scholarly journals STRATIFICATION OF NEPHROCEREBRAL AND CARDIOVASCULAR RISK IN CHRONIC GLOMERULONEPHRITIS (LITERATURE REVIEW)

2018 ◽  
Vol 8 (6) ◽  
pp. 418-423 ◽  
Author(s):  
I. T. Murkamilov ◽  
I. S. Sabirov ◽  
Zh. A. Murkamilova ◽  
V. V. Fomin ◽  
A. I. Sabirova ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Heart Rate ◽  
Renal Function ◽  
Cardiovascular Diseases ◽  
Kidney Disease ◽  
Cerebrovascular Diseases ◽  
The Body ◽  
Chronic Glomerulonephritis ◽  
Increased Risk

This article analyzes the literature data concerning the origin and progression of cerebrovascular and cardiac diseases in renal dysfunction. Cardiovascular diseases and chronic kidney disease have common “traditional” risk factors, while the population growth in patients with renal impairment is currently mainly due to secondary renal damage in socially important diseases such as obesity, hypertension, atherosclerosis, type 2 diabetes, ischemic heart disease and chronic heart failure. The presented data of scientific researches testify to the direct correlation correlation between the decrease of the renal function and the increased risk of cardioand cerebrovascular diseases and death, irrespective of other risk factors. Obesity and associated biological substrates are independent risk factors for persistent impairment of kidney function and an increase in the body mass index causes direct damage to the kidneys, due to the disrupted synthesis of fat cytokines by various cytokines with nephrotoxic action, and also mediated — by inducing the development of diabetes mellitus 2 type and arterial hypertension, which are the most frequent risk factors for chronic kidney disease and cardiovascular diseases. The presented data on the role of endothelial dysfunction in impaired renal function, which contributes to the formation of atherosclerosis, and the increase in the severity of the atherosclerotic process contributes to an increase in the sever ity of renal failure. Literature data on the value of the heart rate are also presented. The increase in the heart rate can lead to atherosclerotic densification of the arteries, which is associated with an increase in the rate of spread of the pulse wave with a violation of the mechanisms of autoregulation of the blood flow in the brain and kidneys.

Stroke in chronic renal failure

2008 ◽  
Vol 149 (15) ◽  
pp. 691-696
Author(s):  
Dániel Bereczki
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Renal Disease ◽  
Chronic Renal Disease ◽  
Kidney Diseases ◽  
Cerebrovascular Diseases ◽  
Lipid Lowering ◽  
Increased Risk ◽  
Intracerebral Hemorrhages

Chronic kidney diseases and cardiovascular diseases have several common risk factors like hypertension and diabetes. In chronic renal disease stroke risk is several times higher than in the average population. The combination of classical risk factors and those characteristic of chronic kidney disease might explain this increased risk. Among acute cerebrovascular diseases intracerebral hemorrhages are more frequent than in those with normal kidney function. The outcome of stroke is worse in chronic kidney disease. The treatment of stroke (thrombolysis, antiplatelet and anticoagulant treatment, statins, etc.) is an area of clinical research in this patient group. There are no reliable data on the application of thrombolysis in acute stroke in patients with chronic renal disease. Aspirin might be administered. Carefulness, individual considerations and lower doses might be appropriate when using other treatments. The condition of the kidney as well as other associated diseases should be considered during administration of antihypertensive and lipid lowering medications.

scholarly journals CHRONIC KIDNEY DISEASE AS A MANIFESTATION OF COMORBIDITY IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE

2018 ◽  
Vol 1 (69) ◽  
pp. 115-122 ◽  
Author(s):  
А Бакина ◽  
A Bakina ◽  
Валентина Павленко ◽  
Valentina Pavlenko
Keyword(s):  
Risk Factors ◽  
Chronic Obstructive Pulmonary Disease ◽  
Chronic Kidney Disease ◽  
Renal Function ◽  
Kidney Disease ◽  
Pulmonary Disease ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Increased Risk

Chronic obstructive pulmonary disease (COPD) has many systemic effects, one of which is impaired renal function. Existing studies prove that patients with COPD often have risk factors for developing chronic kidney disease (CKD). Many risk factors for developing COPD are common for the onset of CKD. However, in routine clinical practice, there is an underestimation of the incidence of renal dysfunction in COPD patients, while in-depth and targeted studies reveal changes in renal function in patients with COPD. Topical methods for identifying initial changes in renal function in COPD patients are the study of the glomerular filtration rate, the evaluation of the level of microalbuminuria, the study of the index of resistance of renal vessels. The importance of identifying CKD in the early stages in COPD patients is determined by the increased risk of cardiovascular events and the onset of cardiorenal syndrome in patients.

Abstract MP74: Long Term Risk-Factor Profiles for Chronic Kidney Disease in the Framingham Heart Study

Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Gearoid M McMahon ◽  
Sarah R Preis ◽  
Shih-Jen Hwang ◽  
Caroline S Fox
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Risk Factor ◽  
Kidney Disease ◽  
Framingham Heart Study ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Standard Deviation Increase ◽  
Heart Study ◽  
Increased Risk

Background: Chronic Kidney Disease (CKD) is an important public health issue and is associated with an increased risk of cardiovascular disease. Risk factors for CKD are well established, but most are typically assessed at or near the time of CKD diagnosis. Our hypothesis was that risk factors for CKD are present earlier in the course of the disease. We compared the prevalence of risk factors between CKD cases and controls at time points up to 30 years prior to CKD diagnosis. Methods: Participants were drawn from the Framingham Heart Study Offspring cohort. CKD was defined as an estimated glomerular filtration rate of ≤60ml/min/1.73m2. Incident CKD cases occurring at examination cycles 6, 7, and 8 were age- and sex-matched 1:2 to controls. Risk factors including systolic blood pressure (SBP), hypertension, lipids, diabetes, smoking status, body mass index (BMI) and dipstick proteinuria were measured at the time of CKD diagnosis and 10, 20 and 30 years prior. Logistic regression models, adjusted for age, sex, and time period, were constructed to compare risk factor profiles at each time point between cases and controls Results: During follow-up, 441 new cases of CKD were identified and these were matched to 882 controls (mean age 69.2 years, 52.4% women). Up to 30 years prior to CKD diagnosis, those who ultimately developed CKD were more likely to have hypertension (OR 1.74, CI 1.21-2.49), be obese (OR 1.74, CI 1.15-2.63) and have higher triglycerides (OR 1.43, CI 1.12-1.84, p=0.005 per 1 standard deviation increase). Each 10mmHg increase in SBP was associated with an OR of 1.22 for future CKD (95% CI 1.10-1.35) Additionally, cases were more likely to have diabetes (OR 2.90, CI 1.59-5.29) and be on antihypertensive therapy (OR 1.65, CI 1.14-2.40, p=0.009) up to 20 years prior to diagnosis. Increasing HDLc was associated with a lower risk of CKD (OR 0.84, CI 0.81-0.97 per 10mg/dl). Conclusions: As many as 30 years prior to diagnosis, risk factors for CKD are identifiable. In particular, modifiable risk factors such as obesity, hypertension and dyslipidemia are present early in the course of the disease. These findings demonstrate the importance of early identification of risk factors in patients at risk of CKD through a life-course approach.

Possibilities of using fosinopril in treatment of patients with chronic kidney disease in combination with cardiovascular diseases and diabetes mellitus

2021 ◽  
pp. 17-25
Author(s):  
E. Yu. Ebzeeva ◽  
O. D. Ostroumova ◽  
S. V. Batyukina ◽  
N. A. Shatalova ◽  
N. M. Doldo ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Chronic Kidney Disease ◽  
Cardiovascular Diseases ◽  
Kidney Disease ◽  
Angiotensin Converting Enzyme ◽  
Enzyme Inhibitor ◽  
The Body ◽  
Converting Enzyme ◽  
Converting Enzyme Inhibitors ◽  
Secondary Damage

Chronic kidney disease is one of the most common diseases in general medical practice, due to their secondary damage to the kidneys in arterial hypertension, chronic heart failure, and diabetes mellitus. The coexistence of hypertension and diabetes increases the likelihood of developing chronic kidney failure tenfold. In turn, chronic kidney disease is an important independent risk factor for the development of cardiovascular complications, including fatal ones, due to the direct relationship of the pathogenetic mechanisms of cardiorenal relationships. Approaches to the treatment of chronic kidney disease should be aimed both at preventing the risks of developing renal dysfunction, and at treating existing pathology. The multifactorial nature of the disease and the complex etiopathogenetic relationships determine the need to optimize existing approaches to the treatment of chronic kidney disease in multimorbidity patients with concomitance cardiovascular diseases and diabetes mellitus. This is also due to the fact that, unlike other target organs, compensation for background disease does not always prevent further deterioration of kidney function. According to the recommendations of the main scientific communities, in such cases, it is advisable to start therapy with the most effective angiotensin-converting enzyme inhibitors that combine nephro-and cardioprotective effects and have a dual route of elimination from the body, which is especially important in multimorbidity, the aim to prevent polypharmacy, reduce the risk of drug interactions and, consequently, side effects. This article reviews the literature data indicating the high efficacy and safety of the angiotensin converting enzyme inhibitor fosinopril in patients with chronic kidney disease in combination with cardiovascular diseases and diabetes mellitus.

Drugs and the kidney

2010 ◽  
pp. 4174-4188
Author(s):  
Aine Burns ◽  
Caroline Ashley
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Function ◽  
Kidney Disease ◽  
Critical Role ◽  
The Body ◽  
Medical Practitioners ◽  
Drug Dosing ◽  
Estimated Glomerular Filtration Rates ◽  
Careful Thought ◽  
Reduced Renal Function

The kidney plays a critical role in the elimination of many drugs from the body, hence consideration should be given to a patient’s renal function whenever any drug is prescribed. Much kidney disease is unrecognized, but the widespread reporting of estimated glomerular filtration rates (eGFR) has brought greater awareness of the prevalence of chronic kidney disease (CKD) and thereby encouraged medical practitioners to take account of reduced renal function when prescribing. CKD is very often one of many coexisting comorbid conditions, especially in elderly patients, when particularly careful thought must be given to appropriate drug dosing and the possibility of drug interactions....

The obese patient (metabolic syndrome)

2015 ◽  
Author(s):  
Maarit Korkeila ◽  
Bengt Lindholm ◽  
Peter Stenvinkel
Keyword(s):  
Risk Factors ◽  
Metabolic Syndrome ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Overweight And Obesity ◽  
Blood Cholesterol ◽  
Long Term Effects ◽  
Reverse Epidemiology ◽  
Increased Risk

Overweight and obesity cause pathophysiological changes in renal function and increase the risk for chronic kidney disease in otherwise healthy subjects. This should not be a surprise as the risk factors for metabolic syndrome largely overlap with those for chronic kidney disease. Intentional weight loss has beneficial effects on risk factors, but long term effects are less clear. Bariatric surgery does seem to achieve rapid benefits on blood pressure and proteinuria as well as on other aspects of metabolic syndrome, but its long term implications for kidney function are less clear cut as there may be an increased risk of nephrolithiasis, and possibly AKI and other complications.Obesity in haemodialysis patients is one of those paradoxical examples of reverse epidemiology where a factor associated with negative outcomes in the general population is associated with better outcomes in dialysis patients. The same is true for high blood cholesterol values. Interpretation is complicated by complex competing outcomes and confounders.

Risk of Stroke, Bleeding, and Death in Patients with Nonvalvular Atrial Fibrillation and Chronic Kidney Disease

Cardiology ◽  
2020 ◽  
Vol 145 (3) ◽  
pp. 178-186
Author(s):  
Yoav Arnson ◽  
Moshe Hoshen ◽  
Adi Berliner-Sendrey ◽  
Orna Reges ◽  
Ran Balicer ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Chronic Kidney Disease ◽  
Renal Function ◽  
Kidney Disease ◽  
Impaired Renal Function ◽  
Bleeding Risk ◽  
Intracranial Bleeding ◽  
Increased Risk ◽  
Ckd Stage ◽  
Stroke Death

Introduction: Atrial fibrillation (AF) and chronic kidney disease (CKD) are both associated with increased risk of stroke, and CKD carries a higher bleeding risk. Oral anticoagulation (OAC) treatment is used to reduce the risk of stroke in patients with nonvalvular AF (NVAF); however, the risk versus benefit of OAC for advanced CKD is continuously debated. We aim to assess the management and outcomes of NVAF patients with impaired renal function within a population-based cohort. Methods: We conducted a retrospective observational cohort study using ICD-9 healthcare coding. Patients with incident NVAF between 2004 and 2015 were identified stratified by CKD stage. We compared treatment strategies and estimated risks of stroke, death, or any major bleeding based on CKD stages and OAC treatment. Results: We identified 85,116 patients with incident NVAF. Patients with impaired renal function were older and had more comorbidities. OAC was most common among stage 2 CKD patients (49%) and least in stages 4–5 CKD patients (27.6%). Higher CKD stages were associated with worse outcomes. Stroke rates increased from 1.04 events per 100 person-years (PY) in stage 1 CKD to 3.72 in stages 4–5 CKD. Mortality increased from 3.42 to 32.95 events/100 PY, and bleeding rates increased from 0.89 to 4.91 events/100 PY. OAC was associated with reduced stroke and intracranial bleeding risk regardless of CKD stage, and with a reduced mortality risk in stages 1–3 CKD. Conclusion: Among NVAF patients, advanced renal failure is associated with higher risk of stroke, death, and bleeding. OAC was associated with reduced stroke and intracranial bleeding risk, and with improved survival in stages 1–3 CKD.

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