Dose-Response Between Cardiovascular Risk Factors and Cardiovascular Mortality Among Incident Peritoneal Dialysis Patients

End-stage renal disease patients are at a heightened risk of developing cardiovascular disease, with contributions from both “traditional” and “nontraditional” cardiovascular risk factors. Some of the nontraditional risk factors, such as extracellular volume overload, inflammation, and hyperphosphatemia, have also been shown to be important predictors of mortality in the dialysis population. This article provides an in-depth review of the evidence that supports the substantial contributions of nontraditional risk factors to adverse cardiovascular outcomes in chronic peritoneal dialysis patients. In addition, it provides evidence to demonstrate how loss of residual renal function may be central to the development of cardiovascular disease in the peritoneal dialysis population.

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P1304FIBROBLAST GROWTH FACTOR (FGF23) AND CARDIOVASCULAR MORTALITY IN DIALYSIS PATIENTS: A 10 YEAR PROSPECTIVE SINGLE CENTER STUDY

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfaa142.p1304 ◽

2020 ◽

Vol 35 (Supplement_3) ◽

Author(s):

Gülay Demirtaş ◽

Sadan Turgut ◽

Sabahat Ozdem ◽

Gultekin Suleymanlar ◽

Üstün Yılmaz ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

Growth Factor ◽

Calcium Phosphate ◽

Cardiovascular Risk Factors ◽

Cardiovascular Mortality ◽

Phosphate Metabolism ◽

Dialysis Patients ◽

Kaplan Meier ◽

Calcium Phosphate Metabolism

Abstract Background and Aims The aim of the study is to evaluate whether circulating fibroblast growth factor 23 (FGF23) predicts cardiovascular mortality in dialysis patients, independent of markers of calcium-phosphate metabolism and cardiovascular risk factors. Method A prospective observational study at Akdeniz University Medical Center including 51 peritoneal dialysis patients and 27 hemodialysis patients was undertaken from 01/2009 to 12/2019. Plasma C-terminal FGF23 concentrations in addition to other measures of mineral metabolism were performed at baseline. Patients were followed for all-cause mortality, cardiovascular mortality, non-fatal MI, non-fatal stroke, coronary revascularization, heart failure hospitalization and atrial fibrillation. Results The mean age of patients 48± 15 years. During a ten year follow up period, there were 47 deaths. The median plasma FGF23 level was 321 pg/ml (interquartile range 51-1784 pg/ml). Patients were stratified by their baseline FGF23 levels according to the tertiles. Cumulative survival analysis by tertiles of FGF23 were made with the Kaplan-Meier survival curve. Kaplan Meier analysis with log-rank did reveal a significant difference between the groups (p=0,048). Conclusion Higher FGF23 levels are associated with an increased incidence of cardiovascular mortality in dialysis patients, independent of other markers of calcium-phosphate metabolism and cardiovascular risk factors.

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Vascular Calcification in Peritoneal Dialysis Patients

Peritoneal Dialysis International ◽

10.1177/089686080802802s04 ◽

2008 ◽

Vol 28 (2_suppl) ◽

pp. 20-25 ◽

Cited By ~ 2

Author(s):

Adriano Luiz Ammirati ◽

Rosa Maria Affonso Moysés ◽

Maria Eugênia Canziani

Keyword(s):

Risk Factors ◽

Chronic Kidney Disease ◽

Peritoneal Dialysis ◽

Cardiovascular Risk ◽

Kidney Disease ◽

Cardiovascular Risk Factors ◽

Vascular Calcification ◽

Common Complication ◽

Dialysis Patients ◽

Independent Prognostic Marker

Vascular calcification (VC) is being recognized as a common complication at all stages of chronic kidney disease, particularly in patients on dialysis. Traditional and nontraditional cardiovascular risk factors both appear to be involved in the development of VC in this population. Although few studies focusing exclusively on peritoneal dialysis (PD) patients are available, some data support the view that VC constitutes an independent prognostic marker of morbidity and mortality in the PD population. In this review, we discuss the potential pathophysiologic pathways of VC in PD patients, and we examine the relevant clinical data.

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Impact of Metabolic Surgery on Type 2 Diabetes Mellitus, Cardiovascular Risk Factors, and Mortality. Review article.

Current Hypertension Reviews ◽

10.2174/1573402116666200804153228 ◽

2020 ◽

Vol 16 ◽

Author(s):

Ricardo Cohen ◽

Noelia S Sforza ◽

Romina G Clemente

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Bariatric Surgery ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Cardiovascular Mortality ◽

Review Article ◽

Controlled Trials ◽

Randomized Controlled

Background: The association between obesity and a reduction in life expectancy is well established, and cardiovascular disease is a leading cause of mortality. Bariatric surgery has long been established as the most effective and durable intervention for obesity, and is the only intervention for obesity that consistently improves multiple comorbidities, reduces cardiovascular disease and long-term mortality. The purpose of this review article is to describe the impact of metabolic/bariatric surgery on type 2 diabetes mellitus and cardiometabolic parameters, including cardiovascular mortality. Methods: A systematic literature search of Pubmed, MEDLINE, and Cochrane Central Register was performed. We included randomized controlled trials, metanalysis, case-control trials, and cohort studies that contain data on reductions in cardiovascular risk factors and cardiovascular mortality in subjects who underwent metabolic/bariatric surgery from January 1, 2005, to June 1, 2020. Conclusion: There is sufficient evidence of randomized controlled trials that metabolic/bariatric surgery is associated with a significant improvement of all cardiovascular risk factors. Although studies are showing a reduction of macrovascular events and cardiovascular mortality, these findings come from observational studies and should be confirmed in randomized clinical trials.

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