scholarly journals ISPD Cardiovascular and Metabolic Guidelines in Adult Peritoneal Dialysis Patients Part I – Assessment and Management of Various Cardiovascular Risk Factors

2015 ◽  
Vol 35 (4) ◽  
pp. 379-387 ◽  
Author(s):  
Angela Yee Moon Wang ◽  
K. Scott Brimble ◽  
Gillian Brunier ◽  
Stephen G. Holt ◽  
Vivekanand Jha ◽  
...  
Keyword(s):  
Risk Factors ◽  
Peritoneal Dialysis ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Lifestyle Modification ◽  
Arterial Disease ◽  
Residual Renal Function ◽  
Cardiovascular Death ◽  
Cardiovascular Complications ◽  
Metabolic Effects

Cardiovascular disease contributes significantly to the adverse clinical outcomes of peritoneal dialysis (PD) patients. Numerous cardiovascular risk factors play important roles in the development of various cardiovascular complications. Of these, loss of residual renal function is regarded as one of the key cardiovascular risk factors and is associated with an increased mortality and cardiovascular death. It is also recognized that PD solutions may incur significant adverse metabolic effects in PD patients. The International Society for Peritoneal Dialysis (ISPD) commissioned a global workgroup in 2012 to formulate a series of recommendations regarding lifestyle modification, assessment and management of various cardiovascular risk factors, as well as management of the various cardiovascular complications including coronary artery disease, heart failure, arrhythmia (specifically atrial fibrillation), cerebrovascular disease, peripheral arterial disease and sudden cardiac death, to be published in 2 guideline documents. This publication forms the first part of the guideline documents and includes recommendations on assessment and management of various cardiovascular risk factors. The documents are intended to serve as a global clinical practice guideline for clinicians who look after PD patients. The ISPD workgroup also identifies areas where evidence is lacking and further research is needed.

scholarly journals SP494CORRELATION OF RESIDUAL RENAL FUNCTION WITH CARDIOVASCULAR RISK FACTORS IN PERITONEAL DIALYSIS PATIENTS: A MULTICENTRE STUDY

2015 ◽  
Vol 30 (suppl_3) ◽  
pp. iii542-iii542
Author(s):  
Nikolina Basic-Jukic ◽  
Josipa Radic ◽  
Bozidar Vujicic ◽  
Zeljka Grdan ◽  
Marko Jakic ◽  
...  
Keyword(s):  
Risk Factors ◽  
Renal Function ◽  
Peritoneal Dialysis ◽  
Cardiovascular Risk ◽  
Multicentre Study ◽  
Cardiovascular Risk Factors ◽  
Residual Renal Function ◽  
Dialysis Patients

C-Reactive Protein and Anti-Chlamydia Pneumoniae Antibodies as Risk Factors of Cardiovascular Death in Incident Patients on Peritoneal Dialysis

2003 ◽  
Vol 23 (2) ◽  
pp. 132-137 ◽  
Author(s):  
Ramón Paniagua ◽  
Yolanda Frías ◽  
Maria De Jesús Ventura ◽  
Ernesto Rodríguez ◽  
María Elena Hurtado ◽  
...  
Keyword(s):  
Risk Factors ◽  
Peritoneal Dialysis ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Chlamydia Pneumoniae ◽  
Clinical Signs ◽  
Cardiovascular Death ◽  
Serum Glucose ◽  
C Reactive Protein ◽  
Reactive Protein

Objective Recently it has been pointed out that inflammation and infections caused by germs such as Chlamydia pneumoniae are independent cardiovascular risk factors for the general population, but information about these relationships in dialysis patients is scarce. This work was done to analyze the association of C-reactive protein (CRP) and IgG anti- Chlamydia pneumoniae antibodies (anti-Chlp-IgG) as independent cardiovascular risk factors in incident patients on continuous ambulatory peritoneal dialysis (CAPD). Design Single-cohort, prospective observational study. Setting Three CAPD centers from the Instituto Mexicano del Seguro Social, and one from the Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Mexico. Patients A cohort of 75 adult incident patients on CAPD, without clinical signs of congestive heart failure, coronary heart disease, or peripheral arterial insufficiency. No restrictions for age, gender, or cause of renal failure were applied. Primary Outcome Mortality. Methods Demographic variables, body composition by electrical bioimpedance, serum glucose, urea, creatinine, lipids, homocysteine, nutritional markers (albumin, prealbumin, and transferrin), CRP, and anti-Chlp-IgG were measured and registered at the time of the first admission. When a patient died, the cause of death was determined by review of the clinical chart. Results Mean follow-up time was 10.25 patient-months. There were 14 cardiovascular deaths. CRP was positive (> 10 mg/L) in 64% of the patients, and anti-Chlp-IgG in 64%; 29% of the patients were positive for both markers. The relative risk for cardiovascular mortality was 6.23 for patients positive for either CRP or anti-Chlp-IgG, and increased to 9.52 when both markers were positive. Multivariate analysis revealed that CRP and anti-Chlp-IgG were stronger cardiovascular death predictors than age, diabetes, and nutritional status. Conclusion These data suggest that inflammation and the presence of Chlamydia pneumoniae infections are important predictors of cardiovascular death in patients on CAPD.

Cardiovascular Risk Factors in Peritoneal Dialysis Patients Revisited

2007 ◽  
Vol 27 (2_suppl) ◽  
pp. 223-227
Author(s):  
Angela Yee-Moon Wang
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Peritoneal Dialysis ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Extracellular Volume ◽  
Volume Overload ◽  
Residual Renal Function ◽  
Dialysis Patients ◽  
Stage Renal Disease

End-stage renal disease patients are at a heightened risk of developing cardiovascular disease, with contributions from both “traditional” and “nontraditional” cardiovascular risk factors. Some of the nontraditional risk factors, such as extracellular volume overload, inflammation, and hyperphosphatemia, have also been shown to be important predictors of mortality in the dialysis population. This article provides an in-depth review of the evidence that supports the substantial contributions of nontraditional risk factors to adverse cardiovascular outcomes in chronic peritoneal dialysis patients. In addition, it provides evidence to demonstrate how loss of residual renal function may be central to the development of cardiovascular disease in the peritoneal dialysis population.

scholarly journals The importance of cardiovascular risk factors in approaching the hypertensive patient by the family doctor

2021 ◽  
Vol 16 (2) ◽  
pp. 241-247
Author(s):  
Cristina-Gabriela MILITARU ◽  
◽  
Gabriel Cristian BEJAN ◽  
Oana NICOLESCU ◽  
Ioana Veronica GRAJDEANU ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Salt Intake ◽  
Family Doctor ◽  
Arterial Disease ◽  
Cardiovascular Complications ◽  
Major Health Problem ◽  
Arterial Blood ◽  
The Impact

Cardiovascular diseases, such as acute myocardial infarction, stroke, peripheral arterial disease, chronic kidney disease, are a major health problem for the patient, in terms of declining quality of life, but also increasing spending on the health system. The aim of this study is to demonstrate the involvement of cardiovascular risk factors related to patients' lifestyle (salt intake, saturated fats, alcohol, smoking, sedentary lifestyle) or other modifiable risk factors (total cholesterol, triglycerides, obesity, hypertension arterial blood sugar, glycemia, metabolic syndrome), in the occurrence of cardiovascular disease and the impact of the association of risk factors in increasing the risk of cardiovascular complications.

Cardiovascular risk factors in hemodialysis and peritoneal dialysis patients

2005 ◽  
Vol 65 (8) ◽  
pp. 739-745 ◽  
Author(s):  
F. M. Yilmaz ◽  
G. Yilmaz ◽  
M. Duranay ◽  
H. Parpucu ◽  
M. Şeneş ◽  
...  
Keyword(s):  
Risk Factors ◽  
Peritoneal Dialysis ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Dialysis Patients

KIDNEY TRANSPLANT AFTER PERITONEAL DIALYSIS: DOES AN IMPROVEMENT IN CARDIOVASCULAR RISK FACTORS?

2010 ◽  
Vol 90 ◽  
pp. 685
Author(s):  
M. J. Pérez-Sáez ◽  
K. Toledo ◽  
L. González-Burdiel ◽  
M. L. Agüera ◽  
D. Del Castillo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Peritoneal Dialysis ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Kidney Transplant

scholarly journals Obesity in Humans Is Characterized by Gut Inflammation as Shown by Pro-Inflammatory Intestinal Macrophage Accumulation

2021 ◽  
Vol 12 ◽  
Author(s):  
Theresa V. Rohm ◽  
Regula Fuchs ◽  
Rahel L. Müller ◽  
Lena Keller ◽  
Zora Baumann ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Vegetable Intake ◽  
Cardiovascular Complications ◽  
Processed Meat ◽  
Low Grade ◽  
Blood Monocytes ◽  
Unhealthy Lifestyle ◽  
Gut Inflammation

Chronic low-grade inflammation is a hallmark of obesity and associated with cardiovascular complications. However, it remains unclear where this inflammation starts. As the gut is constantly exposed to food, gut microbiota, and metabolites, we hypothesized that mucosal immunity triggers an innate inflammatory response in obesity. We characterized five distinct macrophage subpopulations (P1-P5) along the gastrointestinal tract and blood monocyte subpopulations (classical, non-classical, intermediate), which replenish intestinal macrophages, in non-obese (BMI<27kg/m2) and obese individuals (BMI>32kg/m2). To elucidate factors that potentially trigger gut inflammation, we correlated these subpopulations with cardiovascular risk factors and lifestyle behaviors. In obese individuals, we found higher pro-inflammatory macrophages in the stomach, duodenum, and colon. Intermediate blood monocytes were also increased in obesity, suggesting enhanced recruitment to the gut. We identified unhealthy lifestyle habits as potential triggers of gut and systemic inflammation (i.e., low vegetable intake, high processed meat consumption, sedentary lifestyle). Cardiovascular risk factors other than body weight did not affect the innate immune response. Thus, obesity in humans is characterized by gut inflammation as shown by accumulation of pro-inflammatory intestinal macrophages, potentially via recruited blood monocytes. Understanding gut innate immunity in human obesity might open up new targets for immune-modulatory treatments in metabolic disease.

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