scholarly journals Lipid Nutrition for the prevention of Diabetes, Cardio-and Cerebrovascular Disease, and Chronic Kidney Disease－Hidden Causes

2017 ◽  
Vol 26 (1) ◽  
pp. 75-88
Author(s):  
Harumi Okuyama ◽  
Naoki Ohara
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Cerebrovascular Disease ◽  
Lipid Nutrition ◽  
Prevention Of Diabetes

Delirium in Internal Medicine Patients Evaluated Using the Thai Confusion Assessment Method for ICU

2020 ◽  
Vol 103 (7) ◽  
Keyword(s):  
Internal Medicine ◽  
Chronic Kidney Disease ◽  
Substance Abuse ◽  
Kidney Disease ◽  
Alcohol Abuse ◽  
Cerebrovascular Disease ◽  
Confusion Assessment Method ◽  
Assessment Method ◽  
Confusion Assessment ◽  
Hypoactive Delirium

Background: Delirium is the condition of an acute confusional state that disturbs both alertness and cognition. The problem is likely to happen with general internal medicine patients admitted in general wards. Objective: To identify delirium cases in the internal medicine In-Patient Department (IPD) by using the Thai Confusion Assessment Method for intensive care unit (CAM-ICU). Materials and Methods: The cross-sectional study was conducted between February and December 2018. The Thai version of the CAM-ICU was used as the evaluation form to detect delirium. The patients admitted to the IPD of internal medicine were freely randomized to be volunteers. Demographic data, systemic illnesses, neurology diseases, and current medications were recorded. Results: Three hundred fifty-six patients, 175 males (49.2%) and 181 females (50.8%), were included in the present study. The mean age was 61.52 years old. The development of acute confusion was significant in patients 50 years old and older (p<0.001). Multivariate analysis indicated the significant effect of substance abuse (p<0.05), chronic kidney disease (p<0.05), cerebrovascular disease (p<0.05), benzodiazepine usage (p<0.05), alcohol abuse (p<0.05), and age 50 years or older (p<0.001). Sixty-nine cases met the Thai CAM-ICU criteria for delirium of CAM-ICU, but the interns did not notice this problem (p<0.001). Conclusion: Chronic kidney disease, cerebrovascular disease, substance abuse, benzodiazepine use, alcohol abuse, and age 50 years or older are the factors associated with delirium in the present study. Hypoactive delirium is underdiagnosed by doctors but revealed by using CAM-ICU. Keywords: Delirium, CAM-ICU, Hypoactive delirium, RASS

“Does chronic kidney disease define a particular risk pattern of cerebral vessels modifications in patients with symptomatic ischemic cerebrovascular disease?”

Open Medicine ◽  
2010 ◽  
Vol 5 (3) ◽  
pp. 329-337 ◽  
Author(s):  
Ligia Petrica ◽  
Maxim Petrica ◽  
Gluhovschi Gheorghe ◽  
Matcau Liviu ◽  
Gadalean Florica ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Cerebrovascular Disease ◽  
Cerebral Arteries ◽  
Resistance Index ◽  
Transcranial Doppler Ultrasound ◽  
Cardiovascular Complications ◽  
Cerebral Vessels ◽  
Ischaemic Cerebrovascular Disease ◽  
Risk Pattern

AbstractCardiovascular complications, including stroke, may be attributed the highest rate of morbidity and mortality in patients with chronic kidney disease (CKD). The aim of our study was to evaluate the prevalence of CKD in patients with symptomatic ischaemic cerebrovascular disease and to establish of whether CKD may define a particular risk pattern of cerebral vessels modifications in this category of patients. The prevalence of CKD was evaluated in 590 consecutive patients with symptomatic ischaemic cerebrovascular disease admitted to a department of neurology. The types of stroke, the vascular territories, the vascular modifications and the haemodynamic changes (resistance index- RI) found by neurosonology (extracranial and transcranial Doppler ultrasound) were analysed in relation to classic and non-classic cerebrovascular risk factors, as well as to stages of CKD (defined by estimated glomerular filtration rate-eGFR-MDRD4 formula-K/DOQI 2002). The prevalence of CKD in the studied patients was 70.84%. Atherosclerosis in a diffuse pattern was detected in 79.7% of CKD patients, while carotid artery stenoses were found in 10% of cases, occlusions- 5.3%, stenoses + occlusions-1.2%, and multiple stenoses- 3.8% of cases. The RI evaluated in the internal carotid arteries correlated with fibrinogen(P<0.0001) and GFR(P<0.0001), while IR in the middle cerebral arteries correlated with fibrinogen(P<0.05), C-reactive protein(P<0.0001), and GFR(P<0.0001). There is a strong relation between symptomatic cerebrovascular disease and CKD, a fact demonstrated by the increased prevalence of CKD in these patients and by the severity of the cerebral vessels lesions.

scholarly journals Exome wide association study on Albuminuria identifies a novel rare variant inCUBNand additional genes, in 33985 Europeans with and without diabetes

2018 ◽  
Author(s):  
Tarunveer S. Ahluwalia ◽  
Christina-Alexendra Schulz ◽  
Johannes Waage ◽  
Tea Skaaby ◽  
Niina Sandholm ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Association Study ◽  
Genetic Architecture ◽  
European Ancestry ◽  
Common Variants ◽  
Multiple Testing Correction ◽  
Meta Analyses ◽  
Coding Variants ◽  
Prevention Of Diabetes

AbstractIdentifying rare coding variants associated with albuminuria may open new avenues for preventing chronic kidney disease (CKD) and end-stage renal disease which are highly prevalent in patients with diabetes. Efforts to identify genetic susceptibility variants for albuminuria have so far been limited with the majority of studies focusing on common variants.We performed an exome-wide association study to identify coding variants in a two phase (discovery and replication) approach, totaling to 33,985 individuals of European ancestry (15,872 with and 18,113 without diabetes) and further testing in Greenlanders (n = 2,605). We identify a rare (MAF: 0.8%) missense (A1690V) variant inCUBN(rs141640975, β=0.27, p=1.3 × 10−11) associated with albuminuria as a continuous measure in the combined European meta-analyses. Presence of each rare allele of the variant was associated with a 6.4% increase in albuminuria. The rareCUBNvariant had 3 times stronger effect in individuals with diabetes compared to those without(pinteraction:5.4 × 10−4, βDM: 0.69, βnonDM:0.20) in the discovery meta-analyses. Geneaggregate tests based on rare and common variants identify three additional genes associated with albuminuria(HES1, CDC73, andGRM5)after multiple testing correction (P_bonferroni<2.7 × 10−6).The current study identifies a rare coding variant in theCUBNlocus and other potential genes associated with albuminuria in individuals with and without diabetes. These genes have been implicated in renal and cardiovascular dysfunction. These findings provide new insights into the genetic architecture of albuminuria and highlight novel target genes and pathways for prevention of diabetes-related kidney disease.Significance statementIncreased albuminuria is a key manifestation of major health burdens, including chronic kidney disease and/or cardiovascular disease. Although being partially heritable, there is a lack of knowledge on rare genetic variants that contribute to albuminuria. The current study describes the discovery and validation, of a new rare gene mutation (~1%) in theCUBNgene which associates with increased albuminuria. Its effect multiplies 3 folds among diabetes cases compared to non diabetic individuals. The study further uncovers 3 additional genes modulating albuminuria levels in humans. Thus the current study findings provide new insights into the genetic architecture of albuminuria and highlight novel genes/pathways for prevention of diabetes related kidney disease.

scholarly journals Impact of cardiovascular diseases on severity of COVID-19 patients: A systematic review

2021 ◽  
Vol 50 (1) ◽  
pp. 52-60
Author(s):  
Pinki Mishra ◽  
Rizwana Parveen ◽  
Ram Bajpai ◽  
Mohammed Samim ◽  
Nidhi Bharal Agarwal
Keyword(s):  
Cardiovascular Disease ◽  
Chronic Kidney Disease ◽  
Cardiovascular Diseases ◽  
Kidney Disease ◽  
Cerebrovascular Disease ◽  
Meta Analysis ◽  
Random Effect ◽  
Chronic Obstructive ◽  
Cochrane Central Register ◽  
Prevalence Studies

ABSTRACT Introduction: Coronavirus disease 2019 (COVID-19) cases are increasing rapidly worldwide. Similar to Middle East respiratory syndrome where cardiovascular diseases were present in nearly 30% of cases, the increased presence of cardiovascular comorbidities remains true for COVID-19 as well. The mechanism of this association remains unclear at this time. Therefore, we reviewed the available literature and tried to find the probable association between cardiovascular disease with disease severity and mortality in COVID-19 patients. Methods: We searched Medline (via PubMed) and Cochrane Central Register of Controlled Trials for articles published until Sept 5, 2020. Nineteen articles were included involving 6,872 COVID-19 patients. Results: The random-effect meta-analysis showed that cardiovascular disease was significantly associated with severity and mortality for COVID-19: odds ratio (OR) 2.89, 95% confidence interval (CI) 1.98–4.21 for severity and OR 3.00, 95% CI 1.67–5.39 for mortality, respectively. Risk of COVID-19 severity was higher in patients having diabetes, hypertension, chronic obstructive pulmonary disease, malignancy, cerebrovascular disease and chronic kidney disease. Similarly, patients with diabetes, hypertension, chronic liver disease, cerebrovascular disease and chronic kidney disease were at higher risk of mortality. Conclusion: Our findings showed that cardiovascular disease has a negative effect on health status of COVID-19 patients. However, large prevalence studies demonstrating the consequences of comorbid cardiovascular disease are urgently needed to understand the extent of these concerning comorbidities. Keywords: Cardiovascular disease, COVID-19, SARS-CoV-2

scholarly journals Chronic Kidney Disease and Cerebrovascular Disease: Consensus and Guidance From a KDIGO Controversies Conference

Stroke ◽  
2021 ◽  
Author(s):  
Dearbhla M. Kelly ◽  
Zanfina Ademi ◽  
Wolfram Doehner ◽  
Gregory Y.H. Lip ◽  
Patrick Mark ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Cerebrovascular Disease ◽  
Vascular Cognitive Impairment ◽  
Arterial Disease ◽  
Cerebral Hypoperfusion ◽  
Stroke Severity ◽  
Underlying Mechanisms ◽  
Peripheral Arterial

The global health burden of chronic kidney disease is rapidly rising, and chronic kidney disease is an important risk factor for cerebrovascular disease. Proposed underlying mechanisms for this relationship include shared traditional risk factors such as hypertension and diabetes, uremia-related nontraditional risk factors, such as oxidative stress and abnormal calcium-phosphorus metabolism, and dialysis-specific factors such as cerebral hypoperfusion and changes in cardiac structure. Chronic kidney disease frequently complicates routine stroke risk prediction, diagnosis, management, and prevention. It is also associated with worse stroke severity, outcomes and a high burden of silent cerebrovascular disease, and vascular cognitive impairment. Here, we present a summary of the epidemiology, pathophysiology, diagnosis, and treatment of cerebrovascular disease in chronic kidney disease from the Kidney Disease: Improving Global Outcomes Controversies Conference on central and peripheral arterial disease with a focus on knowledge gaps, areas of controversy, and priorities for research.

Sign in / Sign up

Export Citation Format

Share Document