Measures of small and large artery dysfunction have not been investigated in a single cohort for the prediction of cardiovascular (CV) events in patients with nondialysed (ND) chronic kidney disease (CKD). This prospective cohort study aimed to determine whether central pulse wave velocity (cPWV), central pulse pressure (CPP) or microvascular post-occlusive reactive hyperaemia area (PORHHA) independently predict CV events and mortality in CKD-ND. A total of 94 stage 1-5 CKD-ND (65.3±13.1 years; estimated glomerular filtration rate 35.3 (22.8-49.4) ml min(-1) per 1.73 m(2)) patients were followed-up for a median of 52 (36-65) months and had baseline cPWV and CPP measured by applanation tonometry and PORHHA by laser Doppler flowmetry. Multiple failure time Cox regression models were used to determine the predictive role of vascular parameters on CV mortality and events. Based on multiple linear regressions, baseline age, diabetes, CV disease, and systolic blood pressure (SBP) were independently related to cPWV (R(2)=0.3), SBP and PORHHA to CPP (R(2)=0.45), whereas CPP was the only parameter independently related to PORHHA (R(2)=0.16, all P<0.05). During follow-up, 41 CV events occurred (14 CV deaths). In univariate analyses, cPWV (1.07 (1.02-1.13) per m s(-1)), CPP (1.04 (1.01-1.07) per mm Hg) and lnPORHHA (0.70 (0.58-0.85) per ln(PU × s)) were all related to the outcome. Baseline diabetes (HR 3.07 (1.65-5.68)), lnFGF23 (fibroblast growth factor-23; 1.86 (1.13-3.06) per RU ml(-1)) and CPP (1.04 (1.01-1.07) per mm Hg) were independent predictors of CV events. The impaired pulsatile component of large arteries (CPP) independently of other vascular markers (cPWV, PORHHA) predicted CV outcomes in CKD-ND. CPP may integrate the information provided by cPWV and PORHHA.

Objective: The role of biochemical and functional markers of microvascular dysfunction to predict cardiovascular (CV) outcomes in non-dialyzed chronic kidney disease (CKD) remains unclear. In this prospective cohort study we assessed whether biochemical (serum level of angiopoietin-2 (Ang-2), asymmetric and symmetric dimethylarginin (ADMA, SDMA)) and functional (laser Doppler flowmetry (LDF)) measures of microvascular function predicted CV events, CV and all-cause mortality in CKD patients.Methods: Post-occlusive reactive hyperemia area (PORH HA ), acetylcholine and sodium nitroprusside-mediated flow changes were estimated by LDF and Ang-2, ADMA and SDMA were assessed in 105 CKD patients at baseline. Multiple failure time Cox-regression analyses with backward elimination were performed to determine the predictors of the combined endpoint of CV mortality plus CV events or all-cause mortality plus CV events during a median of 66.6 (IQR 39.8-80.4) months of follow-up. Results:In univariate models lnAng-2 and lnPORH HA both predicted the CV outcome besides age, diabetes, baseline CV disease, brachial pulse pressure and lnCRP. In multivariate analysis lnPORH HA (HR: 0.66 (95%CI: 0.49-0.89) per ln(mU*sec)), age (1.03 (1.01-1.06) per year), lnCRP (1.31 (1.06-1.64) per ln(mg/L)) and diabetes (3.33 (1.70-6.53)) remained significant predictors of the CV outcome while lnAng-2 did not enter the model. Neither of the microvascular variables were an independent predictor of all-cause mortality plus CV events. Conclusions:Among the functional and biochemical microvascular parameters PORH HA seems to improve CV risk assessment in CKD. Nevertheless the robustness of traditional risk factors seems to outweigh the role of microvascular biomarkers on all-cause mortality plus CV events at this time.

Objectives: To assess the prevalence of snacking and to explore the relationship between snacking and several demographic, anthropometric, functional and biochemical factors. Methods: The study included 756 individuals over 18 years of age from Medias, Romania. Demographics and data about snacking were collected by trained volunteers. Height, weight, waist circumference, blood pressure were measured with standard equipment according to accepted procedures. Blood glucose and cholesterol were measured by experienced nurses using portable devices. Associations between variables were checked with the Pearson Chi-square test. Odds ratios and 95% confidence intervals were calculated to measure the association between binary variables. Results: About half of the subjects in the studied sample reported snacking less than 2 times / week, 34.5% between 3-4 times / week and 14.8% more than 4 times / week. Statistical analysis found that snacking was associated with gender (males being less likely to snack than females), ethnicity (non-Romanians being less likely to snack than Romanian ethnics), marital status of the subjects (not married people being less likely to snack than married people ), systolic blood pressure (people consuming more often snacks being less likely to have high systolic blood pressure values), and blood sugar level (people eating more frequently between meals being more likely to have higher blood glucose levels). Conclusions: Snacking was a widespread eating habit among the study participants and was significantly associated with gender, ethnicity, marital status, systolic blood pressure and blood glucose levels.

Objectives: Autoimmune gastritis (AG) is a rare condition that increases the risk of developing stomach adenocarcinomas or carcinoid tumours. The objectives of the present research were to summarise the clinical traits of AG patients, together with gastroscopic and histopatho-logic findings, demographic data, and hematologic characteristics. Patients and methods: A medical centre assessed 58 AG patients from January 2019 to December 2022. Results: The majority of the patients were female (73.7%), and the mean age of the participants at the time of the diagnosis was 57.7 ± 12.1 years. We identified pernicious anaemia (54.4%), iron deficiency anaemia (21.1%), as well as autoimmune disorders (96.5%). Though 78.9% of patients reported having gastrointestinal symptoms, 69% presented exclusively upper gastrointestinal symptoms, 17% only had lower, and 14% had concurrent upper and lower gastrointestinal symptoms. All 58 AG patients were examined for associated gastric lesions, although abnormal injuries were detected in only 22 of them. One patient (1.8%) had adenocarcinoma, while five patients (8.8%) had type 1 neuroendocrine tumours (NET). In addition, hyperplastic polyps were found in 16 (28.1%) individuals. Conclusions: Other autoimmune diseases were present with AG, which showed a female predominance. Clinicians should give AG more significant thought by allowing access to interdisciplinary teams.