scholarly journals Death From Stroke in End-Stage Kidney Disease

Stroke ◽  
2019 ◽  
Vol 50 (2) ◽  
pp. 487-490 ◽  
Author(s):  
Nicole L. De La Mata ◽  
Philip Masson ◽  
Rustam Al-Shahi Salman ◽  
Patrick J. Kelly ◽  
Angela C. Webster
Keyword(s):  
Kidney Disease ◽  
General Population ◽  
Standardized Mortality Ratio ◽  
Stroke Mortality ◽  
End Stage Kidney Disease ◽  
Mortality Ratio ◽  
Standardized Mortality Ratios ◽  
Using Data ◽  
End Stage ◽  
Over Time

Background and Purpose— People with end-stage kidney disease (ESKD) are at greater risk of stroke. We aimed to compare stroke mortality between the ESKD population and the general population. Methods— We included all patients with incident ESKD in Australia, 1980 to 2013, and New Zealand, 1988 to 2012. The primary cause of death was ascertained using data linkage with national death registers. We produced standardized mortality ratios for stroke deaths, by age, sex, and calendar year. Results— We included 60 823 patients with ESKD, where 941 stroke deaths occurred during 381 874 person-years. Patients with ESKD had >3× the stroke deaths compared with the general population (standardized mortality ratio, 3.4; 95% CI, 3.2–3.6), markedly higher in younger people and women. The greatest excess was in intracerebral hemorrhages (standardized mortality ratio, 5.2; 95% CI, 4.5–5.9). Excess stroke deaths in patients with ESKD decreased over time, although were still double in 2013 (2013 standardized mortality ratio, 2.1; 95% CI, 1.5–2.9). Conclusions— People with ESKD experience much greater stroke mortality with the greatest difference for women and younger people. However, mortality has improved over time.

scholarly journals Left ventricular geometric patterns in end-stage kidney disease: Determinants and course over time

2018 ◽  
Vol 22 (3) ◽  
pp. 359-368 ◽  
Author(s):  
Menso J. Nubé ◽  
Tiny Hoekstra ◽  
Volkan Doganer ◽  
Michiel L. Bots ◽  
Peter J. Blankestijn ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Left Ventricular ◽  
End Stage Kidney Disease ◽  
Geometric Patterns ◽  
End Stage ◽  
Over Time

scholarly journals Statins and Cardiovascular Disease Outcomes in Chronic Kidney Disease: Reaffirmation vs. Repudiation

2018 ◽  
Vol 15 (12) ◽  
pp. 2733 ◽  
Author(s):  
Chamberlain Obialo ◽  
Elizabeth Ofili ◽  
Keith Norris
Keyword(s):  
Cardiovascular Disease ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
General Population ◽  
Risk Reduction ◽  
Survival Advantage ◽  
End Stage Kidney Disease ◽  
Cvd Risk ◽  
Disease Outcomes ◽  
End Stage

Cardiovascular disease (CVD) burden is several-fold higher in patients with chronic kidney disease (CKD). Although statins have been shown to provide significant CVD benefits in both the general population and patients with CKD, this has not translated into survival advantage in patients with advanced CKD or on dialysis. It has been reported that CVD risk continues to escalate as CKD progresses to end-stage kidney disease (ESKD); however, the CVD risk reduction by statins appears to decline as patients’ progress from the early to later stages of CKD. Statins have also been associated with a higher incidence of stroke in ESKD patients. Thus, the CVD benefits of statins in ESKD remain questionable.

scholarly journals End Stage Kidney Disease in Non-citizen Patients: Epidemiology, Treatment, and an Update to Policy in Illinois

2021 ◽  
Author(s):  
Brittney S. Lange-Maia ◽  
Tricia J. Johnson ◽  
Yumiko I. Gely ◽  
David A. Ansell ◽  
J. Kevin Cmunt ◽  
...  
Keyword(s):  
Kidney Disease ◽  
General Population ◽  
Cost Saving ◽  
Kidney Transplant ◽  
Organ Donors ◽  
End Stage Kidney Disease ◽  
End Stage ◽  
The Impact ◽  
To Receive ◽  
The U.S

AbstractEnd-stage kidney disease (ESKD) is common in the U.S. There is no cure, and survival requires either dialysis or kidney transplant. Medicare provides coverage for most ESKD patients in the U.S., though non-citizens are excluded from most current policies providing standard ESKD care, especially regarding kidney transplants. Despite being eligible to be organ donors, non-citizens often have few avenues to be organ recipients—a major equity problem. Overall, transplants are cost-saving compared to dialysis, and non-citizens have comparable outcomes to the general population. We reviewed the literature regarding the vastly different policies across the U.S., with a focus on current Illinois policy, including updates regarding Illinois legislation which passed in 2014 providing non-citizens to receive coverage for transplants. Unfortunately, despite legislation providing avenues for transplants, funds were not allocated, and the bill has not had the impact that was expected when initially passed. We outline opportunities for improving current policies.

scholarly journals Survival of Patients With Idiopathic Inflammatory Myopathies in Slovenia

2021 ◽  
Vol 8 ◽  
Author(s):  
Alojzija Hočevar ◽  
Andrej Viršček ◽  
Monika Krošel ◽  
Suzana Gradišnik ◽  
Žiga Rotar ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
General Population ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Standardized Mortality Ratio ◽  
First Year ◽  
Idiopathic Inflammatory Myopathies ◽  
Inflammatory Myopathies ◽  
Mortality Ratio ◽  
Using Data

Background: Idiopathic inflammatory myopathies (IIMs) are rare systemic diseases associated with significant morbidity and mortality. The aim of our study was to estimate for the first time the survival of IIM patients in Slovenia.Methods: We included IIM patients diagnosed between January 2005 and December 2020 and followed at two secondary/tertiary rheumatology centers in the country. To study survival/mortality the censor date of April 14 2021 was set. Kaplan–Meier analysis and standardized mortality ratio (SMR) were plotted using data of age and sex matched Slovenian population as a reference. Cox proportional hazards regression analysis was used to study prognostic factors for IIM mortality.Results: During the 16-year observation period, we identified 217 new IIM patients. During follow up 65 (30.0%) patients died. In the first year following IIM diagnosis the SMR was nearly 7-fold higher compared to the matched general population [SMR 6.88 (95%CI 4.41–10.24)] and remained higher also during the following 4 years. However, when excluding IIM patients with cancer, the survival outcome was, except in the first year after IIM diagnosis [SMR 5.55 (95%CI 3.10–9.15)], comparable to matched general population. In addition to cancer [HR 3.71 (95% CI 2.18–6.04)], cardiac involvement [HR 2.18 (95% CI 1.07–4.45)], fever [HR 2.13 (95% CI 1.13–4.03)], and older age [HR 1.07 (95% CI 1.04–1.09)] were extracted as prognostic factors associated with death.Conclusion: The survival of patients with IIM patients was substantially worse compared to matched general population. Cancer was the leading cause of death in our cohort.

Impaired Vitamin D Signaling Is Associated With Frequent Development of Renal Cell Tumor in End-stage Kidney Disease

2020 ◽  
Vol 40 (11) ◽  
pp. 6525-6530
Author(s):  
JANOS DOCS ◽  
DANIEL BANYAI ◽  
TIBOR FLASKO ◽  
ARPAD SZANTO ◽  
GYULA KOVACS
Keyword(s):  
Vitamin D ◽  
Kidney Disease ◽  
Renal Cell ◽  
Cell Tumor ◽  
End Stage Kidney Disease ◽  
Vitamin D Signaling ◽  
End Stage

scholarly journals Cardiopulmonary exercise testing (CPET) in patients with end-stage kidney disease (ESKD): principles, methodology and clinical applications of the optimal tool for exercise tolerance evaluation

2021 ◽  
Author(s):  
Eva Pella ◽  
Afroditi Boutou ◽  
Aristi Boulmpou ◽  
Christodoulos E Papadopoulos ◽  
Aikaterini Papagianni ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Exercise Testing ◽  
Cardiopulmonary Exercise Testing ◽  
Exercise Intolerance ◽  
End Stage Kidney Disease ◽  
Exercise Limitation ◽  
Cardiopulmonary Exercise ◽  
Functional Reserves ◽  
Increased Risk ◽  
End Stage

Abstract Chronic kidney disease (CKD), especially end-stage kidney disease (ESKD), is associated with increased risk for cardiovascular events and all-cause mortality. Exercise intolerance as well as reduced cardiovascular reserve are extremely common in patients with CKD. Cardiopulmonary exercise testing (CPET) is a non-invasive, dynamic technique that provides an integrative evaluation of cardiovascular, pulmonary, neuropsychological and metabolic function during maximal or submaximal exercise, allowing the evaluation of functional reserves of these systems. This assessment is based on the principle that system failure typically occurs when the system is under stress and, thus, CPET is currently considered to be the gold-standard for identifying exercise limitation and differentiating its causes. It has been widely used in several medical fields for risk stratification, clinical evaluation and other applications but its use in everyday practice for CKD patients is scarce. This article describes the basic principles and methodology of CPET and provides an overview of important studies that utilized CPET in patients with ESKD, in an effort to increase awareness of CPET capabilities among practicing nephrologists.

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