Risk Factors for Cardiovascular Disease in Patients Undergoing Peritoneal Dialysis

2007 ◽  
Vol 27 (2_suppl) ◽  
pp. 205-209 ◽  
Author(s):  
Elvia García–López ◽  
Juan J. Carrero ◽  
Mohamed E. Suliman ◽  
Bengt Lindholm ◽  
Peter Stenvinkel
Keyword(s):  
Risk Factors ◽  
Peritoneal Dialysis ◽  
Cardiovascular Risk ◽  
Pressure Control ◽  
High Cardiovascular Risk ◽  
Cardiovascular Research ◽  
Factors Associated ◽  
Glycation End Products ◽  
Anemia Management ◽  
Altered Lipid

Patients on peritoneal dialysis (PD) are at high cardiovascular risk. Although some risk factors are unmodifiable (for example, age, sex, genetics), others are exacerbated in the unfriendly uremic milieu (inflammation, oxidative stress, mineral disturbances) or contribute per se to kidney disease and cardiovascular progression (diabetes mellitus, hypertension). Moreover, several factors associated with PD therapy may both increase (by altered lipid profile, hyperinsulinemia, and formation of advanced glycation end-products) and decrease (by better blood pressure control and anemia management) cardiovascular risk. The present review discusses recent findings and therapy trends in cardiovascular research on the PD population, with emphasis on the roles of inflammation, insulin resistance, homocysteinemia, dyslipidemia, vascular calcification, and genetics/epigenetics.

scholarly journals Demographic and clinical characteristics of hypertensive patients in the internal medicine outpatient clinic of a university hospital in Rio de Janeiro

2004 ◽  
Vol 122 (3) ◽  
pp. 87-93 ◽  
Author(s):  
Elizabeth Silaid Muxfeldt ◽  
Armando da Rocha Nogueira ◽  
Gil Fernando Salles ◽  
Kátia Vergetti Bloch
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Blood Pressure Control ◽  
Rio De Janeiro ◽  
Pressure Control ◽  
Organ Damage ◽  
University Hospital ◽  
High Cardiovascular Risk ◽  
Hypertensive Patients

CONTEXT: Hypertension is one of the most important cardiovascular risk factors but its control is still a challenge for physicians all around the world. For blood pressure control to be improved, it is important to guarantee the quality of attendance provided for hypertensive patients, especially in teaching hospitals, where future physicians are being trained. OBJECTIVE: To characterize the profile of hypertensive patients attending the internal medicine outpatient clinic of a university hospital in Rio de Janeiro,describing their cardiovascular risk and identifying flaws in the treatment provided for severely hypertensive patients, in order to implement an arterial hypertension management program. TYPE OF STUDY: A descriptive cross-sectional population-based study. SETTING: Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro. METHODS: The study was carried out over a period of four months, involving all the hypertensive patients under treatment in the outpatient unit. The attending physician obtained information relating to demographic features, cardiovascular risk factors, target organ damage, blood pressure levels, therapeutic regimens and compliance with treatment. Means and the respective standard deviations and proportions were used to describe the distribution of patient data. RESULTS: Of the total number of patients seen, 24.2% (1,699 patients) were hypertensive. Women accounted for 65.0% of the patients. The mean age was 63.9 years. Dyslipidemia (49.2%) and diabetes (29.8%) were the most frequently reported risk factors and heart disease was the most prevalent end-organ damage. Seventy percent of the patients were classified as high cardiovascular risk. In spite of the high intensity treatment provided for the most severe patients (19.4% on a regimen of 3 or more antihypertensive drugs), the rate of blood pressure control was low (27%). CONCLUSIONS: The patients with arterial hypertension under treatment at the university hospital had a profile of high cardiovascular risk and poor blood pressure control. Greater effort for improving hypertension control is needed, since this is the only way to reduce the morbidity and mortality rates of cardiovascular diseases.

1178-P: Multicomponent Integrated Care Program Benefits on Cardiovascular Risk Factors for Adults with Diabetes and High Cardiovascular Risk: The DIABEMPIC Program

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 1178-P ◽  
Author(s):  
RUBÉN SILVA-TINOCO ◽  
ENEDINA TERESA C. CUATECONTZI ◽  
VIRIDIANA DELATORRE-SALDAÑA ◽  
EILEEN B. GUZMAN ◽  
DOLORES CABRERA-GERARDO ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Integrated Care ◽  
Care Program ◽  
High Cardiovascular Risk ◽  
Program Benefits

scholarly journals Clinical profiles and quality of care of subjects with type 2 diabetes according to their cardiovascular risk: an observational, retrospective study

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Basilio Pintaudi ◽  
Alessia Scatena ◽  
Gabriella Piscitelli ◽  
Vera Frison ◽  
Salvatore Corrao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Quality Of Care ◽  
Cardiovascular Risk ◽  
High Risk ◽  
Cardiovascular Risk Factors ◽  
High Cardiovascular Risk ◽  
Very High

Abstract Background The European Society of Cardiology (ESC) recently defined cardiovascular risk classes for subjects with diabetes. Aim of this study was to explore the distribution of subjects with type 2 diabetes (T2D) by cardiovascular risk groups according to the ESC classification and to describe the quality indicators of care, with particular regard to cardiovascular risk factors. Methods The study is based on data extracted from electronic medical records of patients treated at the 258 Italian diabetes centers participating in the AMD Annals initiative. Patients with T2D were stratified by cardiovascular risk. General descriptive indicators, measures of intermediate outcomes, intensity/appropriateness of pharmacological treatment for diabetes and cardiovascular risk factors, presence of other complications and overall quality of care were evaluated. Results Overall, 473,740 subjects with type 2 diabetes (78.5% at very high cardiovascular risk, 20.9% at high risk and 0.6% at moderate risk) were evaluated. Among people with T2D at very high risk: 26.4% had retinopathy, 39.5% had albuminuria, 18.7% had a previous major cardiovascular event, 39.0% had organ damage, 89.1% had three or more risk factors. The use of DPP4-i markedly increased as cardiovascular risk increased. The prescription of secretagogues also increased and that of GLP1-RAs tended to increase. The use of SGLT2-i was still limited, and only slightly higher in subjects with very high cardiovascular risk. The overall quality of care, as summarized by the Q score, tended to be lower as the level of cardiovascular risk increased. Conclusions A large proportion of subjects with T2D is at high or very high risk. Glucose-lowering drug therapies seem not to be adequately used with respect to their potential advantages in terms of cardiovascular risk reduction. Several actions are necessary to improve the quality of care.

scholarly journals Large auto-hemoinfusion versus rectal insufflation in patients with metabolic syndrome

Ozone Therapy ◽  
2016 ◽  
Vol 1 (1) ◽  
pp. 13
Author(s):  
Francesco Vaiano ◽  
Fortunato Loprete
Keyword(s):  
Metabolic Syndrome ◽  
Cardiovascular Risk ◽  
Clinical Situation ◽  
Gas Mixture ◽  
High Cardiovascular Risk ◽  
Factors Associated ◽  
The Metabolic Syndrome ◽  
Alternative Method

The metabolic syndrome is a clinical situation including a series of factors at high cardiovascular risk; the treatment with an oxygenozone gas mixture can influence all factors associated with this syndrome. The objective of the study has been to verify if the rectal insufflation could replace the large auto-hemoinfusion when treating the metabolic syndrome in those patients who, for various reasons cannot use the auto-hemoinfusion. Twenty-four individuals aged between 34 and 68 were recruited and included in the group treated with ozonated auto-hemoinfusion and other 24 individuals aged between 35 and 67 were recruited and included in the group treated with rectal insufflation of the oxygen-ozone gas mixture. According to the results obtained by means of oxygen-ozone mixture rectal insufflation, which are almost equivalent to the results obtained with the large ozonated auto-hemoinfusion, authors could conclude that the ozonated rectal insufflation can be taken into consideration as alternative method to the large auto-hemoinfusion, while treating the metabolic syndrome, in those patients difficult to manage due to the previously described reasons.

Cardiovascular risk factors in hemodialysis and peritoneal dialysis patients

2005 ◽  
Vol 65 (8) ◽  
pp. 739-745 ◽  
Author(s):  
F. M. Yilmaz ◽  
G. Yilmaz ◽  
M. Duranay ◽  
H. Parpucu ◽  
M. Şeneş ◽  
...  
Keyword(s):  
Risk Factors ◽  
Peritoneal Dialysis ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Dialysis Patients

The Potential Cardiovascular Benefits of Low-Glucose Degradation Product, Biocompatible Peritoneal Dialysis Fluids: A Review of the Literature

2017 ◽  
Vol 37 (4) ◽  
pp. 375-383 ◽  
Author(s):  
Charlotte E. Grantham ◽  
Katherine L. Hull ◽  
Matthew P.M. Graham-Brown ◽  
Daniel S. March ◽  
James O. Burton
Keyword(s):  
Risk Factors ◽  
Peritoneal Dialysis ◽  
Cardiovascular Risk ◽  
Interstitial Fibrosis ◽  
Degradation Products ◽  
Controlled Trial ◽  
Membrane Integrity ◽  
Left Ventricular ◽  
Stage Renal Disease ◽  
End Stage

Cardiovascular mortality in the end-stage renal disease (ESRD) population remains the leading cause of death. Targeting traditional cardiovascular risk factors has proven unsuccessful in this patient population, and therefore attention has turned to risk factors related to chronic kidney disease (CKD). The toxicity of high-glucose peritoneal dialysis (PD) solutions has been well documented. The breakdown of glucose into glucose degradation products (GDP) and advanced glycation end-products (AGE) has the ability to alter cell viability and cause premature apoptosis and is strongly correlated with interstitial fibrosis and microvascular sclerosis. Biocompatible solutions have been introduced to combat the hostile milieu to which PD patients are exposed.Given the considerable cardiovascular burden for PD patients, little is known about the cardiovascular impact the new biocompatible solutions may have. This review analyzes the existing literature regarding the mechanisms through which low-GDP solutions may modulate cardiovascular risk. Interventions using low-GDP solutions have provided encouraging changes in structural cardiovascular measures such as left ventricular mass (LVM), although metabolic changes from reduced GDP and AGE exposure yield inconclusive results on vascular remodelling. It is thought that the local effects of reduced glucose exposure may improve membrane integrity and therefore fluid status. Further research in the form of a robust randomized controlled trial should be carried out to assess the true extent of the cardiovascular benefits these biocompatible solutions may hold.

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