scholarly journals ASSESSMENT OF CARDIOVASCULAR RISK AND COMORBIDITY IN PATIENTS WITH CHRONIC KIDNEY DISEASE

2018 ◽  
pp. 61
Author(s):  
Slobodan Davinić ◽  
Ivana Davinić ◽  
Ivan Tasić
Keyword(s):  
Risk Factors ◽  
Glomerular Filtration Rate ◽  
Cardiovascular Risk ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Kidney Diseases ◽  
Chronic Kidney Diseases ◽  
Mean Values ◽  
High Prevalence ◽  
Traditional Risk Factors

High rates of morbidity and mortality in patients with chronic diseases of the kidney are for the most part caused by the high prevalence of cardiovascular diseases and high rates of fatal cardiovascular events. The aim of the study was to establish the prevalence and distribution of cardiovascular risk factors in patients with chronic kidney diseases, in various stages of chronic renal failure. The examinees were classified into three groups based on the level of glomerular filtration rate: over 60 ml/min/1.73m2; 30-59 ml/min/1.73m2; and 15-29 ml/ min/1.73m2. Traditional risk factors of age, hypertension, systolic blood pressure, glycemia, diabetes, serum level of total cholesterol and triglycerides, triglyceridemia, and hypertrophy  of the left ventricle showed a significantly positive rising trend of their mean values or prevalence, inversely dependent upon the level of declining glomerular filtration rates. Mean values of serum HDL cholesterol level demonstrated a significant declining trend, concomitant with decreasing glomerular filtration rate. The prevalence of hypercholesterolemy, smoking and obesity, as well as the mean value of body mass index, showed significant intergroup variations, but without any continuing trend related to glomerular filtration rate. Non-traditional risk factors of anemia, proteinuria, and hypoalbuminemia showed a significant rising trend of prevalence inversely dependent upon the degree of reduction of glomerular filtration rate. The levels of hematocrit and serum albumins showed a positive correlation with the reduction of glomerular filtration rate. In pre-dialysis patients with chronic kidney diseases, a high prevalence of the studied cardiovascular risk factors was found. Cardiovascular risk progressively rises with decreasing glomerular filtration rate, being significantly elevated as early as the initial stages of renal failure.

scholarly journals Rationale and population-based prospective cohort protocol for the disadvantaged populations at risk of decline in eGFR (CO-DEGREE)

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e031169 ◽  
Author(s):  
Marvin Gonzalez-Quiroz ◽  
Dorothea Nitsch ◽  
Sophie Hamilton ◽  
Cristina O'Callaghan Gordo ◽  
Rajiv Saran ◽  
...  
Keyword(s):  
Risk Factors ◽  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Population Based ◽  
Local Health ◽  
Populations At Risk ◽  
High Prevalence ◽  
Egfr Decline

IntroductionA recently recognised form of chronic kidney disease (CKD) of unknown origin (CKDu) is afflicting communities, mostly in rural areas in several regions of the world. Prevalence studies are being conducted in a number of countries, using a standardised protocol, to estimate the distribution of estimated glomerular filtration rate (eGFR), and thus identify communities with a high prevalence of reduced glomerular filtration rate (GFR). In this paper, we propose a standardised minimum protocol for cohort studies in high-risk communities aimed at investigating the incidence of, and risk factors for, early kidney dysfunction.Methods and analysisThis generic cohort protocol provides the information to establish a prospective population-based cohort study in low-income settings with a high prevalence of CKDu. This involves a baseline survey that included key elements from the DEGREE survey (eg, using the previously published DEGREE methodology) of a population-representative sample, and subsequent follow-up visits in young adults (without a pre-existing diagnosis of CKD (eGFR<60 mL/min/1.73m2), proteinuria or risk factors for CKD at baseline) over several years. Each visit involves a core questionnaire, and collection and storage of biological samples. Local capacity to measure serum creatinine will be required so that immediate feedback on kidney function can be provided to participants. After completion of follow-up, repeat measures of creatinine should be conducted in a central laboratory, using reference standards traceable to isotope dilution mass spectrometry (IDMS) quality control material to quantify the main outcome of eGFR decline over time, alongside a description of the early evolution of disease and risk factors for eGFR decline.Ethics and disseminationEthical approval will be obtained by local researchers, and participants will provide informed consent before the study commences. Participants will typically receive feedback and advice on their laboratory results, and referral to a local health system where appropriate.

scholarly journals Risk Factors for Cardiovascular and Renal Disease in Type 2 Diabetes Mellitus in Patients with Normal and Mildly Reduced Glomerular Filtration Rate

2021 ◽  
Vol 18 (2) ◽  
pp. 61-68
Author(s):  
Marcel Stoiţă ◽  
Amorin Remus Popa
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glomerular Filtration Rate ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Glomerular Filtration ◽  
Filtration Rate

Abstract In this study are investigated the cardiovascular risk factors that as shown in literature also represent risk factors for early glomerular function alteration in type 2 diabetes mellitus patients. The patients were divided according to their glomerular filtration rate in 2 groups, one group of patients with GFR ≥90 mL/min/1.73 m (118 patients) and the other with GFR between 60-89 mL/min/1.73 m2 (126 patients). Older age, hypertension, poor glycemic control, increased BMI, high LDL-cholesterol, high triglyceride level, insulin resistance and high level of apolipoprotein-B appeared to be more prevalent in patients with type 2 diabetes mellitus with mildly reduced kidney function. Even patients with mildly reduced GFR (without confirmed diabetic kidney disease) have an important aggregation of cardiovascular risk factors and their early identification is important for controlling them in order to further prevent glomerular decline.

scholarly journals Does Secretory Clearance Follow Glomerular Filtration Rate in Chronic Kidney Diseases? Reconsidering the Intact Nephron Hypothesis

2017 ◽  
Vol 10 (5) ◽  
pp. 395-403 ◽  
Author(s):  
A Chapron ◽  
DD Shen ◽  
BR Kestenbaum ◽  
C Robinson-Cohen ◽  
J Himmelfarb ◽  
...  
Keyword(s):  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Kidney Diseases ◽  
Chronic Kidney Diseases

scholarly journals The absence of standard modifiable cardiovascular risk factors does not predict better outcomes in patients with acute coronary syndrome

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M.I Gonzalez Del Hoyo ◽  
O.M Peiro Ibanez ◽  
K Vaquez-Nunez ◽  
F Dominguez Benito ◽  
M Ferrero ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Renal Failure ◽  
Glomerular Filtration Rate ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Cox Regression ◽  
Coronary Syndrome

Abstract Introduction The standard modifiable cardiovascular risk factors (SMuRFs), like diabetes mellitus, hyperlipidemia,hypertension and smoking, are central elements of the well-established European Society of Cardiology SCORE calculator. However, acute coronary syndromes (ACS) in SMuRF-less individuals are not uncommon. Purpose Our study aimed to describe the population with and without SMuRFs attended for an ACS and study prognostic factors associated with mortality. Methods We identified 1347 ACS patients without prior history of cardiovascular disease (ACS, cerebrovascular or peripheral artery disease)attended in our university hospital between 2009 and 2012 and examined the proportion of SMuRF-less patients as well as outcomes.The primary outcome was 5-year all-cause death. Results Overall, the median age was 63 years, 73.4% were male and 52 patients (7%)had no SMuRFs. The most common SMuRF was hypertension (60%), followed by smoking (47%), dyslipidemia (48%) and diabetes mellitus (27%). In patients with and without SMuRFs there were no differences in the proportion of females (27% vs 28%), age (63.7 years [IQR 54–75] vs 62 years [IQR 53–71]), renal failure (4.7% vs 0%, p=0.159), prior heart failure (1.6% vs 1.9%, p=0.590) and pulmonary obstructive disease (11.3% vs 9.6%, p=0.707). SMuRF-less patients had substantially less angina in the previously month (1.9% vs 19.1%, p&lt;0.001), were less treated previously with aspirin (3.9% vs 18.9%, p=0.006), betablockers (5.8% vs 16.6%, p=0.039)and ACEI/ARAII (0% vs 38.1%, p&lt;0.001). Patients with SMuRFs presented significantly more frequently with a NSTEMI (63.1% vs 48.1%) and less frequently with STEMI (32.3% vs 44.2%) or a non-classifiable ACS (2.7% vs 7.7%), compared to those without SMurFS. In patients with and without SMuRFs, there were no significant differences in Killip I class (95.4% vs 98%, p=0.370)and GRACE risk score (105 vs 103, p=0.694). Patients with SMuRFS compared to those without had a higher systolic blood pressure (141 mmHg vs 131 mmHg, p=0,03) and a lower glomerular filtration rate (81.8 ml/min/m2 vs 94 ml/min/m2, p=0.04). There were no differences in those with and without SMuRFs in performance of angiography (83% vs 90%, p=0.160), but SMurF-less patients had lower proportion of multivessel disease (18.6% vs 38.2%, p=0.011), higher tendency to percutaneous angioplasty (70.6% vs 57.8%, p=0.073) or performance of CABG (6.1% vs 1.1%, p=0.028).At 5-year follow up (IQR 3–7),SMuRF-less patients had a lower mortality (11.5% vs 23.4%, p=0.049).On multivariable Cox Regression age, chronic renal failure, glomerular filtration rate and GRACE score were independent predictors of death. Coronary angioplasty was a strong protective risk factor of death.However, being SMuRF-less was not protective against mortality. Conclusion The absence of SMuRFs was not an independent predictor of mortality. Our study highlights the importance of the often-overlooked subgroup of ACS patients with atherosclerosis not predicted by SMuRFs. Funding Acknowledgement Type of funding source: None

scholarly journals Features of methods of glomerular filtration rate estimation

2019 ◽  
Vol 3 (22) ◽  
pp. 43-47
Author(s):  
I. A. Volkova ◽  
M. I. Savina
Keyword(s):  
Chronic Kidney Disease ◽  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Kidney Diseases ◽  
Correct Choice ◽  
Chronic Kidney Diseases ◽  
Glomerular Filtration Rate Estimation ◽  
Blood Creatinine

A decrease in glomerular filtration rate (GFR) is an earlier sign of detection of chronic kidney diseases compared to an increase in urea and blood creatinine concentrations. It is impossible to measure the glomerular filtration rate directly. GFR is determined by calculating the concentration of blood creatinine or by measuring the clearance of endogenous creatinine. The work shows the influence of methods for the determination of creatinine on the results of the calculation of glomerular filtration rate and terms for the correct choice of method of measuring glomerular filtration rate in different clinical situations associated with chronic kidney disease.

scholarly journals Association between genetic determinants of clopidogel metabolism and clinical cardiovascular risk indicators in Buryat patients

2019 ◽  
Vol 23 (3) ◽  
pp. 39
Author(s):  
E. M. Zelenskaya ◽  
K. Y. Nikolaev ◽  
O. S. Donirova ◽  
V. D. Altayev ◽  
K. V. Protasov ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Coronary Syndrome ◽  
Glomerular Filtration Rate ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Glomerular Filtration ◽  
Conflict Of Interest ◽  
Filtration Rate ◽  
Coronary Syndrome ◽  
Polymorphic Variants

<p><strong>Background. </strong>In some patients, the metabolism of clopidogrel is altered because of the presence of polymorphic variants rs4244285 (* 2), rs4986893 (* 3) and rs12248560 (* 17) in the <em>CYP2C19 </em>gene. There is also evidence of decreased efficacy of clopidogrel in individuals with the T/T genotype in the variant rs2305948 of the <em>VEGFR-2 </em>gene. Nevertheless, this medication is used widely in Russia due to the availability of generic anticoagulants.</p><p><strong>Aim. </strong>To assess the prevalence of the following polymorphic variants of <em>CYP2C19</em>: rs4244285 (* 2), rs4986893 (* 3) and rs12248560 (* 17); assess the prevalence of the rs2305948 variant of <em>VEGFR-2</em>, and determine cardiovascular risk factors in patients of Buryat nationality.</p><p><strong>Methods. </strong>The study included 113 patients of Buryat nationality who underwent coronary stent placement due to acute coronary syndrome. Patients were stratified by the presence of the following alleles: <em>CYP2C19 </em>* 2, *3, *17 and <em>VEGFR-2 </em>rs2305948. The following laboratory parameters were measured for all patients: blood glucose, lipid spectrum, creatinine, and glomerular filtration rate. The severity of coronary atherosclerosis was evaluated.</p><p><strong>Results. </strong>The frequencies of the alleles and halotypes (<em>CYP2C19 </em>* 2, * 3 and *17) were determined. An association between the carriage of the C/C genotype in rs2305948 and a &lt;60 ml/min/1.73 m<!-- x-tinymce/html --><sup>2</sup> decrease in glomerular filtration rate (χ<!-- x-tinymce/html --><sup>2</sup> = 4.185, p = 0.032) were found. Additionally, the C/C genotype in rs2305948 was associated with higher blood pressure (χ<!-- x-tinymce/html --><sup>2</sup> = 12.593, p = 0.001). For men, we identified a positive correlation between the rs2305948 C/C allele and the number of significant coronary stenoses (R = 0.227, p &lt; 0.05).</p><p><strong>Conclusion. </strong>Among Buryat patients with acute coronary syndrome and percutaneous coronary intervention, the CYP2C19*2,*3 polymorphic variants were associated with a 46.0% decrease in the metabolic rate for clopidogrel. Furthermore, we identified several associations between the C/C genotype in the rs2305948 variant of VEGFR-2 with a number of cardiovascular risk factors.</p><p>Received 2 September 2019. Revised 24 October 2019. Accepted 30 October 2019.</p><p><strong>Funding: </strong>The study did not have sponsorship.</p><p><strong>Conflict of interest: </strong>Authors declare no conflict of interest.</p><p><strong>Author contributions</strong><strong></strong></p><p>Conception and study design: V.D. Altayev, K.V. Protasov, G.I. Lifshits</p><p>Data collection and analysis: Е.М. Zelenskaya, K.Y. Nikolaev, O.S. Donirova, V.D. Altayev, K.V. Protasov, E.N. Voronina, G.I. Lifshits</p><p>Drafting the article: Е.М. Zelenskaya</p><p>Critical revision of the article: Е.М. Zelenskaya</p><p>Final approval of the version to be published: Е.М. Zelenskaya, K.Y. Nikolaev, O.S. Donirova, V.D. Altayev, K.V. Protasov, E.N. Voronina, G.I. Lifshits</p>

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