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Liu D, Guan X, Chen R, Song C, Qiu S, Xu S, Cao J, Liu H. The clinical evaluation of the triglyceride-glucose index as a risk factor for coronary artery disease and severity of coronary artery stenosis in patients with chronic kidney disease. Ren Fail 2024; 46:2320261. [PMID: 38411154 PMCID: PMC10901187 DOI: 10.1080/0886022x.2024.2320261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 02/13/2024] [Indexed: 02/28/2024] Open
Abstract
INTRODUCTION Insulin resistance (IR) plays an important role in the occurrence and development of cardiovascular disease (CVD) in patients with chronic kidney disease (CKD). The triglyceride-glucose (TyG) index is a simple and effective tool to evaluate IR. This study aimed to evaluate the association of the TyG index with coronary artery disease (CAD) and the severity of coronary artery stenosis (CAS) in nondialysis patients with stages 3-5 CKD. METHODS Nondialysis patients with stages 3-5 CKD who underwent the first coronary angiography at Zhongda Hospital affiliated with Southeast University from August 2015 to January 2017 were retrospectively analyzed. CAS was measured by coronary angiography, and the CAS score was calculated as the Gensini score. Logistic regression analysis was used to determine the related factors of CAD and severe CAS. RESULTS A total of 943 patients were enrolled in this cross-sectional study and 720 (76.4%) of these patients were diagnosed with CAD. The TyG index in the CAD group (7.29 ± 0.63) was significantly higher than that in the non-CAD group (7.11 ± 0.61) (p < 0.001). Multivariate logistic regression analysis showed that a higher TyG index was an independent risk factor for CAD in CKD patients after adjusting for related confounding factors (OR = 2.865, 95% CI 1.681-4.885, p < 0.001). Patients in the CAD group were divided into three groups according to the Gensini integral quantile level. Multivariate logistic regression analysis showed that the TyG index was an independent related factor for severe CAS after adjusting for relevant confounding factors (p < 0.001). CONCLUSIONS The TyG index is associated with CAD and the severity of CAS in patients with nondialysis stages 3-5 CKD. A higher TyG index is an independent factor for CAD and severe CAS.
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Affiliation(s)
- Dan Liu
- Institute of Nephrology, Zhong Da Hospital, Southeast University School of Medicine, Nanjing, P.R. China
- Research and Education Centre of General Practice, Zhong Da Hospital, Southeast University, Nanjing, P.R. China
| | - Xiaoyang Guan
- Institute of Nephrology, Zhong Da Hospital, Southeast University School of Medicine, Nanjing, P.R. China
| | - Ruoxin Chen
- Institute of Nephrology, Zhong Da Hospital, Southeast University School of Medicine, Nanjing, P.R. China
| | - Ci Song
- Research and Education Centre of General Practice, Zhong Da Hospital, Southeast University, Nanjing, P.R. China
| | - Shanhu Qiu
- Research and Education Centre of General Practice, Zhong Da Hospital, Southeast University, Nanjing, P.R. China
| | - Shengchun Xu
- Institute of Nephrology, Zhong Da Hospital, Southeast University School of Medicine, Nanjing, P.R. China
| | - Jingyuan Cao
- Department of Nephrology, The Affiliated Taizhou People’s Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine, Nanjing Medical University, Taizhou, P.R. China
| | - Hong Liu
- Institute of Nephrology, Zhong Da Hospital, Southeast University School of Medicine, Nanjing, P.R. China
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Chang LC, Yeh EL, Chuang YC, Wu CH, Kuo CW, Lii CK, Yang YC, Chen HW, Li CC. Luteolin Inhibits Indoxyl Sulfate-Induced ICAM-1 and MCP-1 Expression by Inducing HO-1 Expression in EA.hy926 Human Endothelial Cells. ENVIRONMENTAL TOXICOLOGY 2024. [PMID: 39105397 DOI: 10.1002/tox.24380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 05/31/2024] [Accepted: 07/03/2024] [Indexed: 08/07/2024]
Abstract
In patients with chronic kidney disease, the uremic toxin indoxyl sulfate (IS) accelerates kidney damage and the progression of cardiovascular disease. IS may contribute to vascular diseases by inducing inflammation in endothelial cells. Luteolin has documented antioxidant and anti-inflammatory properties. This study aimed to investigate the effect of luteolin on IS-mediated reactive oxygen species (ROS) production and intercellular adhesion molecule (ICAM-1) and monocyte chemoattractant protein (MCP-1) expression in EA.hy926 cells and the possible mechanisms involved. IS significantly induced ROS production (by 6.03-fold, p < 0.05), ICAM-1 (by 2.19-fold, p < 0.05) and MCP-1 protein expression (by 2.18-fold, p < 0.05), and HL-60 cell adhesion (by 31%, p < 0.05), whereas, luteolin significantly decreased IS-induced ROS production, ICAM-1 and MCP-1 protein expression, and HL-60 cell adhesion. Moreover, luteolin attenuated IS-induced nuclear accumulation of p65 and c-jun. Luteolin dose-dependently increased heme oxygenase-1 (HO-1) expression and the maximum fold induction of HO-1 by luteolin was 3.68-fold (p < 0.05), whereas, HO-1 knockdown abolished the suppression of ICAM-1 and MCP-1 expression by luteolin. Luteolin may protect against IS-induced vessel damage by inducing HO-1 expression in vascular endothelial cells, which suppresses nuclear factor kappa B (NF-κB) and activator protein 1 (AP-1) mediated ICAM-1 and MCP-1 expression.
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Affiliation(s)
- Li-Chien Chang
- Division of Nephrology, Department of Internal Medicine, Armed Forces Taichung General Hospital, Taichung, Taiwan
- National Defense Medical Center, Graduate Institute of Medical Sciences, Taipei, Taiwan
- Department of Nutrition, Chung Shan Medical University, Taichung, Taiwan
- Central Taiwan University of Science and Technology, Taichung, Taiwan
| | - En-Ling Yeh
- Department of Nutrition, College of Medical and Health Care, Hung-Kuang University, Taichung, Taiwan
| | - Ya-Chi Chuang
- Department of Nutrition, Chung Shan Medical University, Taichung, Taiwan
| | - Chia-Hsuan Wu
- Department of Nutrition, Chung Shan Medical University, Taichung, Taiwan
| | - Chia-Wen Kuo
- Division of Nephrology, Department of Internal Medicine, Armed Forces Taichung General Hospital, Taichung, Taiwan
- National Defense Medical Center, Graduate Institute of Medical Sciences, Taipei, Taiwan
- Central Taiwan University of Science and Technology, Taichung, Taiwan
| | - Chong-Kuei Lii
- Department of Nutrition, China Medical University, Taichung, Taiwan
| | - Ya-Chen Yang
- Department of Food Nutrition and Health Biotechnology, Asia University, Taichung, Taiwan
| | - Haw-Wen Chen
- Department of Nutrition, China Medical University, Taichung, Taiwan
| | - Chien-Chun Li
- Department of Nutrition, Chung Shan Medical University, Taichung, Taiwan
- Department of Nutrition, Chung Shan Medical University Hospital, Taichung, Taiwan
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Hirabayashi K, Fujii H, Kono K, Yamatani S, Shimizu M, Watanabe K, Sakamoto K, Goto S, Nishi S. Association of abnormalities in electrocardiography and ultrasonic echocardiography with the occurrence of cardiovascular disease in patients with advanced chronic kidney disease. Clin Exp Nephrol 2024; 28:307-315. [PMID: 38141089 PMCID: PMC10954921 DOI: 10.1007/s10157-023-02437-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 11/15/2023] [Indexed: 12/24/2023]
Abstract
BACKGROUND In patients with chronic kidney disease (CKD), the incidence of cardiovascular disease (CVD) increases with disease progression. CVD screening tests in those with CKD were researched to determine whether abnormalities observed in electrocardiography (ECG) and ultrasonic echocardiography (UCG) were risk factors associated with the development of CVD. METHODS This study included 604 patients with CKD G4 and G5, for whom both ECG and UCG were performed. They were divided into four groups: those without ECG- and UCG-indicated abnormalities (group A, n = 333), with only ECG abnormalities (group B, n = 106), with only UCG abnormalities (group C, n = 75), and with both ECG and UCG abnormalities (group D, n = 90). Multivariate analysis using Cox regression analysis of the occurrence of CVD was performed during a follow-up period. RESULTS During the observation period, 124 patients had clinical events. Among them, 45 patients (13.5%) were in Group A, 25 patients (23.6%) in Group B, 19 patients (25.3%) in Group C, and 35 patients (38.9%) in Group D, respectively. CVD event occurrence was highest in Group D. The results of the multivariate analysis also showed that the CVD event rates were significantly higher in Group C (HR: 2.96, P = < .001) and D (HR: 4.22, P < .001) than in Group A. CONCLUSION In patients with advanced CKD, there was a significant correlation of ECG and UCG abnormalities with CVD events. Additionally, those having both types of abnormalities may have a higher risk of coronary artery disease than other groups.
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Affiliation(s)
- Ken Hirabayashi
- Division of Nephrology and Kidney Center, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan
| | - Hideki Fujii
- Division of Nephrology and Kidney Center, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan.
| | - Keiji Kono
- Division of Nephrology and Kidney Center, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan
| | - Satoshi Yamatani
- Division of Nephrology and Kidney Center, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan
| | - Mao Shimizu
- Division of Nephrology and Kidney Center, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan
| | - Kentaro Watanabe
- Division of Nephrology and Kidney Center, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan
| | - Kazuo Sakamoto
- Division of Nephrology and Kidney Center, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan
| | - Shunsuke Goto
- Division of Nephrology and Kidney Center, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan
| | - Shinichi Nishi
- Division of Nephrology and Kidney Center, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan
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Klimkiewicz J, Grzywacz A, Michałowski A, Gutowski M, Paryż K, Jędrych E, Lubas A. Acute Kidney Injury and Chronic Kidney Disease and Their Impacts on Prognosis among Patients with Severe COVID-19 Pneumonia: An Expert Center Case-Cohort Study. J Clin Med 2024; 13:1486. [PMID: 38592301 PMCID: PMC10932456 DOI: 10.3390/jcm13051486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 02/13/2024] [Accepted: 02/21/2024] [Indexed: 04/10/2024] Open
Abstract
Background: Acute kidney injury (AKI) is associated with substantial mortality. In this case-control study, we analyzed the impacts of AKI and chronic kidney disease (CKD) on outcomes in a group of 323 patients with severe COVID-19. The correlation of clinical and laboratory data with AKI and CKD was also analyzed. Methods: A retrospective case-control study was conducted among AKI, CKD, and normal kidney function (NKF) groups hospitalized in a COVID-19 center in 2021. Results: AKI patients had higher in-hospital mortality (55.2 vs. 18.8%, p < 0.001), more frequent transfers from the HDU to ICU (57.5 vs. 12.9%, p < 0.001), and prolonged hospital stays (15.4 ± 10.7 vs. 10.7 ± 6.7 days, p < 0.001) compared to the NKF group. AKI was a predictor of death (OR 4.794, 95%CI: 2.906-7.906, p < 0.001). AKI patients also had broader lung parenchymal involvement and higher inflammatory markers compared to the NKF group. Patients with prior CKD had higher in-hospital mortality compared to the NKF group (64.0 vs. 18.8%, p < 0.001, OR 4.044, 95%CI: 1.723-9.490, p = 0.013); however, transfers from the HDU to ICU were not more frequent (16.0 vs. 12.9%, p = 0.753). Conclusions: AKI among COVID-19 patients was correlated with more ICU transfers, higher morbidity, and greater markers of severe disease. Patients with CKD had a higher mortality; however, the rate of ICU transfer was not substantially higher due to their poor prognosis.
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Affiliation(s)
- Jakub Klimkiewicz
- Department of Anesthesiology and Intensive Care, COVID-19 Hospital, Military Institute of Medicine-National Research Institute, Szaserów 128 Str., 04-141 Warsaw, Poland; (A.M.); (M.G.); (K.P.)
| | - Anna Grzywacz
- Department of Nephrology, Internal Diseases and Dialysis, COVID-19 Hospital, Military Institute of Medicine-National Research Institute, Szaserów 128 Str., 04-141 Warsaw, Poland; (A.G.); (E.J.); (A.L.)
| | - Andrzej Michałowski
- Department of Anesthesiology and Intensive Care, COVID-19 Hospital, Military Institute of Medicine-National Research Institute, Szaserów 128 Str., 04-141 Warsaw, Poland; (A.M.); (M.G.); (K.P.)
| | - Mateusz Gutowski
- Department of Anesthesiology and Intensive Care, COVID-19 Hospital, Military Institute of Medicine-National Research Institute, Szaserów 128 Str., 04-141 Warsaw, Poland; (A.M.); (M.G.); (K.P.)
| | - Kamil Paryż
- Department of Anesthesiology and Intensive Care, COVID-19 Hospital, Military Institute of Medicine-National Research Institute, Szaserów 128 Str., 04-141 Warsaw, Poland; (A.M.); (M.G.); (K.P.)
| | - Ewelina Jędrych
- Department of Nephrology, Internal Diseases and Dialysis, COVID-19 Hospital, Military Institute of Medicine-National Research Institute, Szaserów 128 Str., 04-141 Warsaw, Poland; (A.G.); (E.J.); (A.L.)
| | - Arkadiusz Lubas
- Department of Nephrology, Internal Diseases and Dialysis, COVID-19 Hospital, Military Institute of Medicine-National Research Institute, Szaserów 128 Str., 04-141 Warsaw, Poland; (A.G.); (E.J.); (A.L.)
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Galos G, Szabados E, Rabai M, Szalai R, Ferkai LA, Papp I, Toth K, Sandor B. Evaluation of Incidence and Risk Factors of Sudden Cardiac Death in Patients with Chronic Coronary Syndrome Attending Physical Training. Cardiol Ther 2023; 12:689-701. [PMID: 37803155 DOI: 10.1007/s40119-023-00331-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 09/04/2023] [Indexed: 10/08/2023] Open
Abstract
INTRODUCTION Regular physical activity is recommended to patients with chronic coronary syndrome (CCS). However, vigorous physical exercise occurs as a risk factor of sudden cardiac death (SCD). The effect of short-term and irregular exercise is controversial. The aim of this research is to assess the role of regular training in the incidence of SCD and to identify risk factors among patients with CCS participating in a long-term training program. METHODS Data of risk factors, therapy, and participation were collected retrospectively for a 10-year period, assessing the length and regularity of participation. The incidence of SCD and related mortality was registered. ANOVA, χ2 test, and multinominal logistic regression and stepwise analysis were performed. RESULTS The Incidence of chronic kidney disease (CKD) was higher (p < 0.01) and taking beta-blockers (BBs) was lower (p = 0.04) in the SCD group. Irregular training, lack of BBs, smoking, and CKD increased the risk of SCD, while female sex, angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers (ACEI/ARBs), and BBs decreased the risk of SCD. CONCLUSIONS Taking ACEI/ARBs and BBs proved to be a protective factor, emphasizing the use of optimal medical therapy. Assessment of cardiac risk factors and control of comorbidities also proved to be important. The occurrence of SCD was connected to irregular physical activity, probably relating to the adverse effects of ad hoc exercising.
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Affiliation(s)
- Gergely Galos
- Division of Cardiology, 1st Department of Medicine, Medical School, University of Pecs, 7624, Pecs, Hungary
- Division of Preventive Cardiology and Rehabilitation, 1st Department of Medicine, Medical School, University of Pecs, 13 Ifjusag Str., Pecs, 7624, Hungary
| | - Eszter Szabados
- Division of Preventive Cardiology and Rehabilitation, 1st Department of Medicine, Medical School, University of Pecs, 13 Ifjusag Str., Pecs, 7624, Hungary
| | - Miklos Rabai
- Division of Cardiology, 1st Department of Medicine, Medical School, University of Pecs, 7624, Pecs, Hungary
| | - Rita Szalai
- Division of Cardiology, 1st Department of Medicine, Medical School, University of Pecs, 7624, Pecs, Hungary
- Division of Preventive Cardiology and Rehabilitation, 1st Department of Medicine, Medical School, University of Pecs, 13 Ifjusag Str., Pecs, 7624, Hungary
| | - Luca Anna Ferkai
- Doctoral School of Health Sciences, University of Pecs, 7621, Pecs, Hungary
| | - Ildiko Papp
- Division of Preventive Cardiology and Rehabilitation, 1st Department of Medicine, Medical School, University of Pecs, 13 Ifjusag Str., Pecs, 7624, Hungary
| | - Kalman Toth
- Division of Cardiology, 1st Department of Medicine, Medical School, University of Pecs, 7624, Pecs, Hungary
| | - Barbara Sandor
- Division of Preventive Cardiology and Rehabilitation, 1st Department of Medicine, Medical School, University of Pecs, 13 Ifjusag Str., Pecs, 7624, Hungary.
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Miura T, Sato T, Yano T, Takaguri A, Miki T, Tohse N, Nishizawa K. Role of Erythropoiesis-Stimulating Agents in Cardiovascular Protection in CKD Patients: Reappraisal of Their Impact and Mechanisms. Cardiovasc Drugs Ther 2023; 37:1175-1192. [PMID: 35150385 DOI: 10.1007/s10557-022-07321-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/28/2022] [Indexed: 11/28/2022]
Abstract
Erythropoiesis-stimulating agents (ESAs) have markedly reduced the need for blood transfusion for renal anemia and are included in standard therapies for patients with chronic kidney disease (CKD). Various protective effects of ESAs on the cardiovascular system have been discovered through basic research, and the effects have received much attention because the rates of cardiovascular events and mortality are high in CKD patients. However, randomized clinical trials did not provide strong evidence that ESAs exert cardioprotection in humans, including CKD patients. It is difficult to assess the cardioprotective effects of ESAs in CKD patients through the clinical data that has been reported to date because the relationship between hemoglobin level rather than ESA dose and cardiovascular event rates was examined in most studies. Interestingly, recent studies using a rat model of CKD showed that the infarct size-limiting effect of an ESA was lost when its dose was increased to a level that normalized blood hemoglobin levels, suggesting that the optimal dose of an ESA for myocardial protection is less than the dose required to normalize hemoglobin levels. Furthermore, animal models of traditional coronary risk factors or comorbidities were resistant to the cardioprotective effects of ESAs because of interruptions in signal-mediated mechanisms downstream of erythropoietin receptors. In this review, we briefly discuss basic and clinical data on the impact of anemia on coronary and systemic circulation, the effects of CKD on the cardiovascular system, and the multiple pharmacological actions of ESAs to examine whether the ESAs that are prescribed for renal anemia exert any cardioprotection in patients with CKD.
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Affiliation(s)
- Tetsuji Miura
- Department of Clinical Pharmacology, Faculty of Pharmaceutical Sciences, Hokkaido University of Science, 15-4-1, Maeda-7, Teine-ku, Sapporo, Japan.
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan.
| | - Tatsuya Sato
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
- Department of Cellular Physiology and Signal Transduction, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Toshiyuki Yano
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Akira Takaguri
- Department of Pharmacology, Faculty of Pharmaceutical Sciences, Hokkaido University of Science, Sapporo, Japan
| | - Takayuki Miki
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
- Department of Cardiology and Diabetes, Oji General Hospital, Tomakomai, Japan
| | - Noritsugu Tohse
- Department of Cellular Physiology and Signal Transduction, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Keitaro Nishizawa
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
- Department of Nephrology, Asahikawa Red Cross, Hospital, Asahikawa, Japan
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Shimizu M, Fujii H, Kono K, Goto S, Watanabe K, Sakamoto K, Nishi S. Clinical Implication of Consistently Strict Phosphate Control for Coronary and Valvular Calcification in Incident Patients Undergoing Hemodialysis. J Atheroscler Thromb 2023; 30:1568-1579. [PMID: 36990726 PMCID: PMC10627770 DOI: 10.5551/jat.64159] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 03/15/2023] [Indexed: 03/29/2023] Open
Abstract
AIMS Serum phosphate control is crucial for the progression of vascular and valvular calcifications. Strict phosphate control is recently suggested; however, there is a lack of convincing evidence. Therefore, we explored the effects of strict phosphate control on vascular and valvular calcifications in incident patients undergoing hemodialysis. METHODS A total of 64 patients undergoing hemodialysis from our previous randomized controlled trial were included in this study. Coronary artery calcification score (CACS) and cardiac valvular calcification score (CVCS) were evaluated using computed tomography and ultrasound cardiography at baseline and 18 months after the initiation of hemodialysis. The absolute changes in CACS (ΔCACS) and CVCS (ΔCVCS) and the percent change in CACS (%ΔCACS) and CVCS (%ΔCVCS) were calculated. Serum phosphate level was measured at 6, 12, and 18 months after the initiation of hemodialysis. Moreover, phosphate control status was evaluated using the area under the curve (AUC) by the amount of time spent with a serum phosphate level of ≥ 4.5 mg/dL and the extent to which this threshold exceeded over the observation period. RESULTS ΔCACS, %ΔCACS, ΔCVCS, and %ΔCVCS were significantly lower in the low AUC group than in the high AUC group. ΔCACS and %ΔCACS were also significantly lower. ΔCVCS and %ΔCVCS tended to be lower in patients whose serum phosphate level never exceeded 4.5 mg/dL than in those whose serum phosphate level continuously exceeded 4.5 mg/dL. AUC significantly correlated with ΔCACS and ΔCVCS. CONCLUSION Consistently strict phosphate control may slow the progression of coronary and valvular calcifications in incident patients undergoing hemodialysis.
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Affiliation(s)
- Mao Shimizu
- Division of Nephrology and Kidney Center, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hideki Fujii
- Division of Nephrology and Kidney Center, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Keiji Kono
- Division of Nephrology and Kidney Center, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Shunsuke Goto
- Division of Nephrology and Kidney Center, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Kentaro Watanabe
- Division of Nephrology and Kidney Center, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Kazuo Sakamoto
- Division of Nephrology and Kidney Center, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Shinichi Nishi
- Division of Nephrology and Kidney Center, Kobe University Graduate School of Medicine, Kobe, Japan
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Miyamori D, Tanaka M, Sato T, Endo K, Mori K, Mikami T, Hosaka I, Hanawa N, Ohnishi H, Furuhashi M. Coexistence of Metabolic Dysfunction-Associated Fatty Liver Disease and Chronic Kidney Disease Is a More Potent Risk Factor for Ischemic Heart Disease. J Am Heart Assoc 2023:e030269. [PMID: 37421273 PMCID: PMC10382120 DOI: 10.1161/jaha.123.030269] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 05/31/2023] [Indexed: 07/10/2023]
Abstract
Background Metabolic dysfunction-associated fatty liver disease (MAFLD), defined as fatty liver with overweight/obesity, type 2 diabetes, or metabolic abnormalities, is a newly proposed disease. However, it remains unclear whether the coexistence of MAFLD and chronic kidney disease (CKD) is a more potent risk factor for ischemic heart disease (IHD). Methods and Results We investigated the risk of the combination of MAFLD and CKD for development of IHD during a 10-year follow-up period in 28 990 Japanese subjects who received annual health examinations. After exclusion of subjects without data for abdominal ultrasonography or with the presence of IHD at baseline, a total of 14 141 subjects (men/women: 9195/4946; mean age, 48 years) were recruited. During the 10-year period (mean, 6.9 years), 479 subjects (men/women, 397/82) had new onset of IHD. Kaplan-Meier survival curves showed significant differences in rates of the cumulative incidence of IHD in subjects with and those without MAFLD (n=4581) and CKD (n=990; stages 1/2/3/4-5, 198/398/375/19). Multivariable Cox proportional hazard model analyses showed that coexistence of MAFLD and CKD, but not MAFLD or CKD alone, was an independent predictor for development of IHD after adjustment for age, sex, current smoking habit, family history of IHD, overweight/obesity, diabetes, hypertension, and dyslipidemia (hazard ratio, 1.51 [95% CI, 1.02-2.22]). The addition of the combination of MAFLD and CKD to traditional risk factors for IHD significantly improved the discriminatory capability. Conclusions The coexistence of MAFLD and CKD predicts new onset of IHD better than does MAFLD or CKD alone.
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Affiliation(s)
- Daisuke Miyamori
- Department of Cardiovascular, Renal and Metabolic Medicine Sapporo Medical University School of Medicine Sapporo Japan
- Department of Nephrology Asahikawa Red Cross Hospital Asahikawa Japan
| | - Marenao Tanaka
- Department of Cardiovascular, Renal and Metabolic Medicine Sapporo Medical University School of Medicine Sapporo Japan
- Department of Internal Medicine Tanaka Medical Clinic Yoichi Japan
| | - Tatsuya Sato
- Department of Cardiovascular, Renal and Metabolic Medicine Sapporo Medical University School of Medicine Sapporo Japan
- Department of Cellular Physiology and Signal Transduction Sapporo Medical University School of Medicine Sapporo Japan
| | - Keisuke Endo
- Department of Cardiovascular, Renal and Metabolic Medicine Sapporo Medical University School of Medicine Sapporo Japan
| | - Kazuma Mori
- Department of Immunology and Microbiology National Defense Medical College Tokorozawa Japan
| | - Takuma Mikami
- Department of Cardiovascular Surgery Sapporo Medical University School of Medicine Sapporo Japan
| | - Itaru Hosaka
- Department of Cardiovascular Surgery Sapporo Medical University School of Medicine Sapporo Japan
| | - Nagisa Hanawa
- Department of Health Checkup and Promotion Keijinkai Maruyama Clinic Sapporo Japan
| | - Hirofumi Ohnishi
- Department of Cardiovascular, Renal and Metabolic Medicine Sapporo Medical University School of Medicine Sapporo Japan
- Department of Public Health Sapporo Medical University School of Medicine Sapporo Japan
| | - Masato Furuhashi
- Department of Cardiovascular, Renal and Metabolic Medicine Sapporo Medical University School of Medicine Sapporo Japan
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Chen H, Spirito A, Sartori S, Nicolas J, Cao D, Zhang Z, Baber U, Kamaleldin K, Guthrie J, Vogel B, Sweeny J, Krishnan P, Sharma SK, Kini A, Dangas G, Mehran R. Impact of complex percutaneous coronary intervention features on clinical outcomes in patients with or without chronic kidney disease. Catheter Cardiovasc Interv 2023; 101:511-519. [PMID: 36691863 DOI: 10.1002/ccd.30569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 01/11/2023] [Indexed: 01/25/2023]
Abstract
BACKGROUND Patients with chronic kidney disease (CKD) are at higher risk of ischemic and bleeding events after percutaneous coronary intervention (PCI). Complex PCI (CPCI) is associated with higher rates of ischemic complications. Whether CPCI confers an additive risk of adverse events in CKD patients is unclear. METHODS Patients who underwent PCI at a single tertiary-care-center between 2012 and 2019 were stratified by CKD status and CPCI. The primary outcome was major adverse cardiac events (MACE), a composite of all-cause death, myocardial infarction (MI), and target-vessel revascularization (TVR) at 1-year follow-up. Secondary outcomes included the individual components of the primary outcome and major bleeding. RESULTS Out of 15,071 patients, 4537 (30.1%) had CKD and 10,534 (69.9%) had no CKD. Patients undergoing CPCI were 1151 (25.4%) and 2983 (28.3%) in the two cohorts, respectively. At one year, CPCI compared with no CPCI was associated with higher risk of MACE in both CKD (Adj. HR 1.72, 95% confidence interval [CI] 1.45-2.06, p < 0.001) and no-CKD patients (Adj. hazard ratios [HR] 2.19, 95% CI 1.91-2.51, p < 0.001; p of interaction 0.057), determined by an excess of death, MI and TVR in CKD patients and of TVR and MI only in no-CKD. CPCI was related with a consistent increase of major bleeding in the CKD (Adj. HR 1.49, 95% CI 1.18-1.87, p < 0.001) and no-CKD group (Adj. HR 1.23, 95% CI 0.98-1.54, p = 0.071, p of interaction 0.206). CONCLUSION At 1-year follow-up, CPCI was associated with higher risk of MACE and major bleeding irrespective of concomitant CKD. CPCI predicted mortality in CKD patients only.
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Affiliation(s)
- Huazhen Chen
- The Zena and Michael A. Wiener Cardiovascular institute, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | - Alessandro Spirito
- The Zena and Michael A. Wiener Cardiovascular institute, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | - Samantha Sartori
- The Zena and Michael A. Wiener Cardiovascular institute, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | - Johny Nicolas
- The Zena and Michael A. Wiener Cardiovascular institute, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | - Davide Cao
- The Zena and Michael A. Wiener Cardiovascular institute, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | - Zhongjie Zhang
- The Zena and Michael A. Wiener Cardiovascular institute, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | - Usman Baber
- University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Karim Kamaleldin
- The Zena and Michael A. Wiener Cardiovascular institute, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | - Jeffers Guthrie
- The Zena and Michael A. Wiener Cardiovascular institute, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | - Birgit Vogel
- The Zena and Michael A. Wiener Cardiovascular institute, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | - Joseph Sweeny
- The Zena and Michael A. Wiener Cardiovascular institute, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | - Prakash Krishnan
- The Zena and Michael A. Wiener Cardiovascular institute, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | - Samin K Sharma
- The Zena and Michael A. Wiener Cardiovascular institute, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | - Annapoorna Kini
- The Zena and Michael A. Wiener Cardiovascular institute, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | - George Dangas
- The Zena and Michael A. Wiener Cardiovascular institute, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | - Roxana Mehran
- The Zena and Michael A. Wiener Cardiovascular institute, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
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10
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Ramezanzadeh E, Fallah Arzpeyma S, Vakilpour A, Abedi M, Hassanipour S. Endothelial function assessment by flow-mediated dilation of the brachial artery in acute kidney injury and chronic kidney disease. CASPIAN JOURNAL OF INTERNAL MEDICINE 2023; 14:668-675. [PMID: 38024183 PMCID: PMC10646350 DOI: 10.22088/cjim.14.4.668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 07/24/2022] [Accepted: 10/15/2022] [Indexed: 12/01/2023]
Abstract
Background Endothelial dysfunction has a significant role in the pathogenesis of cardiovascular events in patients with kidney dysfunction. The present study aimed to compare the level of endothelial dysfunction in patients with chronic kidney disease (CKD) and acute kidney injury (AKI) by brachial artery flow-mediated dilation (FMD) technique. Also, we sought to find whether this non-invasive technique may assist in accurately distinguishing the acute or chronic nature of kidney failure in patients presenting with uremia for the first time. Methods Demographic and medical characteristics, and laboratory and renal ultrasonography data of the patients with AKI and CKD were collected and compared with a control group. Brachial artery FMD was measured using a Toshiba aplio 300 device with a 7.5 MHz linear probe. Results In a total of 175 patients with a mean (SD) age of 55.96(15.54) years, FMD% was significantly lower in the CKD and AKI patients compared to the control group (Mean±SD: 16.28%±10.52%), 16.28 %±4.35%, and 24.24±5.71, respectively, p<0.001). Among the different causes of AKI, contrast-induced nephropathy (10.78%±1.75%), volume depletion (14.87%±1.22%), and post-renal AKI (15.96%±1.54%) had the lowest levels of FMD. Also, a significant correlation between FMD and eGFR (r=0.26, P<0.001), serum Hb (r=0.18, P=0.013), Na (r=0.19, P=0.011), BUN (r=-0.21, P=0.005) and Cr (r=- 0.13, P=0.084) was reported. Conclusion Compared to the control group, CKD and AKI patients showed greater levels of endothelial dysfunction as evidenced by lower brachial artery FMD. However, the FMD technique did not appear to be a practical method in differentiating CKD and AKI in patients presenting with uremia for the first time.
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Affiliation(s)
- Elham Ramezanzadeh
- Razi Clinic Research Development Center, Gilan University of Medical Sciences, Rasht, Iran
| | - Sima Fallah Arzpeyma
- Razi Clinic Research Development Center, Gilan University of Medical Sciences, Rasht, Iran
| | - Azin Vakilpour
- Cardiovascular Diseases Research Center, Department of Cardiology, Heshmat Hospital, School of Medicine, Gilan University of Medical Sciences, Rasht, Iran
| | - Mohammadsadegh Abedi
- Razi Clinic Research Development Center, Gilan University of Medical Sciences, Rasht, Iran
| | - Soheil Hassanipour
- Cardiovascular Diseases Research Center, Department of Cardiology, Heshmat Hospital, School of Medicine, Gilan University of Medical Sciences, Rasht, Iran
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11
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Kelderman JR, Jolink FEJ, Benjamens S, Monroy-Gonzalez AG, Pol RA, Slart RHJA. Diagnostic accuracy of myocardial perfusion imaging in patients evaluated for kidney transplantation: A systematic review and meta-analysis. J Nucl Cardiol 2022; 29:3405-3415. [PMID: 33948891 PMCID: PMC9834355 DOI: 10.1007/s12350-021-02621-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 03/29/2021] [Indexed: 01/22/2023]
Abstract
BACKGROUND Cardiovascular disease is the most common cause of death after kidney transplantation. Coronary artery disease (CAD) assessment is therefore mandatory in patients evaluated for transplantation. We aimed to assess the diagnostic accuracy for CAD of single-photon emission computed tomography (SPECT) compared to the standards invasive coronary angiography (ICA) and coronary computed tomography angiography (CCTA) in patients evaluated for kidney transplantation. METHODS We performed a systematic literature search in PubMed, EMBASE, Web of Science, OvidSP (Medline), The Cochrane Library and Google Scholar. Studies investigating the diagnostic accuracy of myocardial perfusion imaging (MPI) SPECT in patients evaluated for kidney transplantation were retrieved. After a risk of bias assessment using QUADAS-2, a meta-analysis was conducted. RESULTS Out of 1459 records, 13 MPI SPECT studies were included in the meta-analysis with a total of 1245 MPI SPECT scans. There were no studies available with CCTA as reference. Pooled sensitivity of MPI SPECT for CAD was 0.66 (95% CI 0.53 to 0.77), pooled specificity was 0.75 (95% CI 0.63 to 0.84) and the area under the curve (AUC) was 0.76. Positive likelihood ratio was 2.50 (95% CI 1.78 to 3.51) and negative likelihood ratio was 0.41 (95% CI 0.28 to 0.61). Pooled positive predictive value was 64.9% and pooled negative predictive value was 74.1%. Significant heterogeneity existed across the included studies. CONCLUSIONS MPI SPECT had a moderate diagnostic accuracy in patients evaluated for kidney transplantation, with a high rate of false-negative findings. The use of an anatomical gold standard against a functional imaging test in the included studies is however suboptimal.
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Affiliation(s)
- Jeroen R Kelderman
- University of Groningen, Medical Imaging Centre, Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen, The Netherlands
| | - Floris E J Jolink
- University of Groningen, Division of Transplant Surgery, Department of Surgery, University Medical Center Groningen, Groningen, The Netherlands
| | - Stan Benjamens
- University of Groningen, Medical Imaging Centre, Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen, The Netherlands
- University of Groningen, Division of Transplant Surgery, Department of Surgery, University Medical Center Groningen, Groningen, The Netherlands
| | - Andrea G Monroy-Gonzalez
- University of Groningen, Medical Imaging Centre, Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen, The Netherlands
| | - Robert A Pol
- University of Groningen, Division of Transplant Surgery, Department of Surgery, University Medical Center Groningen, Groningen, The Netherlands
| | - Riemer H J A Slart
- University of Groningen, Medical Imaging Centre, Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen, The Netherlands.
- Department of Biomedical Photonic Imaging, Faculty of Science and Technology, University of Twente, Enschede, The Netherlands.
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12
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Lin LH, Liu H, Jin DH, Zou J, Xie YX, Qiu H, Jia M, Li DM, Liu BC. Fibrinogen-to-albumin ratio is related to the severity of coronary artery disease in chronic kidney disease patients undergoing coronary angiography. Nefrologia 2022; 42:696-703. [PMID: 36402683 DOI: 10.1016/j.nefroe.2022.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 05/19/2021] [Indexed: 06/16/2023] Open
Abstract
OBJECTIVES This study was to explore the potential relationship between the fibrinogen-to-albumin ratio (FAR) and the presence and severity of coronary artery disease (CAD) in stage 3-5 predialysis chronic kidney disease (CKD) patients. DESIGN This study included 978 patients undergoing coronary angiography (CAG). CAD was defined as the presence of obstructive stenosis>50% of the lumen diameter in any of the four main coronary arteries. Gensini scores (GSs), left main coronary artery (LMCA) and three-vessel coronary artery disease (TVD) were used to elevate the severity of CAD. RESULTS The adjusted odds ratios of CAD were 3.059 (95% CI: 1.859-5.032) and 2.670 (95% CI: 1.605-4.441) in the third and fourth quartiles of FAR compared with the first quartile, respectively. Among 759 patients diagnosed with CAD, multivariate logistic regression analysis showed that FAR (at the 0.01 level) was significantly positively associated with the presence of LMCA (adjusted OR=1.177, 95% CI 1.067-1.299, P=0.001) or TVD (adjusted OR=1.154, 95% CI 1.076-1.238, P<0.001), and a higher GS (adjusted OR=1.152, 95% CI 1.073-1.238, P<0.001). CONCLUSIONS FAR levels were independently associated with the presence and severity of CAD in stage 3-5 predialysis CKD patients.
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Affiliation(s)
- Li-Hua Lin
- Department of Nephrology, The People's Hospital of Suzhou New District, Suzhou, Jiangsu 215129, China; Department of Nephrology, Zhong Da Hospital Affiliated to Southeast University, Nanjing, Jiangsu 210009, China
| | - Hong Liu
- Department of Nephrology, Zhong Da Hospital Affiliated to Southeast University, Nanjing, Jiangsu 210009, China.
| | - Dong-Hua Jin
- Department of Nephrology, The People's Hospital of Suzhou New District, Suzhou, Jiangsu 215129, China.
| | - Jun Zou
- Department of Nephrology, Xin Hua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200092, China
| | - Yu-Xian Xie
- Department of Nephrology, The People's Hospital of Suzhou New District, Suzhou, Jiangsu 215129, China
| | - Hong Qiu
- Department of Nephrology, The People's Hospital of Suzhou New District, Suzhou, Jiangsu 215129, China
| | - Miao Jia
- Department of Nephrology, The People's Hospital of Suzhou New District, Suzhou, Jiangsu 215129, China
| | - Da-Mei Li
- Department of Nephrology, The People's Hospital of Suzhou New District, Suzhou, Jiangsu 215129, China
| | - Bi-Cheng Liu
- Department of Nephrology, Zhong Da Hospital Affiliated to Southeast University, Nanjing, Jiangsu 210009, China
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13
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Jacob J, Boczkowska S, Zaluska W, Buraczynska M. Apolipoprotein A5 gene polymorphism (rs662799) and cardiovascular disease in end-stage kidney disease patients. BMC Nephrol 2022; 23:307. [PMID: 36071387 PMCID: PMC9450442 DOI: 10.1186/s12882-022-02925-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 08/22/2022] [Indexed: 11/29/2022] Open
Abstract
Background Plasma triglyceride (TG) levels are a significant risk factor for cardiovascular disease (CVD). The APOA5 gene is one of the crucial factors in plasma TG metabolism regulation. The rs662799 polymorphism in the APOA5 gene has been reported to be associated with cardiovascular disease. The goal of this study was to evaluate the potential association of this variant with CVD in patients with end-stage kidney disease. Methods In this case–control study the polymorphism was analyzed using the PCR–RFLP method in 800 consecutive patients with ESKD and 500 healthy controls. The genotype and allele distribution was compared between subgroups of patients with CVD (552) versus those without CVD (248). Results The frequency of the minor allele (C) in the healthy individuals was 9% compared to 12% in ESRD group (p = 0.09). The difference between groups was slightly higher for CC homozygote (3.5% versus 1.6%, p = 0.042). The ESKD patient group was analyzed according to the presence or absence of CVD. The significant differences in the polymorphism distribution were revealed in this analysis. The frequency of the C allele in the CVD + subgroup was 14% compared to 6% in CVD- patients (p = 0.001). In the CVD + subgroup the ORs (95% CI) for the C allele and CC genotype were 2.41 (1.61–3.6), p < 0.001 and 3.13 (1.07–9.14), p = 0.036, respectively. This indicates to the association of the variant C allele with cardiovascular disease in ESKD patients. The CC homozygotes have a threefold higher odds of CVD compared to TT homozygotes. The highest frequency of the C allele (18%) was observed in subgroup of patients with diabetic nephropathy, with OR (95% CI) 3.40 (2.13–5.43), p < 0.001.The presence of minor allele (CC and CT genotypes) was significantly associated with increased plasma triglyceride levels (p < 0.001 for both CVD + and CVD- groups). Conclusion The present study demonstrated the effect of rs662799 polymorphism on plasma TG levels and its association with the development of cardiovascular disease in ESKD patients.
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Affiliation(s)
- Jerry Jacob
- Hope Medical Institute, Newport News, VA, USA
| | - Sylwia Boczkowska
- Department of Nephrology, Medical University of Lublin, Jaczewskiego 8, 20-950, Lublin, Poland
| | - Wojciech Zaluska
- Department of Nephrology, Medical University of Lublin, Jaczewskiego 8, 20-950, Lublin, Poland
| | - Monika Buraczynska
- Department of Nephrology, Medical University of Lublin, Jaczewskiego 8, 20-950, Lublin, Poland.
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14
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Yartsev VN. Effects of Nephrectomy on the Electrical Field Stimulation-Evoked Changes in Tone of Arteries from the Normotensive and Spontaneously Hypertensive Rats. J EVOL BIOCHEM PHYS+ 2022. [DOI: 10.1134/s0022093022050301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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15
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Lin Y, Xu W, Hou Y, Wang S, Zhang H, Ran M, Huang Y, Wang Y, Yang G. The multifaceted role of ferroptosis in kidney diseases. Chem Biol Interact 2022; 365:110107. [PMID: 35985518 DOI: 10.1016/j.cbi.2022.110107] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 08/08/2022] [Accepted: 08/09/2022] [Indexed: 11/20/2022]
Abstract
Ferroptosis, a form of cell death caused by the excessive accumulation of iron-dependent lipid peroxides. Studies over the last decade have identified multiple pathways that affect the sensitivity of cells to ferroptosis. Renal diseases, the tenth leading cause of death in the world, has been affecting the life of people for a long time. Numerous studies have shown that ferroptosis is inextricably linked to damage to kidney cells. Here, we review the pathophysiological features of the kidney, the basic pathways of ferroptosis, and the mechanisms of ferroptosis-induced kidney injury. It is proposed a promising outlook for the treatment of renal diseases by influencing ferroptosis.
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Affiliation(s)
- Yuxuan Lin
- Department of Food Nutrition and Safety, Dalian Medical University, No. 9W. Lushun South Road, Dalian, 116044, China
| | - Wenqi Xu
- Department of Food Nutrition and Safety, Dalian Medical University, No. 9W. Lushun South Road, Dalian, 116044, China
| | - Yunfeng Hou
- Department of Food Nutrition and Safety, Dalian Medical University, No. 9W. Lushun South Road, Dalian, 116044, China
| | - Shaopeng Wang
- Department of Cardiology, The First Affiliated Hospital of Dalian Medical University, Dalian, 116011, China
| | - Haoyang Zhang
- Department of Food Nutrition and Safety, Dalian Medical University, No. 9W. Lushun South Road, Dalian, 116044, China
| | - Maohuan Ran
- Department of Food Nutrition and Safety, Dalian Medical University, No. 9W. Lushun South Road, Dalian, 116044, China
| | - Yiming Huang
- Department of Food Nutrition and Safety, Dalian Medical University, No. 9W. Lushun South Road, Dalian, 116044, China
| | - Yimeng Wang
- Department of Food Nutrition and Safety, Dalian Medical University, No. 9W. Lushun South Road, Dalian, 116044, China
| | - Guang Yang
- Department of Food Nutrition and Safety, Dalian Medical University, No. 9W. Lushun South Road, Dalian, 116044, China.
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16
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Assarzadeh S, Vahdat S, Seirafian S, Pourfarzam M, Badri S. Effect of Selenium Supplementation on Lipid Profile, Anemia, and Inflammation Indices in Hemodialysis Patients. J Res Pharm Pract 2022; 11:103-108. [PMID: 37304224 PMCID: PMC10252574 DOI: 10.4103/jrpp.jrpp_68_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 08/05/2022] [Indexed: 06/13/2023] Open
Abstract
Objective Trace elements deficiency is common among end-stage renal disease (ESRD) patients due to excessive loss during dialysis and the lower intake secondary to loss of appetite. Selenium (Se) is a trace element that plays an important role in the radical scavenging system and helps the body defend against oxidative stress. This study aims to evaluate the effects of Se supplementation on lipid profile, anemia, and inflammation indices in ESRD patients. Methods Fifty-nine hemodialysis patients enrolled and were randomly divided into two groups. Two hundred microgram Se capsules once daily for the case group and matching placebo for the control group were administered for three months. Demographic data were collected at the study beginning. Uric acid (UA), anemia and inflammation indices, and lipid profiles were recorded at the beginning and the end of the study. Findings UA and UA-to-HDL (high-density lipoprotein) ratio decreased significantly in the case group (P < 0.001). The changes in lipid profile were not significant among both groups. Hemoglobin slightly increased in the case group, however, it decreased significantly in the control group (P = 0.031). High-sensitivity C-reactive protein (hs-CRP) decreased in the case group and increased in the control group, however, none of these changes were significant. Conclusion According to the results of this study, selenium supplementation in ESRD patients could reduce some risk factors related to their mortality, such as the ratio of uric acid to HDL. However, the changes related to lipid profile, hemoglobin level and hs-CRP biomarker were not significant.
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Affiliation(s)
- Samaneh Assarzadeh
- Department of Clinical Pharmacy and Pharmacy Practice, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sahar Vahdat
- Isfahan Kidney Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shiva Seirafian
- Isfahan Kidney Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Morteza Pourfarzam
- Department of Clinical Biochemistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shirinsadat Badri
- Department of Clinical Pharmacy and Pharmacy Practice, Isfahan University of Medical Sciences, Isfahan, Iran
- Isfahan Kidney Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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17
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Shamloo M, Mollard R, Wang H, Kingra K, Tangri N, MacKay D. A randomized double-blind cross-over trial to study the effects of resistant starch prebiotic in chronic kidney disease (ReSPECKD). Trials 2022; 23:72. [PMID: 35073986 PMCID: PMC8785497 DOI: 10.1186/s13063-022-06009-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 01/06/2022] [Indexed: 12/25/2022] Open
Abstract
Background Chronic kidney disease (CKD) is associated with a reduced quality of life and an increased risk of kidney failure, cardiovascular events, and all-cause mortality. Accumulation of nitrogen-based uremic toxins leads to worsening of symptoms in individuals with CKD. Many uremic toxins, such as indoxyl and p-cresol sulphate, are produced exclusively by the gut microbiome through the proteolytic digestion of aromatic amino acids. Strategies to reduce the production of these toxins by the gut microbiome in individuals with CKD may lessen symptom burden and delay the onset of dialysis. One such strategy is to change the overall metabolism of the gut microbiome so that less uremic toxins are produced. This can be accomplished by manipulating the energy source available to the microbiome. Fermentable carbohydrates which reach the gut microbiome, like resistant starch (RS), have been shown to inhibit or reduce bacterial amino acid metabolism. This study aims to investigate the effects of resistant potato starch (RPS) as a prebiotic in individuals with CKD before the onset of dialysis. Methods This is a double-blind, randomized two-period crossover trial. Thirty-six eligible participants will consent to follow a 26-week study regimen. Participants will receive 2 sachets per day containing either 15 g of RPS (MSPrebiotic, resistant potato starch treatment) or 15 g cornstarch (Amioca TF, digestible starch control). Changes in blood uremic toxins will be investigated as the primary outcome. Secondary outcomes include the effect of RPS consumption on symptoms, quality of life and abundance, and diversity and functionality of the gut microbiome. Discussion This randomized trial will provide further insight into whether the consumption of RPS as a prebiotic will reduce uremic toxins and symptoms in individuals who have CKD. Trial registration ClinicalTrials.govNCT04961164. Registered on 14 July 2021
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Affiliation(s)
- Maryam Shamloo
- Chronic Disease Innovation Centre, Seven Oaks General Hospital, Winnipeg, MB, Canada.,Department of Human Nutritional Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Rebecca Mollard
- Chronic Disease Innovation Centre, Seven Oaks General Hospital, Winnipeg, MB, Canada.,Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Haizhou Wang
- Chronic Disease Innovation Centre, Seven Oaks General Hospital, Winnipeg, MB, Canada
| | - Kulwant Kingra
- Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Navdeep Tangri
- Chronic Disease Innovation Centre, Seven Oaks General Hospital, Winnipeg, MB, Canada.,Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Dylan MacKay
- Department of Human Nutritional Sciences, University of Manitoba, Winnipeg, MB, Canada. .,Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada.
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18
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Ku TC, Wang PH, Huang JL, Chen HY, Fang JT, Hsieh HL, Chen JL. The survival outcome of nasopharyngeal cancer patients with traditional Chinese medicine external use: A hospital-based study. JOURNAL OF ETHNOPHARMACOLOGY 2021; 279:114380. [PMID: 34197958 DOI: 10.1016/j.jep.2021.114380] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 06/13/2021] [Accepted: 06/26/2021] [Indexed: 06/13/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE External-use traditional Chinese medicine (TCM) agents are widely used to relieve the adverse effects of radiation therapy in nasopharyngeal cancer patients. AIM OF THE STUDY Our study aimed to evaluate the influence of external-use TCM agents to relieve radiotherapy-related adverse effects on the efficacy of radiation therapy and the prognosis of nasopharyngeal cancer patients. MATERIALS AND METHODS By using the Chang Gung Research Database (CGRD), we analyzed 1823 newly diagnosed nasopharyngeal cancer patients with radiotherapy-related adverse effects between 2001/01 and 2015/12. We used Kaplan-Meier analysis and a Cox regression model to estimate the differences in effects on survival outcomes between two groups, TCM external users and non-TCM external users. RESULTS We found that TCM external users had significantly better 3-year and 5-year overall survival rates (log-rank test, p = 0.0377 and p = 0.034, respectively) than non-TCM external users. The 3-year and 5-year disease-free survival rates were not statistically significantly different between the groups. We also found a trend of improved 3-year and 5-year overall survival rates in TCM external users with advanced-stage disease, without statistical significance (log-rank test, p = 0.10 and p = 0.089, respectively). The subgroup analysis revealed lower risks of mortality in TCM external users among the nonhypertension, nonhyperlipidemia, nonischemic heart disease, noncirrhosis, and nonchronic kidney disease groups. CONCLUSIONS Our study showed that TCM agents external use could significantly improve 3-year and 5-year overall survival rates in nasopharyngeal cancer patients with radiotherapy-related adverse effects.
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Affiliation(s)
- Te-Chien Ku
- Division of Chinese Internal Medicine, Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
| | - Pin-Han Wang
- Division of Chinese Internal Medicine, Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
| | - Jhen-Ling Huang
- Center for Big Data Analytics and Statistics, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
| | - Hsing-Yu Chen
- Division of Chinese Internal Medicine, Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
| | - Ji-Tseng Fang
- Kidney Research Center, Department of Nephrology, Chang Gung Memorial Hospital, Taoyuan, Taiwan; School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
| | - Hsi-Lung Hsieh
- Department of Nursing, Division of Basic Medical Sciences, Research Center for Chinese Herbal Medicine, And Graduate Institute of Health Industry Technology, Chang Gung University of Science and Technology, Taoyuan, Taiwan; Department of Neurology, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
| | - Jiun-Liang Chen
- Division of Chinese Internal Medicine, Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan; School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
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19
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Yartsev VN. Effect of Nephrectomy on Arterial Reactivity in Spontaneously Hypertensive Rats. J EVOL BIOCHEM PHYS+ 2021. [DOI: 10.1134/s0022093021050124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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20
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Fibrinogen-to-albumin ratio is related to the severity of coronary artery disease in chronic kidney disease patients undergoing coronary angiography. Nefrologia 2021. [DOI: 10.1016/j.nefro.2021.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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21
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Kai T, Oka S, Hoshino K, Watanabe K, Nakamura J, Abe M, Watanabe A. Renal Dysfunction as a Predictor of Slow-Flow/No-Reflow Phenomenon and Impaired ST Segment Resolution After Percutaneous Coronary Intervention in ST-Elevation Myocardial Infarction With Initial Thrombolysis in Myocardial Infarction Grade 0. Circ J 2021; 85:1770-1778. [PMID: 34305099 DOI: 10.1253/circj.cj-21-0221] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND The slow-flow/no-reflow phenomenon and impaired ST segment resolution (STR) following primary percutaneous coronary intervention (PCI) in ST-elevation myocardial infarction (STEMI) predict unfavorable prognosis and are characterized by obstruction of the coronary microvascular. Several predictors of slow-flow/no-reflow have been revealed, but few studies have investigated predictors of slow-flow/no-reflow and STR exclusively in acute myocardial infarction patients with initial Thrombolysis in Myocardial Infarction (TIMI) Grade 0.Methods and Results:In all, 279 STEMI patients with initial TIMI Grade 0 were enrolled in the study. Slow-flow/no-reflow was defined as TIMI Grade <3 by angiography after PCI, and impaired STR was defined as STR <50% on an electrocardiogram after PCI. Slow-flow/no-reflow was observed in 31 patients. In multivariate analysis, estimated glomerular filtration rate (eGFR; odds ratio [OR] 0.97; P=0.007), a history of cerebrovascular disease (OR 4.65, P=0.007), time to recanalization ≥4 h (OR 2.76, P=0.023), and systolic blood pressure ≤90 mmHg (OR 3.45, P=0.046) were independent predictors of slow-flow/no-reflow. Impaired STR was observed in 102 of 248 patients with TIMI Grade 3. In multivariate analysis, eGFR (OR 0.94, P<0.001) and occlusion of the left anterior descending artery (OR 4.48, P<0.001) were independent predictors of impaired STR; eGFR was the only independent predictor of both slow-flow/no-reflow and impaired STR. CONCLUSIONS Renal dysfunction may be related to coronary microvascular dysfunction and obstruction.
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Affiliation(s)
- Takahiko Kai
- Department of Cardiology, Fujieda Municipal General Hospital
| | - Satoshi Oka
- Department of Cardiology, Fujieda Municipal General Hospital
| | | | | | - Jun Nakamura
- Department of Cardiology, Fujieda Municipal General Hospital
| | - Makoto Abe
- Department of Cardiology, Fujieda Municipal General Hospital
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22
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Buraczynska M, Jacob J, Gwiazda-Tyndel K, Ksiazek A. LDLR gene polymorphism (rs688) affects susceptibility to cardiovascular disease in end-stage kidney disease patients. BMC Nephrol 2021; 22:316. [PMID: 34556050 PMCID: PMC8459523 DOI: 10.1186/s12882-021-02532-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 08/14/2021] [Indexed: 11/20/2022] Open
Abstract
Background The low-density lipoprotein receptor (LDLR) plays a significant role in maintaining the cellular cholesterol homeostasis. Mutations in the LDLR gene can lead to a significant rise in plasma LDL levels that may result in an increased risk of atherosclerosis and coronary heart disease. The purpose of this study was to assess the potential association of the LDLR rs688 polymorphism with cardiovascular disease (CVD) in patients with end-stage kidney disease (ESKD) undergoing hemodialysis. Methods In this case-control study the polymorphism was genotyped by the allele specific PCR method in 800 patients with ESKD and 500 healthy controls. The genotype and allele distribution was compared in subgroups of patients with CVD (552) versus those without CVD (248). Results A significant difference was observed in genotype distribution among ESKD patients and healthy controls. The frequencies of the T allele and TT genotype in ESKD group were significantly higher, with OR (95% CI) 2.2 (1.87–2.6), p < 0.0001 and 5.84 (3.94–8.65), p < 0.0001, respectively. In the he ESKD cohort the distribution of the rs688 was compared between CVD+ and CVD- subgroups. A strong association of the polymorphism with the CVD risk was observed in this analysis. The frequencies of the T allele and TT genotype were significantly higher in CVD+ subgroup, with OR (95% CI) 3.4 (2.71–4.26), p < 0.0001 and 13.2 (7.87–22.09), p < 0.0001, respectively. A multivariate logistic regression analysis was performed to estimate the association between rs688 T variant and risk of CVD. After adjustment for age, sex, BMI, hypertension and diabetes, both CT and TT genotypes were associated with an increased risk of developing CVD in the dominant, recessive and codominant models of inheritance. No significant differences in serum LDL cholesterol levels were found when compared between genotypes. Conclusions The present study is the first to demonstrate the association of the LDLR gene polymorphism with increased susceptibility to cardiovascular disease in ESKD patients. This finding needs further investigation to confirm that LDLR rs688 might be a novel genetic risk factor with some prognostic capacity for CVD in ESKD patients.
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Affiliation(s)
- Monika Buraczynska
- Department of Nephrology, Medical University of Lublin, Jaczewskiego 8, 20-950, Lublin, Poland.
| | - Jerry Jacob
- Hope Medical Institute, Newport News, Virginia, USA
| | - Karolina Gwiazda-Tyndel
- Department of Nephrology, Medical University of Lublin, Jaczewskiego 8, 20-950, Lublin, Poland
| | - Andrzej Ksiazek
- Department of Nephrology, Medical University of Lublin, Jaczewskiego 8, 20-950, Lublin, Poland
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23
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Ashton V, Kerolus‐Georgi S, Moore KT. The Pharmacology, Efficacy, and Safety of Rivaroxaban in Renally Impaired Patient Populations. J Clin Pharmacol 2021; 61:1010-1026. [PMID: 33599985 PMCID: PMC8360104 DOI: 10.1002/jcph.1838] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 02/14/2021] [Indexed: 01/25/2023]
Abstract
Rivaroxaban is a factor Xa inhibitor oral anticoagulant first approved for use in the United States in 2011. Under the drug class commonly termed direct oral anticoagulants, rivaroxaban is approved for the most indications within its class, 7 indications, which are: (1) reduction of risk of stroke and systemic embolism (SE) in nonvalvular atrial fibrillation, (2) treatment of deep vein thrombosis (DVT), (3) treatment of pulmonary embolism (PE), (4) reduction in the risk of recurrence of DVT and/or PE, (5) prophylaxis of DVT following hip or knee replacement surgery, (6) prophylaxis of venous thromboembolism in acutely ill medical patients at risk for thromboembolic complications not at high risk of bleeding, and (7) reduction of risk of major cardiovascular events in patients with chronic coronary artery disease or peripheral artery disease. Considering the relationship between cardiovascular disease, renal impairment, and the use of oral anticoagulants, the following targeted review was created. This review reports the results of the primary pharmacology, pharmacokinetic modeling, clinical safety and efficacy, and real-world postmarketing effectiveness and safety of rivaroxaban in patients with various degrees of renal impairment. Based on these data, rivaroxaban is a viable option for when anticoagulation is needed in patients who have both cardiovascular disease and renal impairment. However, as with any therapy, the benefits and risks of intervention should be carefully assessed and balanced. Patients treated with rivaroxaban for several of its approved indications should have their kidney function assessed prior to and during continued therapy to ensure consistency with the drug label.
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Affiliation(s)
- Veronica Ashton
- Janssen Pharmaceuticals, Inc.Janssen Scientific AffairsTitusvilleNew JerseyUSA
| | | | - Kenneth T. Moore
- Janssen Pharmaceuticals, Inc.Janssen Medical AffairsTitusvilleNew JerseyUSA
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24
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Wu X, Lin J, Xue N, Teng J, Wang Y, Li Y, Xu X, Shen Z, Ding X, Fang Y. Relationship Between Gene Polymorphism of Methylenetetrahydrofolate Reductase C677T and Left Ventricular Hypertrophy in Chinese Patients with Chronic Kidney Disease. Lab Med 2021; 52:519-527. [PMID: 33693817 DOI: 10.1093/labmed/lmab004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE This study aimed to investigate the relationship between the gene polymorphism of methylenetetrahydrofolate reductase (MTHFR) C677T and left ventricular hypertrophy (LVH) in patients with chronic kidney disease (CKD). METHODS A total of 763 Chinese patients with CKD undergoing genetic testing were included in the study. The association between the gene polymorphism of MTHFR C677T and echocardiographic parameters was analyzed through univariate and multivariate analyses. RESULTS We found a remarkably positive association between MTHFR C677T gene polymorphism and LVH indexes, including interventricular septal thickness (F = 3.8; P = .022), left ventricular posterior wall thickness (F = 3.0; P = .052), left ventricular mass (F = 3.9; P = .022), and left ventricular mass index (F = 2.6; P = .075). After adjusting for the potential confounders linking the polymorphism,we found that the positive association between the polymorphism and LVH indexes still existed in patients with CKD in some multiple linear regression models (P <.05). CONCLUSION MTHFR C677T gene polymorphism may be a genetic susceptibility marker for the development of LVH in patients with CKD.
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Affiliation(s)
- Xie Wu
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Key Laboratory of Kidney and Blood Purification, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Jing Lin
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Key Laboratory of Kidney and Blood Purification, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Medical Center of Kidney Disease, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Institute of Kidney and Dialysis, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Ning Xue
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Medical Center of Kidney Disease, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Institute of Kidney and Dialysis, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Jie Teng
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Key Laboratory of Kidney and Blood Purification, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Medical Center of Kidney Disease, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Institute of Kidney and Dialysis, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yaqiong Wang
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Medical Center of Kidney Disease, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Institute of Kidney and Dialysis, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yang Li
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Key Laboratory of Kidney and Blood Purification, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Xunhui Xu
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Key Laboratory of Kidney and Blood Purification, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Ziyan Shen
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Medical Center of Kidney Disease, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Institute of Kidney and Dialysis, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Xiaoqiang Ding
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Key Laboratory of Kidney and Blood Purification, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Medical Center of Kidney Disease, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Institute of Kidney and Dialysis, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yi Fang
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Key Laboratory of Kidney and Blood Purification, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Medical Center of Kidney Disease, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Institute of Kidney and Dialysis, Zhongshan Hospital, Fudan University, Shanghai, China
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25
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Takeuchi M, Dohi T, Takahashi N, Endo H, Doi S, Kato Y, Okai I, Iwata H, Okazaki S, Isoda K, Miyauchi K, Minamino T. The prognostic implications of chronic kidney disease and anemia on long-term outcomes in patients undergoing percutaneous coronary intervention. Heart Vessels 2021; 36:1117-1124. [PMID: 33606067 DOI: 10.1007/s00380-021-01794-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 01/22/2021] [Indexed: 11/26/2022]
Abstract
Chronic kidney disease (CKD) and anemia are each individually associated with worse clinical outcomes in patients with coronary artery disease (CAD). However, the prognostic impact of both CKD and anemia on clinical outcomes, when they coexist, remains unclear in CAD patients after percutaneous coronary intervention (PCI). We studied 2484 CAD patients who underwent their first PCI and had available date on preprocedural hemoglobin between 2000 and 2016. The patients were divided into four groups according to the presence of CKD and/or anemia. We evaluated the incidences of all-cause death and major adverse cardiac and cerebrovascular events (MACCEs), including cardiovascular death, non-fatal myocardial infarction, and stroke. Among the patients, 310 patients (12.5%) had both CKD and anemia (CKD with anemia group), 309 (12.4%) had CKD only, 461(18.6%) had anemia only, and 1404 (56.5%) had neither CKD nor anemia. Patients in the CKD with anemia group were older and had a higher incidence of hypertension and diabetes mellitus. During a median follow-up period of 3.7 years, Kaplan-Meier curves showed that patients in the CKD with anemia group had significantly higher incidences of MACCE and all-cause death than the CKD only and anemia only group (both log-rank p < 0.001). Using patients with the no CKD or anemia group as a reference, the adjusted hazard ratios (HRs), 95% confidence interval for MACCE were 1.51 (0.92-2.47) for the CKD only, 1.48 (0.94-2.32) for the anemia only and 2.00 (1.18-3.38) for the CKD with anemia group. Moreover, the adjusted HR for all-cause death were 1.42 (0.96-2.10) for the CKD only, 1.79 (1.28-2.51) for the anemia only, and 1.92 (1.30-2.84) for the CKD with anemia group. In conclusion, the combined effects of both CKD and anemia on outcomes after PCI were worse than either of their individual effects.
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Affiliation(s)
- Mitsuhiro Takeuchi
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Tomotaka Dohi
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
| | - Norihito Takahashi
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Hirohisa Endo
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Shinichiro Doi
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Yoshiteru Kato
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Iwao Okai
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Hiroshi Iwata
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Shinya Okazaki
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Kikuo Isoda
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Katsumi Miyauchi
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Tohru Minamino
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
- Japan Agency for Medical Research and Development-Core Research for Evolutionary Medical Science and Technology (AMED-CREST), Japan Agency for Medical Research and Development, Tokyo, Japan
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26
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Huang Q, Zhang F, Chen S, Dong Z, Liu W, Zhou X. Clinical characteristics in patients with coronary slow flow phenomenon: A retrospective study. Medicine (Baltimore) 2021; 100:e24643. [PMID: 33578588 PMCID: PMC10545414 DOI: 10.1097/md.0000000000024643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 12/23/2020] [Accepted: 01/15/2021] [Indexed: 11/26/2022] Open
Abstract
ABSTRACT Coronary slow flow phenomenon (CSFP) is a coronary artery disease in which coronary angiography shows no obvious stenosis, but there is a delay in blood flow perfusion. The etiopathogenic mechanisms of CSFP are still unclear. The aim of the present study was to investigate the role of clinical characteristics in patients with CSFP, and to provide a reference for exploring the potential mechanisms of CSFP. Patients with angiographically normal epicardial arteries were enrolled (145 patients with CSFP and 145 normal controls). Collected clinical information and laboratory indexes, which measured by peripheral venous blood samples before coronary angiography. Logistic regression analysis was performed for statistical analysis. The present study found 19 clinical and laboratory indexes with statistical differences between the two groups in univariate analysis. Multivariate analysis showed that monocyte count, haemoglobin, serum creatinine and globulin were independent predictors of CSFP. Moreover, the monocyte count, haemoglobin, creatinine and globulin levels were significantly higher in the CSFP patients than the controls, with positive associations between these parameters and the extent of CSFP. In addition, ROC analysis showed the diagnostic value of the above indexes for CSFP.
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Affiliation(s)
- Qiaojuan Huang
- Department of Cardiology, the First Affiliated Hospital of Chongqing Medical University
| | - Fan Zhang
- Department of Epidemiology, School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Siyu Chen
- Department of Cardiology, the First Affiliated Hospital of Chongqing Medical University
| | - Zhaoying Dong
- Department of Cardiology, the First Affiliated Hospital of Chongqing Medical University
| | - Weiwei Liu
- Department of Cardiology, the First Affiliated Hospital of Chongqing Medical University
| | - Xiaoli Zhou
- Department of Cardiology, the First Affiliated Hospital of Chongqing Medical University
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27
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Yao M, Liu H, Li B, Liu Y, Mu Y. The Relationship Between Earlier Onset of Natural Menopause and Elevated Urinary Albumin-Creatinine Ratio in Postmenopausal Chinese Women. Diabetes Metab Syndr Obes 2021; 14:847-856. [PMID: 33658819 PMCID: PMC7920510 DOI: 10.2147/dmso.s292041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 02/05/2021] [Indexed: 12/29/2022] Open
Abstract
PURPOSE There is a close correlation between menopausal age and cardiovascular disease (CVD) risk. Some research suggests that this risk is attributable to an elevated urinary albumin-creatinine ratio (UACR), but further work is needed to explore the link between UACR and age at time of menopause. PATIENTS AND METHODS Data analyzed in the present study were derived from seven regional centers participating in the REACTION study. A total of 21,672 postmenopausal women met with our study inclusion and exclusion criteria, and were split into three groups based upon their age at onset of natural menopause. A UACR ≥ 30 mg/g was the primary outcome measure for this study. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated with a logistic regression approach. RESULTS Relative to women who were 46-50 years old at time of natural menopause, those with an earlier onset of menopause (≤45 years) exhibited an increased risk of UACR elevation following adjustment for confounding variables (OR: 1.18, 95% CI: 1.04-1.33), whereas the opposite was true for women with a later age of menopause onset (>50 years) (OR: 0.86, 95% CI: 0.78-0.94). For every 1-year delay in the onset of menopause, UACR risk fell by 3% (OR: 0.97, 95% CI: 0.96-0.98). CONCLUSION In summary, early menopause (≤45 years old) was linked to a higher risk of UACR elevation in postmenopausal women. However, further work will be needed to understand the mechanistic basis for these findings.
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Affiliation(s)
- Mingyan Yao
- Department of Endocrinology, Chinese People’s Liberation Army General Hospital, Beijing, 100853, People’s Republic of China
- Department of Endocrinology, Baoding NO.1 Central Hospital, Baoding, 071000, People’s Republic of China
| | - Hongzhou Liu
- Department of Endocrinology, Chinese People’s Liberation Army General Hospital, Beijing, 100853, People’s Republic of China
| | - Bing Li
- Department of Endocrinology, Chinese People’s Liberation Army General Hospital, Beijing, 100853, People’s Republic of China
| | - Yang Liu
- Department of Endocrinology, Chinese People’s Liberation Army General Hospital, Beijing, 100853, People’s Republic of China
| | - Yiming Mu
- Department of Endocrinology, Chinese People’s Liberation Army General Hospital, Beijing, 100853, People’s Republic of China
- Correspondence: Yiming Mu Department of Endocrinology, Chinese People’s Liberation Army General Hospital, No. 28 Fuxing Road, Beijing, 100853, People’s Republic of China Email
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28
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Assarzadeh S, Badri S, Vahdat S, Pourfarzam M, Seirafian S, Ataei S. Potential benefits of selenium supplementation in patients with kidney disease. J Res Pharm Pract 2021; 10:149-158. [PMID: 35769838 PMCID: PMC9235365 DOI: 10.4103/jrpp.jrpp_3_22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 02/08/2022] [Indexed: 11/05/2022] Open
Abstract
Trace element deficiency is common among patients with end-stage renal disease (ESRD); the reason is that since these patients undergo dialysis, they lose these elements more than healthy people, and also the use of trace elements is restricted due to loss of appetite. Selenium (Se) is a trace element that is essential for the oxidative stress defense system. Se deficiency leads to some complications similar to those often seen in ESRD patients, such as all-cause mortality due to cardiovascular diseases, bone loss, uric acid elevation, and anemia. This article aims to review the evidence on consequences of Se deficiency in ESRD patients, as well as effects of Se supplementation in hemodialysis patients. Multiple databases were searched to summarize the available evidence on selenium's role in kidney diseases. Since the complications of ESRD and those of Se deficiency are mostly similar, this triggers the idea that Se deficiency may be considered as a cause of these problems, but it needs to be more assessed that Se deficiency is a single factor or there are other factors participated in. Also the role of Se supplementation on resolving the mentioned complications, needs to be more studied through welldesigned clinical studies.
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29
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Przybyciński J, Dziedziejko V, Puchałowicz K, Domański L, Pawlik A. Adiponectin in Chronic Kidney Disease. Int J Mol Sci 2020; 21:ijms21249375. [PMID: 33317050 PMCID: PMC7764041 DOI: 10.3390/ijms21249375] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 12/01/2020] [Accepted: 12/07/2020] [Indexed: 12/14/2022] Open
Abstract
Adiponectin is the adipokine associated with insulin sensitization, reducing liver gluconeogenesis, and increasing fatty acid oxidation and glucose uptake. Adiponectin is present in the kidneys, mainly in the arterial endothelium and smooth muscle cells, as well as in the capillary endothelium, and might be considered as a marker of many negative factors in chronic kidney disease. The last few years have brought a rising body of evidence that adiponectin is a multipotential protein with anti-inflammatory, metabolic, anti-atherogenic, and reactive oxygen species (ROS) protective actions. Similarly, adiponectin has shown many positive and direct actions in kidney diseases, and among many kidney cells. Data from large cross-sectional and cohort studies showed a positive correlation between serum adiponectin and mortality in chronic kidney disease. This suggests a complex interaction between local adiponectin action, comorbidities, and uremic milieu. In this review we discuss the role of adiponectin in chronic kidney disease.
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Affiliation(s)
- Jarosław Przybyciński
- Department of Nephrology, Transplantology and Internal Medicine, Pomeranian Medical University in Szczecin, Powstańców Wlkp. 72, 70-111 Szczecin, Poland; (J.P.); (L.D.)
| | - Violetta Dziedziejko
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University in Szczecin, Powstańców Wlkp. 72, 70-111 Szczecin, Poland; (V.D.); (K.P.)
| | - Kamila Puchałowicz
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University in Szczecin, Powstańców Wlkp. 72, 70-111 Szczecin, Poland; (V.D.); (K.P.)
| | - Leszek Domański
- Department of Nephrology, Transplantology and Internal Medicine, Pomeranian Medical University in Szczecin, Powstańców Wlkp. 72, 70-111 Szczecin, Poland; (J.P.); (L.D.)
| | - Andrzej Pawlik
- Department of Physiology, Pomeranian Medical University in Szczecin, Powstańców Wlkp. 72, 70-111 Szczecin, Poland
- Correspondence: ; Tel.: +48-91-4661611
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30
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Dental caries status is associated with arteriosclerosis in patients on hemodialysis. Clin Exp Nephrol 2020; 25:87-93. [PMID: 32918134 DOI: 10.1007/s10157-020-01966-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 08/27/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND We previously found that worse dental caries status was associated with high pulse pressure among patients on hemodialysis, indicating that such patients might have arteriosclerosis. In this study, we used abdominal computed tomography to evaluate arteriosclerosis in patients on hemodialysis and investigated the association between arteriosclerosis and dental caries status. We also prospectively examined risk factors associated with 2-year prognosis. METHODS The dental caries and periodontal disease statuses of 80 patients on hemodialysis were evaluated using the decayed, missing, or filled teeth (DMFT) index, and periodontal pocket depth, respectively. The aortic calcification index was semiquantitatively measured using computed tomography images of the abdominal aorta. Clinical data were also analyzed after all patients on hemodialysis provided written, informed consent to participate in the study. RESULTS Regression analysis demonstrated a significant correlation between the DMFT and aortic calcification indexes. Multiple regression analysis showed that the DMFT index was significantly correlated with the aortic calcification index, following adjustment for age, sex, and dialysis period. Thirteen of the 80 patients died during the 2-year follow-up period; logistic regression analysis showed that mortality rate was significantly associated with the aortic calcification index, but not the DMFT index. However, periodontal pocket depth was not correlated with the aortic calcification index. CONCLUSION These findings suggest that worse dental caries status could be associated with arteriosclerosis among patients on hemodialysis, which may indirectly affect the prognosis of arteriosclerosis in these patients.
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Duran M, Elcik D, Inanc MT, Yarlıoglues M, Celik IE, Oksuz F, Murat S. Relationship between mild renal dysfunction and coronary artery disease in young patients with stable angina pectoris. Biomark Med 2020; 14:433-440. [PMID: 32270689 DOI: 10.2217/bmm-2019-0319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: We investigated the relationship between mild renal dysfunction (MRD) and the presence of coronary artery disease (CAD) in people under 60 years of age. Materials & methods: A total of 634 (317 patients with vessel stenosis ≥50% and 317 with normal angiography) individuals diagnosed with stable angina pectoris and estimated glomerular filtration rate (eGFR) ≥60 ml/min/1.73 m2 were included in the present study. Results: The mean eGFR was lower (95.3 ± 23.7 vs 109.7 ± 22.3, respectively, p = 0.002) and the number of patients with MRD was higher in patients with CAD (137, 43.2%) than in the control group (52, 16.4%, p < 0.001). The multivariate analysis showed that lower eGFR is an independent risk factor for presence of CAD in people under 60 years of age with stable angina pectoris. Conclusion: According to our retrospective study, the risk of developing CAD appears to be slightly increased in individuals under 60 years of age with MRD.
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Affiliation(s)
- Mustafa Duran
- Department of Cardiology, Faculty of Hamidiye Medicine, University of Health Science Turkey, Ankara Research & Education Hospital, Ankara, Turkey
| | - Deniz Elcik
- Department of Cardiology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Mehmet T Inanc
- Department of Cardiology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Mikail Yarlıoglues
- Department of Cardiology, Faculty of Hamidiye Medicine, University of Health Science Turkey, Ankara Research & Education Hospital, Ankara, Turkey
| | - Ibrahim E Celik
- Department of Cardiology, Faculty of Hamidiye Medicine, University of Health Science Turkey, Ankara Research & Education Hospital, Ankara, Turkey
| | - Fatih Oksuz
- Department of Cardiology, Faculty of Hamidiye Medicine, University of Health Science Turkey, Ankara Research & Education Hospital, Ankara, Turkey
| | - Sani Murat
- Department of Cardiology, Faculty of Hamidiye Medicine, University of Health Science Turkey, Ankara Research & Education Hospital, Ankara, Turkey
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Jian W, Wei CM, Guan JH, Mo CH, Xu YT, Zheng WB, Li L, Gui C. Association between serum HER2/ErbB2 levels and coronary artery disease: a case-control study. J Transl Med 2020; 18:124. [PMID: 32160892 PMCID: PMC7066824 DOI: 10.1186/s12967-020-02292-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 03/05/2020] [Indexed: 12/12/2022] Open
Abstract
Background Research has associated human epidermal growth factor receptor (HER2) with glucose and lipid metabolism. However, the association between circulating HER2 levels and coronary artery disease (CAD) remains to be elucidated. Methods We performed a case–control study with 435 participants (237 CAD patients and 198 controls) who underwent diagnostic coronary angiography from September 2018 to October 2019. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for CAD were calculated with multiple logistic regression models after adjustment for confounders. Results Overall, increased serum HER2 levels were independently associated with the presence of CAD (OR per 1-standard deviation (SD) increase: 1.438, 95% CI 1.13–1.83; P = 0.003) and the number of stenotic vessels (OR per 1-SD increase: 1.399, 95% CI 1.15–1.71; P = 0.001). In the subgroup analysis, a significant interaction of HER2 with body mass index (BMI) on the presence of CAD was observed (adjusted interaction P = 0.046). Increased serum HER2 levels were strongly associated with the presence of CAD in participants with BMI ≥ 25 kg/m2 (OR per 1-SD increase: 2.143, 95% CI 1.37–3.35; P = 0.001), whereas no significant association was found in participants with BMI < 25 kg/m2 (OR per 1-SD increase: 1.225, 95% CI 0.90–1.67; P = 0.201). Conclusion Elevated HER2 level is associated with an increased risk of CAD, particularly in people with obesity. This finding yields new insight into the pathological mechanisms underlying CAD, and warrants further research regarding HER2 as a preventive and therapeutic target of CAD.
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Affiliation(s)
- Wen Jian
- Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University, 06 Shuangyong Road, Nanning, 530021, Guangxi, People's Republic of China.,Guangxi Key Laboratory Base of Precision Medicine in Cardio-Cerebrovascular Diseases Control and Prevention, Nanning, 530021, Guangxi, People's Republic of China.,Guangxi Clinical Research Center for Cardio-Cerebrovascular Diseases, Nanning, 530021, Guangxi, People's Republic of China
| | - Chun-Mei Wei
- Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University, 06 Shuangyong Road, Nanning, 530021, Guangxi, People's Republic of China.,Guangxi Key Laboratory Base of Precision Medicine in Cardio-Cerebrovascular Diseases Control and Prevention, Nanning, 530021, Guangxi, People's Republic of China.,Guangxi Clinical Research Center for Cardio-Cerebrovascular Diseases, Nanning, 530021, Guangxi, People's Republic of China
| | - Jia-Hui Guan
- Department of Respiratory Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, People's Republic of China
| | - Chang-Hua Mo
- Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University, 06 Shuangyong Road, Nanning, 530021, Guangxi, People's Republic of China
| | - Yu-Tao Xu
- Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University, 06 Shuangyong Road, Nanning, 530021, Guangxi, People's Republic of China.,Guangxi Key Laboratory Base of Precision Medicine in Cardio-Cerebrovascular Diseases Control and Prevention, Nanning, 530021, Guangxi, People's Republic of China.,Guangxi Clinical Research Center for Cardio-Cerebrovascular Diseases, Nanning, 530021, Guangxi, People's Republic of China
| | - Wen-Bo Zheng
- Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University, 06 Shuangyong Road, Nanning, 530021, Guangxi, People's Republic of China.,Guangxi Key Laboratory Base of Precision Medicine in Cardio-Cerebrovascular Diseases Control and Prevention, Nanning, 530021, Guangxi, People's Republic of China.,Guangxi Clinical Research Center for Cardio-Cerebrovascular Diseases, Nanning, 530021, Guangxi, People's Republic of China
| | - Lang Li
- Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University, 06 Shuangyong Road, Nanning, 530021, Guangxi, People's Republic of China.,Guangxi Key Laboratory Base of Precision Medicine in Cardio-Cerebrovascular Diseases Control and Prevention, Nanning, 530021, Guangxi, People's Republic of China.,Guangxi Clinical Research Center for Cardio-Cerebrovascular Diseases, Nanning, 530021, Guangxi, People's Republic of China
| | - Chun Gui
- Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University, 06 Shuangyong Road, Nanning, 530021, Guangxi, People's Republic of China. .,Guangxi Key Laboratory Base of Precision Medicine in Cardio-Cerebrovascular Diseases Control and Prevention, Nanning, 530021, Guangxi, People's Republic of China. .,Guangxi Clinical Research Center for Cardio-Cerebrovascular Diseases, Nanning, 530021, Guangxi, People's Republic of China.
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Deng W, Peng L, Yu J, Shuai T, Chen Z, Li Z. Characteristics of coronary artery atherosclerotic plaques in chronic kidney disease: evaluation with coronary CT angiography. Clin Radiol 2019; 74:731.e1-731.e9. [PMID: 31285036 DOI: 10.1016/j.crad.2019.06.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 06/12/2019] [Indexed: 02/06/2023]
Abstract
AIM To determine the characteristics of coronary artery atherosclerotic plaques in chronic kidney disease (CKD) with coronary computed tomography angiography (CTA). MATERIALS AND METHODS Sixty-six patients with CKD who underwent coronary CTA were analysed retrospectively. The extent, distribution, and types of plaques and stenosis severity were evaluated. The imaging features were compared between dialysis and non-dialysis groups. In the dialysis group, the imaging features were compared between diabetes and non-diabetes patients. RESULTS In total, 152 coronary vessels (2.3±1.3 per patient) and 306 segments (4.6±3.5 per patient) were found to have plaques. The most common diseased coronary vessel was the left anterior descending (LAD) artery (53 vessels, 34.9%) followed by the left circumflex (LCX) artery (39 vessels, 25.7%), and right coronary artery (RCA; 37 vessels, 24.3%) in sequence. The most commonly involved coronary artery segment was the middle segment of LAD artery (14.1%). Calcified plaques (65.9%) were detected more frequently than mixed (25.6%) or non-calcified (8.5%) plaques (p<0.001). Among the degrees of coronary stenosis, minimal stenosis (55.8%) was the most common (p<0.001). The majority of calcified plaques were non-obstructive plaques (n=134, 78.2%), while about half of non-calcified (n=14, 63.6%) and mixed plaques (n=30, 45.5%) were obstructive plaques (p<0.001). CONCLUSION A heavy plaque burden was detected in CKD patients at coronary CTA. Non-obstructive calcified plaque was the most common imaging feature. CKD patients with type 2 diabetes mellitus had more obstructive mixed plaques.
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Affiliation(s)
- W Deng
- Department of Radiology, and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - L Peng
- Department of Radiology, and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
| | - J Yu
- Department of Radiology, and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - T Shuai
- Department of Radiology, and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Z Chen
- Department of Radiology, and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Z Li
- Department of Radiology, and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
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