Cardiovascular Disease in Patients with Kidney Disease

2012 ◽  
Author(s):  
Ernest I Mandel ◽  
David M. Charytan

Cardiovascular disease (CVD) is prevalent in patients with chronic kidney disease (CKD) and is the leading cause of morbidity and mortality in dialysis patients. Clinical practice guidelines established by the National Kidney Foundation identify five stages of CKD defined by estimated glomerular filtration rate (eGFR) as determined by the abbreviated Modification of Diet in Renal Disease (MDRD) study equation. The National Health and Nutrition Epidemiology Survey (NHANES III) estimated that 13% of adults in the United States have CKD. An estimated 5 to 10% of the world's population—a staggering 300 to 600 million people—have CKD. This chapter covers the epidemiology, clinical spectrum, pathogenesis, and management of CVD in patients who have CKD. The clinical spectrum of CVD in patients with CKD is divided into four major categories: arterial disease, myocardial disease, disorders of cardiac rhythm, and valvular disease. Sections discuss some or all of the following: epidemiology/pathophysiology, diagnosis, management, risk factors, intervention, prevention. The chapter includes 4 tables and 6 figures. Figures present age-standardized rates of death, Kaplan–Meier estimates of rates of death, mortality by stage of CKD, hazard ratios and 95% confidence intervals for all-cause and cardiovascular mortality, cardio-renal syndrome pathophysiology, and ratios for actual to expected number of occurrences of sudden death. Tables list the five stages of CKD, types of CVD associated with CKD, risk factors for CVD in patients with CKD/end-stage renal disease (ESRD), and factors contributing to platelet dysfunction and enhanced bleeding risk in CKD/ESRD. This chapter contains 191 references.

2018 ◽  
Author(s):  
Joshua S. Hundert ◽  
Ajay K Singh

Management of early renal failure helps in the reduction or prevention of end-stage renal disease. The monitoring of renal function is discussed, and the chapter includes a table that shows commonly used methods for monitoring. Risk factors for chronic renal failure include stroke and cardiac disease. Risk factors for renal disease progression are diabetes mellitus, hypertension, proteinuria, smoking, protein intake, and hyperlipidemia. Complications of chronic renal failure that are addressed include sodium and water imbalance, potassium imbalance, acidosis, calcium and phosphorus imbalance, and anemia. There is also a section that discusses the case for early referral to a nephrologist. Tables present the equations used to estimate the glomerular filtration rate (GFR); stages of chronic kidney disease and the appropriate steps in their management; risk factors for chronic kidney disease in which the testing of proteinuria and estimation of GFR are indicated; appropriate diet for patients who have chronic kidney disease; and guidelines for diagnosing and treating anemia resulting from chronic kidney disease. An algorithm outlines the steps in management of calcium and phosphate in patients with kidney disease. This review contains 3 figures, 10 tables and 50 references Key Words End-stage renal disease, chronic kidney disease, glomerular filtration rate, Modification of Diet in Renal Disease, Proteinuric renal disease, Hyperuricemia


2019 ◽  
Vol 13 (4) ◽  
pp. 625-630
Author(s):  
Erena N Weathers ◽  
Jennifer L Waller ◽  
N Stanley Nahman ◽  
Rhonda E Colombo ◽  
Mufaddal F Kheda ◽  
...  

Abstract Background Syphilis is a sexually transmitted infection with an incidence of 14.9 cases per 100 000 persons in the USA in 2011. Untreated syphilis may remain quiescent for years but can also result in clinical sequelae, including neurosyphilis. End-stage renal disease (ESRD) patients may be at risk for syphilis due to a higher incidence of risk factors for the disease, including human immunodeficiency virus (HIV). Despite the presence of these risk factors, the incidence of syphilis in the ESRD population has not been reported. To address this issue, we investigated the incidence and risk factors for syphilis in the ESRD population using the United States Renal Data System (USRDS). Methods This study analyzed incident ESRD patients from 2004 to 2010. Based on International Classification of Diseases, Ninth Revision codes for syphilis, we determined the incidence and risk factors for syphilis following an inpatient diagnosis. Generalized linear modeling was used to examine the relative risk (RR) for the disease when controlling for demographic and other clinical risk factors. Results A total of 383 diagnoses of syphilis were identified after screening 759 066 patients. The 8-year incidence of any type of syphilis was 50.45 cases per 100 000 person-years. Other unspecified syphilis (29.77 cases per 100 000 person-years) and neurosyphilis (10.93 cases per 100 000 person-years) were the most common diagnoses. The greatest incidence was found on the East and West Coasts. Patients with the disease were younger and more likely to be black and non-Hispanic. In the final model, the adjusted RR for syphilis was significantly increased with HIV (7.61), hepatitis C (3.57), herpes simplex (2.06) and hepatitis B (1.75). Conclusions The incidence of syphilis is >3-fold greater in ESRD patients when compared with the general population and is associated with sexually transmitted viral infections. Neurosyphilis is a common occurrence and is treatable, suggesting that all assessments of confusion in dialysis patients should include screening for the disease.


2015 ◽  
Vol 110 ◽  
pp. S919-S920
Author(s):  
Parkpoom Phatharacharukul ◽  
Charat Thongprayoon ◽  
Wisit Cheungpasitporn ◽  
Peter J. Edmonds ◽  
Quanhathai Kaewpoowat ◽  
...  

2018 ◽  
Author(s):  
Joshua S. Hundert ◽  
Ajay K Singh

Management of early renal failure helps in the reduction or prevention of end-stage renal disease. The monitoring of renal function is discussed, and the chapter includes a table that shows commonly used methods for monitoring. Risk factors for chronic renal failure include stroke and cardiac disease. Risk factors for renal disease progression are diabetes mellitus, hypertension, proteinuria, smoking, protein intake, and hyperlipidemia. Complications of chronic renal failure that are addressed include sodium and water imbalance, potassium imbalance, acidosis, calcium and phosphorus imbalance, and anemia. There is also a section that discusses the case for early referral to a nephrologist. Tables present the equations used to estimate the glomerular filtration rate (GFR); stages of chronic kidney disease and the appropriate steps in their management; risk factors for chronic kidney disease in which the testing of proteinuria and estimation of GFR are indicated; appropriate diet for patients who have chronic kidney disease; and guidelines for diagnosing and treating anemia resulting from chronic kidney disease. An algorithm outlines the steps in management of calcium and phosphate in patients with kidney disease. This review contains 3 figures, 10 tables and 50 references Key Words End-stage renal disease, chronic kidney disease, glomerular filtration rate, Modification of Diet in Renal Disease, Proteinuric renal disease, Hyperuricemia


2018 ◽  
Author(s):  
Joshua S. Hundert ◽  
Ajay K Singh

Management of early renal failure helps in the reduction or prevention of end-stage renal disease. The monitoring of renal function is discussed, and the chapter includes a table that shows commonly used methods for monitoring. Risk factors for chronic renal failure include stroke and cardiac disease. Risk factors for renal disease progression are diabetes mellitus, hypertension, proteinuria, smoking, protein intake, and hyperlipidemia. Complications of chronic renal failure that are addressed include sodium and water imbalance, potassium imbalance, acidosis, calcium and phosphorus imbalance, and anemia. There is also a section that discusses the case for early referral to a nephrologist. Tables present the equations used to estimate the glomerular filtration rate (GFR); stages of chronic kidney disease and the appropriate steps in their management; risk factors for chronic kidney disease in which the testing of proteinuria and estimation of GFR are indicated; appropriate diet for patients who have chronic kidney disease; and guidelines for diagnosing and treating anemia resulting from chronic kidney disease. An algorithm outlines the steps in management of calcium and phosphate in patients with kidney disease. This review contains 3 figures, 10 tables and 50 references Key Words End-stage renal disease, chronic kidney disease, glomerular filtration rate, Modification of Diet in Renal Disease, Proteinuric renal disease, Hyperuricemia


2018 ◽  
Author(s):  
Joshua S. Hundert ◽  
Ajay K Singh

Management of early renal failure helps in the reduction or prevention of end-stage renal disease. The monitoring of renal function is discussed, and the chapter includes a table that shows commonly used methods for monitoring. Risk factors for chronic renal failure include stroke and cardiac disease. Risk factors for renal disease progression are diabetes mellitus, hypertension, proteinuria, smoking, protein intake, and hyperlipidemia. Complications of chronic renal failure that are addressed include sodium and water imbalance, potassium imbalance, acidosis, calcium and phosphorus imbalance, and anemia. There is also a section that discusses the case for early referral to a nephrologist. Tables present the equations used to estimate the glomerular filtration rate (GFR); stages of chronic kidney disease and the appropriate steps in their management; risk factors for chronic kidney disease in which the testing of proteinuria and estimation of GFR are indicated; appropriate diet for patients who have chronic kidney disease; and guidelines for diagnosing and treating anemia resulting from chronic kidney disease. An algorithm outlines the steps in management of calcium and phosphate in patients with kidney disease. This review contains 3 figures, 10 tables and 50 references Key Words End-stage renal disease, chronic kidney disease, glomerular filtration rate, Modification of Diet in Renal Disease, Proteinuric renal disease, Hyperuricemia


2007 ◽  
Vol 107 (4) ◽  
pp. c177-c181 ◽  
Author(s):  
Maarten W. Taal ◽  
Mhairi K. Sigrist ◽  
Apostolos Fakis ◽  
Richard J. Fluck ◽  
Christopher W. McIntyre

2009 ◽  
Vol 57 (4) ◽  
pp. 583-589 ◽  
Author(s):  
Marino A. Bruce ◽  
Bettina M. Beech ◽  
Mario Sims ◽  
Tony N. Brown ◽  
Sharon B. Wyatt ◽  
...  

Kidney disease is one of the most striking examples of health disparities in American public health. Disparities in the prevalence and progression of kidney disease are generally thought to be a function of group differences in the prevalence of kidney disease risk factors such as diabetes, hypertension, and obesity. However, the presence of these comorbidities does not completely explain the elevated rate of progression from chronic kidney disease (CKD) to end-stage renal disease among high-risk populations such as African Americans. We believe that the social environment is an important element in the pathway from CKD risk factors to CKD and end-stage renal disease. This review of the literature draws heavily from social science and social epidemiology to present a conceptual frame specifying how social, economic, and psychosocial factors interact to affect the risks for and the progression of kidney disease.


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