The Kidney and COVID-19: Pandemic Effects on the Patients

COVID-19 pathogens were identified as new coronaviruses by the sequencing of sample lower respiratory tracts from patients affected, which share a sequence of 79.6 percent identified as severe acute respiratory syndrome coronavirus. The virus has spread rapidly worldwide and was reported as a pandemic on 11 March 2020 since its detection in Wuhan, China in December 2019. The principal characteristics of COVID-19 were diffuse alveolar damage and acute respiratory failure, involving other organs. Although co-morbidities such as diabetes and cardiovascular disease have reported as risk factors of COVID-19, there is still no proof of an increased vulnerability to chronic renal disease in patients with chronic kidney disease (CKDs), although there are several studies continuing worldwide. CKD is differentiated by kidney structure abnormalities or functions which last > 3 months and have an impact on patient health. The deaths were not specifically caused by COVID-19, but were considered systemic causes. In HD patients with COVID-19 there were decreased lymphopenia, reduced serum levels of inflammatory receptors and more severe clinical disease than patients with HD CKD. Therefore, additional precautions should be taken in CKD patients to minimize risk of the infection. Doctors can also be carefully watched to identify signs of worsening of the disease in CKD patients with confirmed COVID-19.

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Stroke in chronic renal failure

Orvosi Hetilap ◽

10.1556/oh.2008.28292 ◽

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.

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Faculty Opinions recommendation of Cardiovascular disease, chronic kidney disease, and diabetes mortality burden of cardiometabolic risk factors from 1980 to 2010: a comparative risk assessment.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.718544355.793499139 ◽

2014 ◽

Author(s):

Carmine Zoccali ◽

Davide Bolignano

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Risk Assessment ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Cardiometabolic Risk ◽

Comparative Risk Assessment ◽

Diabetes Mortality ◽

Mortality Burden ◽

Comparative Risk

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Cardiovascular Protection With Sodium-Glucose Cotransporter-2 Inhibitors and Mineralocorticoid Receptor Antagonists in Chronic Kidney Disease

Hypertension ◽

10.1161/hypertensionaha.121.17005 ◽

2021 ◽

Vol 77 (5) ◽

pp. 1442-1455

Author(s):

Pantelis Sarafidis ◽

Christodoulos E. Papadopoulos ◽

Vasilios Kamperidis ◽

George Giannakoulas ◽

Michael Doumas

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Cardiovascular Events ◽

Mineralocorticoid Receptor ◽

Mineralocorticoid Receptor Antagonists ◽

Receptor Antagonists ◽

Cardiovascular Protection ◽

Sodium Glucose Cotransporter

Chronic kidney disease (CKD) and cardiovascular disease are intimately linked. They share major risk factors, including age, hypertension, and diabetes, and common pathogenetic mechanisms. Furthermore, reduced renal function and kidney injury documented with albuminuria are independent risk factors for cardiovascular events and mortality. In major renal outcome trials and subsequent meta-analyses in patients with CKD, ACE (angiotensin-converting enzyme) inhibitors and ARBs (angiotensin II receptor blockers) were shown to effectively retard CKD progression but not to significantly reduce cardiovascular events or mortality. Thus, a high residual risk for cardiovascular disease progression under standard-of-care treatment is still present for patients with CKD. In contrast to the above, several outcome trials with SGLT-2 (sodium-glucose cotransporter-2) inhibitors and MRAs (mineralocorticoid receptor antagonists) clearly suggest that these agents, apart from nephroprotection, offer important cardioprotection in this population. This article discusses existing evidence on the effects of SGLT-2 inhibitors and MRAs on cardiovascular outcomes in patients with CKD that open new roads in cardiovascular protection of this heavily burdened population.

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Prevalence and risk factors for cardiovascular disease among chronic kidney disease patients: results from the Chinese cohort study of chronic kidney disease (C-STRIDE)

BMC Nephrology ◽

10.1186/s12882-017-0441-9 ◽

2017 ◽

Vol 18 (1) ◽

Cited By ~ 20

Author(s):

Jun Yuan ◽

◽

Xin-Rong Zou ◽

Si-Ping Han ◽

Hong Cheng ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Chronic Kidney Disease ◽

Cohort Study ◽

Kidney Disease ◽

Chinese Cohort

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A Pilot Randomized Crossover Trial Assessing the Safety and Short-Term Effects of Walnut Consumption by Patients with Chronic Kidney Disease

Nutrients ◽

10.3390/nu12010063 ◽

2019 ◽

Vol 12 (1) ◽

pp. 63 ◽

Cited By ~ 1

Author(s):

Pilar Sanchis ◽

Marilisa Molina ◽

Francisco Berga ◽

Elena Muñoz ◽

Regina Fortuny ◽

...

Keyword(s):

Risk Factors ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Inositol Phosphates ◽

Control Diet ◽

Fibroblast Growth Factor 23 ◽

Serum Levels ◽

Short Term ◽

Daily Consumption ◽

Randomized Crossover Trial

The aim of this study of patients with chronic kidney disease (CKD) is to assess the safety of daily consumption of walnuts on the physiological levels of phosphorous, potassium, parathyroid hormone (PTH), and fibroblast growth factor 23 (FGF23), and to assess the short-term benefits of this intervention on risk factors associated with cardiovascular events. This led us to perform a prospective, randomized, crossover, pilot clinical trial examined 13 patients with CKD. Subjects were randomly assigned to a diet of 30 g of walnuts per day or the control diet. After 30 days, each group was given a 30-day washout period, and then switched to the alternate diet for 30 days. Urinary and serum levels of phosphorous and potassium, multiple vascular risk factors, and urinary inositol phosphates (InsPs) were measured at baseline and at the end of the intervention period. Our results showed that the walnut dietary supplement led to reduced blood pressure, LDL cholesterol, and albumin excretion, but had no effect on the physiological levels of phosphorous, potassium, PTH, and FGF23. This is the first report to show that daily consumption of walnuts by patients with CKD does not alter their physiological levels of phosphorous, potassium, PTH, and FGF23 when included in a sodium-, protein-, phosphate-, and potassium-controlled diet, and it could be an effective strategy for reducing cardiovascular risk in patients with CKD.

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