Stentul JJ ureteral - care este optiunea mai buna? New Considerations Regarding Chronic Kidney Disease, Cardiovascular Disease and Dyslipidemia in Diabetic Patients

2018 ◽  
Vol 69 (8) ◽  
pp. 2064-2066
Author(s):  
Mircea Munteanu ◽  
Adrian Apostol ◽  
Viviana Ivan
Keyword(s):  
Cardiovascular Disease ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Total Cholesterol ◽  
Total Cholesterol Level ◽  
Vascular Complications ◽  
Hdl Cholesterol ◽  
Controlled Study ◽  
Diabetic Patients ◽  
Artery Disease

The aim of the present study is to investigate the prevalance of chronic kidney disease (CKD), of cardiovascular disease (CVD) and dyslipidemia in patients with diabetes mellitus (DM). We conducted a prospective, controlled study involving 420 diabetic patients (120 T1DM, 300 T2DM) and investigate the following aspects: the presence of vascular complications (stroke, coronary artery disease, peripheral artery disease), lipid profile (total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides), kidney function (glomerular filtration rate, albuminuria), blood pressure, HbA1C. The results that in diabetic patients with CKD there is an increased prevalence of CVD and of dislipidemia. Also we noticed a negative correlation between total cholesterol level and decease in eGFR in all patients, with or without CKD.

scholarly journals Association of Novel Advanced Glycation End-Product (AGE10) with Complications of Diabetes as Measured by Enzyme-Linked Immunosorbent Assay

2021 ◽  
Vol 10 (19) ◽  
pp. 4499
Author(s):  
Agnieszka Bronowicka-Szydełko ◽  
Małgorzata Krzystek-Korpacka ◽  
Małgorzata Gacka ◽  
Jadwiga Pietkiewicz ◽  
Urszula Jakobsche-Policht ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Estimated Glomerular Filtration Rate ◽  
Vascular Complications ◽  
Organ Damage ◽  
Enzyme Linked Immunosorbent Assay ◽  
Diabetic Patients ◽  
Advanced Glycation ◽  
Standard Curve ◽  
Glycation End Products

Advanced glycation end-products (AGEs) contribute to vascular complications and organ damage in diabetes. The unique AGE epitope (AGE10) has recently been identified in human serum using synthetic melibiose-derived AGE (MAGE). We aimed at developing ELISA for AGE10 quantification, determining whether AGE10 is present in diabetic patients (n = 82), and evaluating its association with diabetic complications. In a competitive ELISA developed, the reaction of synthetic MAGE with anti-MAGE was inhibited by physiological AGE10 present in serum. In this assay, new murine IgE anti-MAGE monoclonal antibodies, which do not recognize conventional AGEs, a synthetic MAGE used to coat the plate, and LMW-MAGE (low molecular mass MAGE) necessary to plot a standard curve were used. AGE10 was significantly higher in patients with microangiopathy, in whom it depended on treatment, being lower in patients treated with aspirin. AGE10 levels were positively correlated with estimated glomerular filtration rate (eGFR) and negatively with creatinine. As a marker of stage ≥3 chronic kidney disease or microangiopathy, AGE10 displayed moderate overall accuracy (respectively, 69% and 71%) and good sensitivity (82.6% and 83.3%) but poor specificity (58.1% and 57.8%). In conclusion, newly developed immunoassay allows for AGE10 quantification. AGE10 elevation is associated with microangiopathy while its decrease accompanies stage ≥3 chronic kidney disease.

scholarly journals Improving Total-Cholesterol/HDL-Cholesterol Ratio Results in an Endothelial Dysfunction Recovery in Peripheral Artery Disease Patients

Cholesterol ◽  
2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Silvia Bleda ◽  
Joaquín de Haro ◽  
César Varela ◽  
Leticia Esparza ◽  
Javier Rodriguez ◽  
...  
Keyword(s):  
Treatment Group ◽  
Total Cholesterol ◽  
Peripheral Artery Disease ◽  
Plasma Levels ◽  
Hdl Cholesterol ◽  
Controlled Study ◽  
Peripheral Artery ◽  
Cholesterol Ratio ◽  
Atorvastatin Group ◽  
Artery Disease

Aims. To evaluate the effects of variations of total-cholesterol/HDL-cholesterol ratio and the effects of the atorvastatin on endothelial function in peripheral artery disease (PAD). Material and Methods. A prospective, randomised controlled study was carried out in 150 PAD patients. Patients randomized to the control group () were treated with antiplatelet drugs, angiotensin-converting-enzyme inhibitors and cardiovascular-risk-factor control. Experimental group () also received treatment with atorvastatin for a month. It was determined baseline nitrite plasma levels and total-cholesterol/HDL-cholesterol ratio and after one month of treatment in both groups. It was also analysed the correlation between the gradient of nitrite levels and the differential of total-cholesterol/HDL ratio in treatment group. Results. After a month, a reduction in nitrite levels was detected in treatment group ( μM versus 5.7 ± 1.8 μM, ). It was shown a higher decrease in nitrite plasma levels in the atorvastatin group finding lower levels assessments (5.7 ± 1.8 μM versus 13.1 ± 9.1 μM, resp., ). A significant reduction in total-cholesterol/HDL-cholesterol ratio was observed in statin group after treatment (). A strong correlation was found between the gradient of nitrite levels and the differential of total-cholesterol/HDL-cholesterol ratio in atorvastatin group (; ). Conclusions. Improvement of nitrite levels are associated with decreased total cholesterol/HDL ratio values in PAD patients treated with atorvastatin.

scholarly journals Study of clinical profile of chronic kidney disease in non-diabetic patients

2021 ◽  
Author(s):  
Ravi Kumar U. ◽  
Shashank J. ◽  
Narayana Swamy
Keyword(s):  
Diabetes Mellitus ◽  
Cardiovascular Disease ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Diabetic Patients ◽  
Hypertensive Nephropathy ◽  
Major Health Problem ◽  
Clinical Signs And Symptoms

Background: Chronic kidney disease (CKD) encompasses a spectrum of different pathophysiological processes associated with abnormal kidney function and a progressive decline in glomerular filtration rate. Cardiovascular disease is one of the major cause of morbidity and mortality in patients at every stage of CKD. Diabetes mellitus and hypertension together being major cause for CKD. Hypertension is a common cause for CKD and an independent risk factor for cardiovascular disease. This study mainly focused on the causes of CKD other than diabetes mellitus. An early detection and appropriate intervention of these patients will possibly help prevent progression of renal disease.Methods:We assessed 55 non diabetic CKD patients who presented to the OPD/IPD in Victoria hospital, Bowring and Lady Curzon hospital and other hospitals affiliated to Bangalore medical college and research institute during period June 2018 to December 2019. A detailed history and clinical examination was performed and patients were subjected to necessary investigations.Results: The commonest etiology for CKD was found to be hypertensive nephropathy followed by glomerulonephritis. Common symptoms were generalized weakness, lower limb swelling. Commonest signs are pallor, pedal edema and hypertension.Conclusions:CKD is a major health problem. Diabetic nephropathy is the commonest cause for CKD followed by hypertensive nephropathy and glomerulonephritis. Anaemia, pedal oedema, oliguria and generalised weakness were the major presenting clinical signs and symptoms in CKD. This condition when detected in early stages and managed can slow down the progression of CKDs and delay the need of renal replacement therapy.  

scholarly journals Endocan level in patients with chronic kidney disease

2021 ◽  
Vol 11-12 (221-222) ◽  
pp. 35-42
Author(s):  
Togzhan Abdikalikova ◽  
◽  
Lyudmila Turgunova ◽  
Botagoz Baidildina ◽  
Zhanar Mursalova ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Chronic Kidney Disease ◽  
Glomerular Filtration Rate ◽  
Cardiovascular Risk ◽  
Kidney Disease ◽  
Total Cholesterol ◽  
Filtration Rate ◽  
Active Smoking

The relevance of the work is due to the high prevalence of chronic kidney disease (CKD) among the population and high mortality from cardiovascular disease (CVD) in this population. In this connection, it is necessary to search for new biomarkers in order to early identify individuals with cardiovascular risk in patients with CKD. The purpose of this study to assess the endocan level in patients with CKD depending on the glomerular filtration rate (GFR), to study the relationship between the endocan level and other cardiovascular risk factors in patients with CKD. Material and methods. 153 respondents with various stages of CKD were examined. The study included socio-demographic, anthropometric data, blood pressure measurements, cholesterol, high density lipoprotein (HDL), triglycerides (TG), glucose and endocan. Data analysis was performed using the statistical software package SPSS 22. Results and discussion. The respondents in the groups did not differ in such indicators as gender, age, marital status, frequency of active smoking, diabetes, body mass index (BMI). Significant differences were found in the level of education (p=0.04), income (p=0.008), systolic pressure (SBP) (p=0.0001) and diastolic blood pressure (DBP) (p=0.0001). Levels of total cholesterol (cholesterol), (p=0.0001), uric acid (p=0.0001), cystatin C (p=0.0001) and endocan (p=0.0001) also had significant differences depending on GFR. Conclusion. A comparative analysis of the frequency of “traditional” cardiovascular risk factors among patients with various stages of CKD showed the absence of differences in the frequency of active smoking, diabetes mellitus, obesity and the presence of significant differences in blood pressure and total cholesterol (p = 0.0001). Evaluation of the endocan level depending on the stage of CKD showed that with the progression of CKD, the endocan level increases significantly (p = 0.0001), which may indicate the progression of endothelial dysfunction with impaired renal function. Further studies are needed to determine the prognostic value of endocan in the development of cardiovascular events in patients with CKD. Keywords: chronic kidney disease, cardiovascular disease, glomerular filtration rate, biomarkers, endocan.

PREVALENCE OF DYSLIPIDEMIA IN CHRONIC KIDNEY DISEASE

2021 ◽  
pp. 68-69
Author(s):  
P. Lakshmi Bhavana ◽  
G. Lokendranath ◽  
G. Vijaya Kumar
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Conservative Management ◽  
Hdl Cholesterol ◽  
Maintenance Hemodialysis ◽  
Medical College ◽  
Cholesterol Levels ◽  
The Difference ◽  
Artery Disease ◽  
Altered Lipid

BACKGROUND: Chronic kidney disease (CKD) is a worldwide health problem with increasing incidence and prevalence. The annual mortality rate of patients undergoing dialysis is more than 20%. The leading causes of morbidity and mortality in CKD are cardiovascular diseases, primarily atherosclerotic coronary artery disease. Dyslipidemia is a common complication of CKD. It is a signicant risk factor for the development of cardiovascular disease. Alteration in lipid prole correlates with declining glomerular ltration rate (GFR) and degree of proteinuria. AIM: Ÿ To identify the altered lipid prole in patients with chronic kidney disease. Ÿ To note the alterations in different lipoprotein fractions in chronic kidney disease patients. Ÿ To note the difference in lipid prole in CKD patients on conservative management and maintenance hemodialysis. MATERIALS AND METHODS: A Hospital-based observational Prospective study was conducted in the Department of Medicine, Santhiram medical college, and general hospital for six months. Chronic kidney disease patients who are non-diabetic were taken for the study with informed and written consent taken from the patient. RESULTS: Plasma triglycerides(153.14±54.37mg/dl) were elevated, and plasma HDL (36±43.5mg/dl) was decreased in CKD patients. There is no signicant elevation of total cholesterol levels. On comparing lipid proles of CKD patients on conservative management and hemodialysis, there was a signicant increase in triglycerides in the hemodialysis group. CONCLUSION: Signicant elevation of triglycerides and VLDL was observed in patients of CKD on hemodialysis. Further, a reduced HDL cholesterol level was also observed in both conservative and hemodialysis groups of CKD patients. Dyslipidemia observed in Uremic patients may contribute to accelerated atherosclerosis and further progression of chronic renal failure.

Cardiovascular Protection in Chronic Kidney Disease

2019 ◽  
pp. 295-308
Author(s):  
Jonathan W. Waks ◽  
Rulan S. Parekh ◽  
Larisa G. Tereshchenko
Keyword(s):  
Cardiovascular Disease ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Morbidity And Mortality ◽  
High Risk Population ◽  
Cardiovascular Morbidity And Mortality ◽  
The Us ◽  
Artery Disease ◽  
Stage Renal Disease ◽  
End Stage

Chronic kidney disease (CKD) affects over 15% of the US population, and over 650,000 people have end-stage renal disease requiring dialysis. Persons with CKD have an increased prevalence of all forms of cardiovascular disease, including coronary artery disease, cerebrovascular disease, hypertension, dyslipidemia, diabetes, congestive heart failure, and sudden cardiac death. CKD itself is also an independent risk factor for developing all forms of cardiovascular disease. The diagnosis of cardiovascular disease in persons with CKD presents unique difficulties, and many standard therapies for reducing cardiovascular morbidity and mortality, such as statins, also tend to be less successful in patients with severe CKD. This chapter will provide an overview of the epidemiology of cardiovascular disease in patients with CKD and will discuss strategies to diagnose cardiovascular disease and to reduce cardiovascular risk, morbidity, and mortality in this high-risk population.

P1020ROLE OF CHRONIC KIDNEY DISEASE AND ASSOCIATED BIOCHEMICAL ALTERATION ON ARTERIAL STIFFNESS IN T2 DIABETIC PATIENTS WITHOUT CARDIOVASCULAR DISEASE

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Silverio Rotondi ◽  
Lida Tartaglione ◽  
Marzia Pasquali ◽  
Maria Luisa Muci ◽  
Sandro Mazzaferro ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Vitamin D ◽  
Kidney Disease ◽  
Vascular Complications ◽  
Vascular Damage ◽  
Diabetic Patients ◽  
Biochemical Alterations ◽  
Ckd Stage ◽  
25 Oh Vitamin D

Abstract Background and Aims DMT2 and its complications such as chronic kidney disease (CKD) lead to increase vascular stiffness, measurable with CAVI, and biochemical alterations in substances implicated in vascular damage like Klotho, FGF23, and Sclerostin. The aim of the study was to evaluate the role of CKD stage 1-2 and possible alterations of 25 (OH)Vitamin-D, FGF23, Klotho, and Sclerostin on early vascular damage in DMT2 patients Method Patients included: DMT2 from <10 years, age <60 years, no insulin therapy, eGFR≥60 ml/min/1.73m2, absence of vascular complications. We have evaluated CAVI, albumin-excretion-rate (ACR), 25(OH)Vitamin-D, Klotho, FGF23, and Sclerostin. 30 healthy subjects were the control for CAVI, Klotho, FGF23 and Sclerostin. Results We enrolled 40 women and 60 men, average age 56 years (IQR: 52-59), 5-year DMT2 (IQR: 2.7-7), HbA1c 6.3% (5.8-6.7), eGFR of 95 ml/min/1.73m2. FGF23 (42±10 vs controls 29.8±11 pmol/l, p<.05) and Sclerostin (36.2±7 vs 26.6±1 pmol/l, p<.05) were increased and Klotho reduced (673±300 vs 845±330 pg/ml, p<.05). CKD (ACR≥30mg/gr; eGFR between 60-90 ml/min /1.73m2) was present in 12.6%. The mean CAVI value was normal. Patients with borderline (≥8, 33%) and pathological (≥9, 13%) CAVI were older (p.001), with longer duration of DMT2 (p.022) and lower 25(OH)Vitamin-D (p.041). CAVI correlated positively with age (p.001), Hb1Ac (p.036), systolic blood pressure (SBP) (p.012) and diastolic blood pressure (DBP) (p.001) and correlated negatively with 25(OH)Vitamin-D (p.046). The multivariate analysis showed positive predictors of CAVI age (p.001), DBP (p.0001), ACR (p.008) and Klotho (p.017). Conclusion In our DMT2 population, borderline and pathological CAVI is associated with increased ACR, elevated DBP and reduced 25(OH)Vitamin-D. Furthermore the alterations of FGF23, Sclerostin and Klotho, secondary to CKD, are an early sign of possible vascular damage. ACR, 25(OH)Vitamin-D and DBP can be modifiable risk factors for early vascular damage in DMT2

Prevalence of atheromatous and non-atheromatous cardiovascular disease by age in chronic kidney disease

2018 ◽  
Vol 35 (5) ◽  
pp. 827-836 ◽  
Author(s):  
Cédric Villain ◽  
Marie Metzger ◽  
Christian Combe ◽  
Denis Fouque ◽  
Luc Frimat ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Estimated Glomerular Filtration Rate ◽  
Age Groups ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Disease Epidemiology ◽  
Artery Disease

Abstract Background Although chronic kidney disease (CKD) and age are major risk factors for cardiovascular disease (CVD), little is known about the relative proportions of atheromatous and non-atheromatous CVD by age in CKD patients. Methods We used baseline data from the French Chronic Kidney Disease-Renal Epidemiology and Information Network (CKD-REIN) cohort of 3033 patients (65% men) with CKD Stages 3–4 to study crude and adjusted associations between age, the estimated glomerular filtration rate (eGFR), atheromatous CVD (coronary artery disease, peripheral artery disease and stroke) and non-atheromatous CVD (heart failure, cardiac arrhythmia and valvular heart disease). Results Mean age was 66.8 and mean Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) eGFR was 32.9 mL/min/1.73 m2. In the <65, (65–74), (75–84) and ≥85 year age groups, the prevalence was, respectively, 18.7, 35.5, 42.9 and 37.8% for atheromatous CVD, and 14.9, 28.4, 38.1 and 56.4% for non-atheromatous CVD. After adjusting for albuminuria, sex and CVD risk factors, the odds ratio (OR) [95% confidence interval (CI)] for (65–74), (75–84) and ≥85 age groups (compared with the <65 group) was, respectively, 1.99 (1.61–2.46), 2.89 (2.30–3.62), 2.72 (1.77–4.18) for atheromatous CVD and 2.07 (1.66–2.58), 3.15 (2.50–3.97), 7.04 (4.67–10.61) for non-atheromatous CVD. Compared with patients with an eGFR ≥30 mL/min/1.73 m2, those with an eGFR <30 mL/min/1.73 m2 had a higher OR for atheromatous CVD [1.21 (1.01–1.44)] and non-atheromatous CVD [1.16 (0.97–1.38)]. Conclusions In this large cohort of CKD patients, both atheromatous and non-atheromatous CVD were highly prevalent and more frequent in older patients. In a given age group, the prevalence of atheromatous and non-atheromatous CVD was similar (except for a greater prevalence of non-atheromatous CVD after 85).

scholarly journals Subpopulations of High-Density Lipoprotein: Friends or Foes in Cardiovascular Disease Risk in Chronic Kidney Disease?

Biomedicines ◽  
2021 ◽  
Vol 9 (5) ◽  
pp. 554
Author(s):  
Susana Coimbra ◽  
Flávio Reis ◽  
Maria João Valente ◽  
Susana Rocha ◽  
Cristina Catarino ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
High Density Lipoprotein ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Density Lipoprotein ◽  
Hdl Cholesterol ◽  
Size Composition ◽  
High Density

Dyslipidemia is a major traditional risk factor for cardiovascular disease (CVD) in chronic kidney disease (CKD) patients, although the altered lipid profile does not explain the number and severity of CVD events. High-density lipoprotein (HDL) is a heterogeneous (size, composition, and functionality) population of particles with different atherogenic or atheroprotective properties. HDL-cholesterol concentrations per se may not entirely reflect a beneficial or a risk profile for CVD. Large HDL in CKD patients may have a unique proteome and lipid composition, impairing their cholesterol efflux capacity. This lack of HDL functionality may contribute to the paradoxical coexistence of increased large HDL and enhanced risk for CVD events. Moreover, CKD is associated with inflammation, oxidative stress, diabetes, and/or hypertension that are able to interfere with the anti-inflammatory, antioxidative, and antithrombotic properties of HDL subpopulations. How these changes interfere with HDL functions in CKD is still poorly understood. Further studies are warranted to fully clarify if different HDL subpopulations present different functionalities and/or atheroprotective effects. To achieve this goal, the standardization of techniques would be valuable.

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