, whereas higher amounts possessed a null effect.

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