scholarly journals Association between chronic kidney disease and physical activity level in patients with ischemic heart disease

2017 ◽  
Vol 3 (1) ◽  
Author(s):  
Ryota Matsuzawa ◽  
Takashi Masuda ◽  
Kentaro Kamiya ◽  
Nobuaki Hamazaki ◽  
Kohei Nozaki ◽  
...  
2020 ◽  
Vol 16 (4) ◽  
pp. 654-662
Author(s):  
O. D. Ostroumova ◽  
I. A. Alautdinova ◽  
A. I. Kochetkov ◽  
S. N. Litvinova

Cardiovascular diseases are the leading cause of death both in the world and in the Russian Federation. The most significant contributors to the increase in mortality are arterial hypertension (AH) and ischemic heart disease (IHD). Dihydropyridine calcium channel blockers (CCBs) are the first line of treatment for these conditions. This is noted in the clinical guidelines for the diagnosis and treatment of AH and in the guidelines for the management of patients with chronic coronary syndromes. CCBs are a heterogeneous group of drugs that have both general and individual pharmacokinetic and pharmacodynamic properties. They are used in patients with AH and/or IHD, including those with concomitant diseases (diabetes mellitus, chronic kidney disease, bronchial asthma, chronic obstructive pulmonary disease, peripheral arterial disease). Felodipine is one of the CCBs. It has a combination of clinical effects, allowing the drug to be prescribed as a first-line therapy for AH, IHD and a combination of these diseases. This is noted in the registered indications for its use. This CCB has a sufficient evidence base of clinical trials demonstrating not only good antihypertensive and antianginal potential of the drug, but also the nephroprotection and cerebroprotection properties. The nephroprotective effect of felodipine is associated with a slowdown in the progression of chronic kidney disease, and the cerebroprotective effect is associated with a decrease in the risk of stroke and an improvement in cognitive functioning. The safety profile of felodipine is favorable: peripheral edema develops much less frequently. This is confirmed by the results of comparative studies. Felodipine is recommended for a wide range of patients with AH, IHD and their combination due to such clinical and pharmacological properties.


2021 ◽  
Vol 15 (7) ◽  
pp. 2059-2061
Author(s):  
Muhammad Farhan Akhtar ◽  
Hafiz Muhammad Waqas Siddque ◽  
Talha Nazir ◽  
Ubaid Khan

Introduction: The disease burden of Chronic Kidney Disease (CKD) is increasing every day and adding the burden on our healthcare system. Many patients are being treated by hemodialysis due to a very limited recourses available. Cardiovascular complications such as ischemic heart disease (IHD) are very common in patients who are being treated by hemodialysis and one of the leading causes of death in these patients. Objective: Frequency of IHD in the patients of ESRD. Methodology: Cross-sectional type of study was piloted for duration of three months from April 2019 to June 2019 in Nephrology Department Mayo Hospital Lahore. Eighty one patients were recruited who fulfilled the inclusion criteria i.e. patients suffering end stage renal disease on maintenance hemodialysis through non-probability, convenient sampling. A standard questionnaire was used to collect the data. All the data was analyzed by using SPSS (software package for statistical analysis) version 20. Results: The study was carried out among 81 patients with diagnosis of Chronic Kidney Disease on the maintenance hemodialysis. Most patients in study were falling in the range of 21-60 years. The study included 46 (56.8%) males and 35(43.2%) females. The frequency of Ischemic Heart Diseases in these patients was found to be 56.8% (46/81 cases). Conclusion: Both genders are equally affected. The frequency of IHD in patients of end stage renal disease who are on hemodialysis is observed to be high, but not as much high as observed in previous studies. Both genders are affected almost equally. Key Words: Ischemic Heart Disease, End stage renal disease, chronic kidney disease, Hemodialysis


2019 ◽  
Vol 33 (4) ◽  
pp. 443-451 ◽  
Author(s):  
Efstratios Koutroumpakis ◽  
Elvira O. Gosmanova ◽  
Heather Stahura ◽  
Stephanie Jou ◽  
Rabah Alreshq ◽  
...  

2011 ◽  
Vol 8 (4) ◽  
pp. 475-480 ◽  
Author(s):  
Xiao Jun Wen ◽  
Lina S. Balluz

Background:Most ischemic heart disease (IHD) prevention programs that promote physical activity (PA) have focused on overweight/obese populations. Persons with normal body mass index (BMI) may mistakenly think that they are not at risk for IHD and remain physically inactive. Studies exploring the risk of IHD and PA level among adults aged 45 years and older with normal weight are limited.Methods:Cross-sectional study to examine the prevalence of IHD and PA level among 94455 respondents aged 45 years and older with normal BMI using the 2007 Behavioral Risk Factor Surveillance System data.Results:Approximately 50% of respondents reported low/inactive PA. The prevalence of IHD among persons with inactive, low, medium, and high PA was 16.6% (95% CI = 15.1−18.1%), 9.6% (8.9−10.3%), 8.9% (8.3−9.6%), and 5.4% (4.9−5.9%). The adjusted odds ratios of IHD among persons with low, medium, and high PA compared with those with inactive PA was 0.68 (95% CI = 0.59−0.79), 0.63 (0.54−0.73), and 0.49 (0.42−0.57).Conclusions:The percentage of respondents with low or inactive PA among populations aged 45 years and older with BMI 18 to <25 was alarmingly high and independently associated with higher IHD prevalence. Persons who are not overweight/ obese still need to have adequate PA to reduce the risk of IHD.


2019 ◽  
Vol 6 (4) ◽  
pp. 1046
Author(s):  
Mihir D. Pandya ◽  
Archana D. Asher

Background: Patients with chronic kidney disease require arteriovenous fistulas for hemodialysis. The aim of our study was to share our experience of creating arteriovenous fistulas for hemodialysis and to analyze the factors affecting the outcome of arteriovenous fistulas.Methods: This is a prospective study carried out in Guru Gobind Singh Government Hospital, Jamnagar from August 2013 to July 2015. All patients with chronic kidney disease in whom arteriovenous fistula was created surgically for hemodialysis were included in this study.Results: Maximum patients (34%) were in the age group of 51-60 years. 76% of the patients were males and 24% were females. Co morbid conditions like diabetes mellitus, hypertension and ischemic heart disease were present in 20%, 26%, and 16% of patients respectively. Success rate of arteriovenous fistulas in patients with diabetes mellitus, hypertension and ischemic heart disease was 30%, 69.2% and 25% respectively. Success rate of arteriovenous fistulas in patients without diabetes mellitus, hypertension and ischemic heart disease was 92.5%, 83.8% and 90.5% respectively. Early failure was present in 20% of the patients. Most common cause of early failure was thrombosis, which occurred in 8% of total patients. Other causes of early failure were wound infection, stenosis and aneurysm, which occurred in 6%, 4% and 2% patients respectively.Conclusions: Presence of diabetes mellitus and ischemic heart disease was associated with a higher risk of arteriovenous fistula failure. The success rate reported in our study was fairly acceptable.


2020 ◽  
Vol 0 (0) ◽  
pp. 0-0
Author(s):  
youssf Nassar ◽  
Ahmed Harfoosh ◽  
Ahmed Abd El Aziz ◽  
Asmaa Saleh ◽  
noura Mostafa

2020 ◽  
Vol 1 (6) ◽  
pp. 257-260
Author(s):  
Alexander Beschloss ◽  
John Mueller ◽  
Jon-Michael E Caldwell ◽  
Alex Ha ◽  
Joseph M Lombardi ◽  
...  

Aims Medical comorbidities are a critical factor in the decision-making process for operative management and risk-stratification. The Hierarchical Condition Categories (HCC) risk adjustment model is a powerful measure of illness severity for patients treated by surgeons. The HCC is utilized by Medicare to predict medical expenditure risk and to reimburse physicians accordingly. HCC weighs comorbidities differently to calculate risk. This study determines the prevalence of medical comorbidities and the average HCC score in Medicare patients being evaluated by neurosurgeons and orthopaedic surgeon, as well as a subset of academic spine surgeons within both specialities, in the USA. Methods The Medicare Provider Utilization and Payment Database, which is based on data from the Centers for Medicare and Medicaid Services’ National Claims History Standard Analytic Files, was analyzed for this study. Every surgeon who submitted a valid Medicare Part B non-institutional claim during the 2013 calendar year was included in this study. This database was queried for medical comorbidities and HCC scores of each patient who had, at minimum, a single office visit with a surgeon. This data included 21,204 orthopaedic surgeons and 4,372 neurosurgeons across 54 states/territories in the USA. Results Orthopaedic surgeons evaluated patients with a mean HCC of 1.21, while neurosurgeons evaluated patients with a mean HCC of 1.34 (p < 0.05). The rates of specific comorbidities in patients seen by orthopaedic surgeons/neurosurgeons is as follows: Ischemic heart disease (35%/39%), diabetes (31%/33%), depression (23%/31%), chronic kidney disease (19%/23%), and heart failure (17%/19%). Conclusion Nationally, comorbidity rate and HCC value for these Medicare patients are higher than national averages for the US population, with ischemic heart disease being six-times higher, diabetes two-times higher, depression three- to four-times higher, chronic kidney disease three-times higher, and heart failure nine-times higher among patients evaluated by orthopaedic surgeons and neurosurgeons. Cite this article: Bone Joint Open 2020;1-6:257–260.


Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Keita Sano ◽  
Yasushi Kodama ◽  
Mitsumasa Hirano ◽  
Isao Takishima ◽  
Aritaka Makino ◽  
...  

Sympathetic activity is heightened in chronic kidney disease (CKD). The increased sympathetic activity is a risk of future cardiovascular disease (CVD) events. Dopamine, a precursor of norepinephrine biosynthesis, is metabolized in the kidney and excreted into urine, and its plasma levels are increased in renal dysfunction. Thus, we examined whether plasma levels of endogenous dopamine may be related to future CVD events in patients with CKD. A total of 840 patients in stable condition with chronic heart disease (622 patients with ischemic heart disease and 218 with non-ischemic heart disease) (586 patients with GFR ≥ 60 ml/min/1.73 m 2 [normal/mild CKD]; 153 patients with 60 > GFR ≥ 30 [moderate CKD]; 101 patients with 30 > GRF [advanced CKD]) were prospectively followed-up for 5 years or until one of the following CVD events: cardiac death, non-fatal myocardial infarction, unstable angina pectoris requiring unplanned revascularization, worsening heart failure requiring hospitalization, or stroke. Plasma levels of endogenous free dopamine at entry were measured by high-performance liquid chromatography. Patients with a higher stage of CKD had higher dopamine levels than patients with a lower stage (63.0 ± 5.5, 45.0 ± 5.1, and 26 ± 1.2 pg/mL, respectively, ρ = 0.54, p < 0.0001 Spearman rank correlation test). During the follow-up period, 233 patients had CVD events (cardiac death in 54, myocardial infarction in 18, others events in 161) (113 events [19%] in normal/mild CKD, 64 [42%] in moderate CKD, and 56 [55%] in advanced CKD). In patients with moderate CKD and advanced CKD, higher dopamine levels (≥ 40 pg/mL, defined by ROC analysis) were the strongest predictor of CVD events (HR 2.1 and 3.3, 95% CI 1.2 – 3.7 and 1.5 – 7.2, p = 0.006 and 0.003, respectively) in a multivariate Cox hazards analysis using plasma norepinephrine and BNP levels, hypertension, and hyperlipidemia as covariates. In contrast, dopamine levels did not have predictive value in normal/mild CKD (HR 1.2, 95% CI 0.7 – 2.0, p = 0.5). High plasma levels of endogenous free dopamine are a risk factor for future CVD in patients with CKD independently of norepinephrine levels. Increases in plasma endogenous free dopamine levels may serve as a mechanistic link between CKD and CVD.


Sign in / Sign up

Export Citation Format

Share Document