scholarly journals The Role of a “Treat-to-Target” Approach in the Long-Term Renal Outcomes of Patients with Gout

2019 ◽  
Vol 8 (7) ◽  
pp. 1067
Author(s):  
Woo-Joong Kim ◽  
Jung Soo Song ◽  
Sang Tae Choi
Keyword(s):  
Renal Function ◽  
Kidney Disease ◽  
Chronic Kidney Disease Stage ◽  
Multivariable Analysis ◽  
Serum Urate ◽  
Disease Stage ◽  
Treat To Target ◽  
Renal Outcomes ◽  
Significant Difference

Background: Although gout is accompanied by the substantial burden of kidney disease, there are limited data to assess renal function as a therapeutic target. This study evaluated the importance of implementing a “treat-to-target” approach in relation to renal outcomes. Methods: Patients with gout who underwent continuous urate-lowering therapy (ULT) for at least 12 months were included. The effect of ULT on renal function was investigated by means of a sequential comparison of the estimated glomerular filtration rate (eGFR). Results: Improvement in renal function was only demonstrated in subjects in whom the serum urate target of <6 mg/dL was achieved (76.40 ± 18.81 mL/min/1.73 m2 vs. 80.30 ± 20.41 mL/min/1.73 m2, p < 0.001). A significant difference in the mean change in eGFR with respect to serum urate target achievement was shown in individuals with chronic kidney disease stage 3 (−0.35 ± 3.87 mL/min/1.73 m2 vs. 5.33 ± 11.64 mL/min/1.73 m2, p = 0.019). Multivariable analysis predicted that patients ≥65 years old had a decreased likelihood of improvement (OR 0.31, 95% CI 0.13–0.75, p = 0.009). Conclusions: The “treat-to-target” approach in the long-term management of gout is associated with better renal outcomes, with a greater impact on those with impaired renal function.

1013-P: Long-Term Metformin Use and Risk of Death and CV-Renal Outcomes in Type 2 Diabetes with Chronic Kidney Disease (Stage 1-4)

Diabetes ◽  
2021 ◽  
Vol 70 (Supplement 1) ◽  
pp. 1013-P
Author(s):  
AIMIN YANG ◽  
ERIC S.H. LAU ◽  
HONGJIANG WU ◽  
RONALD C. MA ◽  
ALICE P. KONG ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Chronic Kidney Disease Stage ◽  
Disease Stage ◽  
Renal Outcomes ◽  
Risk Of Death ◽  
Stage 1

scholarly journals MO192ASYMPTOMATIC HYPERURICEMIA AS A RISK FACTOR OF OUTCOME IN CARDIORENAL PATIENTS

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Suela Mumajesi ◽  
Alma Idrizi ◽  
Matilda Imeraj ◽  
Vilma Cadri ◽  
Nevi Pasko ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Risk Factor ◽  
Kidney Disease ◽  
Chronic Kidney Disease Stage ◽  
Binary Logistic Regression ◽  
Cardiorenal Syndrome ◽  
Disease Stage ◽  
Long Term Outcome ◽  
The Impact

Abstract Objective The purpose of the study was to evaluate the impact of asymptomatic hyperuricemia on long-term outcome including death, rehospitalization in cardiorenal patients. Introduction Hyperuricemia is associated with progression of kidney failure, cardiovascular diseases and cardiorenal syndrome, which represents a significant health burden. There is a growing interes on evaluation of serum acid levels(SUA) as a risk factor in cardiorenal syndrome, because of the evidences that xanthine oxidase inhibitors are satisfactorily useful on cardio and renal protection. Materials and Methods This was a descriptive cross–sectional study. A two-years follow up was conducted to determine the outcome in cardiorenal patients. Each patient went through clinical examination with a standard valuation including the determination of uric acid levels. 139 patients (pts) with chronic kidney disease stage 3 from whom 119 had cardiorenal syndrome were included in the study. Statistical analysis was performed by χ2 test, Fisher's exact test and binary logistic regression. Results Hyperuricemia was founded in 65.5% of pts determined by acid uric levels higher then 7.2 mg/dl and had a strong assosiation with cardiorenal syndrome,p=0.03.The average age was 56.7 ± 12.5 years. Males were 62.2%% pts, p=0.031. Bivariate analysis revealed a strong relationship between hyperurcemia and cardiovascular components: hypertension p=0.047, diabetes mellitus p=0.021, sex p=0.03, death p=0.051 and rehospitalization in 18 pts, p=0.02. Subsequently binary logistic regression showed that higher acid uric levels even there were not statistically correlated with mortality, were a significant predictor for all-cause death (Odds Ratio [OR] 4.2, 95% confidence interval [CI] 0.87–20.35, p = 0.073). Conclusions Asymptomatic hyperuricemia was common and had a powerfull significant association with cardiorenal syndrome.Higher SUA was unconventionally associated with long-term adverse outcomes in these patients, so our efforts should be focused in immediate identification and treatment of this old forbidden marker. Key words chromic kidney disease, cardiovascular disease, etc

scholarly journals The Effect of Long-term Sodium-glucose Cotransporter 2 Inhibitor Treatment on Renal Function in the Patients with Type 2 Diabetes

2020 ◽  
Vol 95 (4) ◽  
pp. 236-243
Author(s):  
Jong Ha Baek ◽  
Tae Jung Oh ◽  
Ju-Young Moon ◽  
Taehee Kim ◽  
Seung Hyu Ko ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Renal Function ◽  
Kidney Disease ◽  
Sglt2 Inhibitor ◽  
Sglt2 Inhibitors ◽  
Renal Outcomes ◽  
Sodium Glucose Cotransporter ◽  
Inhibitor Treatment

Chronic kidney disease is developed commonly in type 2 diabetes mellitus (T2DM) and is the most common cause of end-stage renal disease and related cardiovascular complications. Meanwhile, despite the current standard of care including optimized glucose control and the use of single-agent blockade of the renin-angiotensin-aldosterone system (RAAS), patients with T2DM remain at increased risk for death and complications from cardiorenal causes. The recent studies using sodium-glucose cotransporter 2 (SGLT2) inhibitors have shown not only glucose lowering effect, but also a reduction in blood pressure, weight loss, and a lowering cardiovascular risk. Regarding renal outcomes, the use of SGLT2 inhibitor slows the progression of kidney disease compared to placebo when added to standard care. However, concern has been raised that currently available SGLT2 inhibitors in Korea may be also associated with improved renal outcomes with long-term treatment. As a result, we aimed to evaluate the effect of long-term SGLT2 inhibitor treatment on renal function in the patients with T2DM using meta-analysis. (Korean J Med 2020;95:236-243)

scholarly journals Comparison of Dipper and Non-Dipper Hypertension Patterns According to Chronic Kidney Disease Stage

2019 ◽  
Vol 1 (2) ◽  
pp. 15-23
Author(s):  
Esra Turan Erkek ◽  
Seydahmet Akin ◽  
Yasemin Ozgur ◽  
Zeki Aydin ◽  
Zerrin Bicik
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Target Organ Damage ◽  
Chronic Kidney Disease Stage ◽  
Disease Stage ◽  
Related Factors ◽  
Hypertensive Patients ◽  
Female Patients ◽  
Significant Difference ◽  
Stage 1

Introduction Hypertension is a major cardiovascular risk factor. There is a strong relationship between blood pressure (BP) elevation and stroke, myocardial infarction, heart failure and mortality due to kidney disease. It is known that the loss of the dipping pattern in hypertension is associated with increased target organ damage. In our study, we aimed to investigate the prevalence of dipper hypertension (DHT) and nondipper hypertension (NDHT) and related factors in patients with stage 1 and 2 chronic kidney disease (CKD). Materials and Methods A total of 158 patients diagnosed with stage 1 or stage 2 CKD were included in the study. Demographic characteristics, anthropometric measurements, physical examination findings and laboratory results of the patients were recorded. Ambulatory BP monitoring was performed in all patients. Results Of the 158 patients (female n: 98), 78 (49%) were in the stage 1 CKD group and 80 (51%) were in the stage 2 CKD group. No significant difference was observed in the prevalence of DHT or NDHT between hypertensive patients in the stage 1 and 2 CKD groups. The rate of NDHT was 59.5% (94/158 patients). Female patients had more DHT in the general population and in the stage 1 group than male patients (p=0.05, p=0.01, respectively). Conclusion No significant difference was observed in the prevalence of DHT or NDHT between hypertensive patients in the stage 1 and 2 CKD groups. The prevalence of DHT in female patients was significantly higher in both groups than in men in both groups, but especially in the stage 1 CKD group.

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