Hypertension in end-stage kidney disease

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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Psychosocial factors affecting patients with end-stage kidney disease and the impact of the social worker

Journal of Nephrology ◽

10.1007/s40620-021-01098-8 ◽

2021 ◽

Author(s):

Micaella Sotera Hansen ◽

Wubshet Tesfaye ◽

Beena Sewlal ◽

Bharati Mehta ◽

Kamal Sud ◽

...

Keyword(s):

Kidney Disease ◽

Psychosocial Factors ◽

Social Worker ◽

End Stage Kidney Disease ◽

Factors Affecting ◽

The Social ◽

End Stage ◽

The Impact

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Chronic kidney disease, pregnancy and haemodialysis: Case reports from a single centre in Kenya and literature review

Obstetric Medicine ◽

10.1177/1753495x20985408 ◽

2021 ◽

pp. 1753495X2098540

Author(s):

Samuel K Kabinga ◽

Jackline Otieno ◽

John Ngige ◽

Seth O Mcligeyo

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Case Reports ◽

Tertiary Hospital ◽

Reproductive Age ◽

Review Of Literature ◽

Single Centre ◽

End Stage Kidney Disease ◽

Women Of Reproductive Age ◽

End Stage

Chronic kidney disease (CKD) and end stage kidney disease are prevalent even in women of reproductive age. These are known to reduce fertility and successful pregnancy. There are chances of conception even in advanced CKD, though laden with complications. We present two cases of women who conceived in advanced CKD and are on haemodialysis in a tertiary hospital in Kenya and review of literature.

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All-Cause Mortality and Progression to End-Stage Kidney Disease Following Percutaneous Revascularization or Surgical Coronary Revascularization in Patients with CKD

Kidney International Reports ◽

10.1016/j.ekir.2021.03.882 ◽

2021 ◽

Author(s):

David M. Charytan ◽

Katya Zelevinsky ◽

Robert Wolf ◽

Sharon-Lise T. Normand

Keyword(s):

Kidney Disease ◽

Coronary Revascularization ◽

End Stage Kidney Disease ◽

All Cause Mortality ◽

Percutaneous Revascularization ◽

End Stage

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The impact of artificial intelligence and big data on end-stage kidney disease treatments

Expert Systems with Applications ◽

10.1016/j.eswa.2021.115076 ◽

2021 ◽

pp. 115076

Author(s):

Covadonga Díez-Sanmartín ◽

Antonio Sarasa-Cabezuelo ◽

Amado Andrés Belmonte

Keyword(s):

Artificial Intelligence ◽

Big Data ◽

Kidney Disease ◽

End Stage Kidney Disease ◽

End Stage ◽

The Impact

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Age dependence of brachial cuff-based ambulatory PWV in end-stage kidney disease patients undergoing long-term peritoneal dialysis

Peritoneal Dialysis International ◽

10.1177/0896860821996927 ◽

2021 ◽

pp. 089686082199692

Author(s):

Vasilios Vaios ◽

Panagiotis I Georgianos ◽

Georgia Vareta ◽

Dimitrios Divanis ◽

Evangelia Dounousi ◽

...

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Heart Rate ◽

Peritoneal Dialysis ◽

Kidney Disease ◽

Pulse Wave ◽

Age Dependence ◽

End Stage Kidney Disease ◽

End Stage

Background: The newly introduced device Mobil-O-Graph (IEM, Stolberg, Germany) combines brachial cuff oscillometry and pulse wave analysis, enabling the determination of pulse wave velocity (PWV) via complex mathematic algorithms during 24-h ambulatory blood pressure monitoring (ABPM). However, the determinants of oscillometric PWV in the end-stage kidney disease (ESKD) population remain poorly understood. Methods: In this study, 81 ESKD patients undergoing long-term peritoneal dialysis underwent 24-h ABPM with the Mobil-O-Graph device. The association of 24-h oscillometric PWV with several demographic, clinical and haemodynamic parameters was explored using linear regression analysis. Results: In univariate analysis, among 21 risk factors, 24-h PWV exhibited a positive relationship with age, body mass index, overhydration assessed via bioimpedance spectroscopy, diabetic status, history of dyslipidaemia and coronary heart disease, and it had a negative relationship with female sex and 24-h heart rate. In stepwise multivariate analysis, age ( β: 0.883), 24-h systolic blood pressure (BP) ( β: 0.217) and 24-h heart rate ( β: −0.083) were the only three factors that remained as independent determinants of 24-h PWV (adjusted R 2 = 0.929). These associations were not modified when all 21 risk factors were analysed conjointly or when the model included only variables shown to be significant in univariate comparisons. Conclusion: The present study shows that age together with simultaneously assessed oscillometric BP and heart rate are the major determinants of Mobil-O-Graph-derived PWV, explaining >90% of the total variation of this marker. This age dependence of oscillometric PWV limits the validity of this marker to detect the premature vascular ageing, a unique characteristic of vascular remodelling in ESKD.

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