Cardiovascular Disease and CKD: Core Curriculum 2010

Shastri, Shani; Sarnak, Mark J.

doi:10.1053/j.ajkd.2010.03.019

Cited by 63 publications

(48 citation statements)

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“…The National Kidney Foundation (NKF) developed initial recommendations pertaining to CVD risk in diabetic and hypertensive patients with increased urinary albumin excretion 22) . Subsequently, these were expanded not only to patients with early evidence of CKD, but also to patients with advanced CKD and receiving renal replacement therapies 17,23) . Thus, the presence of CKD was considered a risk equivalent for CVD, thereby placing these patients at the highest risk.…”

Section: )mentioning

confidence: 99%

Lipid Abnormalities in Patients with Chronic Kidney Disease: Implications for the Pathophysiology of Atherosclerosis

Keane

Tomassini

Neff

2013

JAT

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Cardiovascular disease is increased in patients with chronic kidney disease (CKD) and is the principle cause of morbidity and mortality in these patients. In patients with stage 5 CKD, structural changes in the myocardium have been implicated as the principle cardiovascular processes leading to this increase in morbidity and mortality, while atherosclerotic events including acute myocardial infarction and strokes are responsible for approximately 10-15% of cardiovascular deaths. Dyslipidemia is common in CKD patients and is usually not characterized by elevated cholesterol levels, except in patients with marked proteinuria. Increased triglyceride levels in conjunction with decreased highdensity lipoprotein levels are the commonest qualitative abnormality. Characteristically, abnormalities in the metabolism of apolipoprotein (apo) B-containing lipoproteins have been described, including both gut derived (apoB-48) as well as those produced by hepatic synthesis (apoB-100). A decrease in enzymatic delipidation as well as reduced receptor removal of these lipoproteins both contribute to the increased levels of these apo-B-containing particles and their remnants (which are believed to be highly atherogenic). Abnormalities in the metabolism of apoA-containing lipoproteins are also present and these changes contribute to the lower levels of HDL seen. Qualitative abnormalities of these HDL particles may be associated with cellular oxidative injury and contribute to a proinflammatory, pro-thrombotic milieu that is frequently present in CKD patients. J Atheroscler

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confidence: 99%

Lipid Abnormalities in Patients with Chronic Kidney Disease: Implications for the Pathophysiology of Atherosclerosis

Keane

Tomassini

Neff

2013

JAT

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“…2 Quando consideradas todas as causas de morte, cerca de 30% são classificadas como parada cardíaca, morte de causa desconhecida ou arritmia cardíaca. 2,3 Pacientes em hemodiálise apresentam maior taxa de morte por arritmia cardíaca, quando comparada à diálise peritoneal (62 versus 42 eventos/1000 pacientes/ ano), 4 com maior propensão das ocorrências nas últi-mas 12 horas do maior período interdialítico e nas 12 horas que se sucedem a uma sessão de hemodiálise. 5 A hemodiálise per se parece impor um risco adicional de MSC induzido pela sobrecarga hemodinâ-mica e pelo estresse inflamatório, dadas as observações de isquemia miocárdica intradialítica, redução do intervalo RR no eletrocardiograma e à maior frequência de alterações de repolarização ventricular, com prolongamento de intervalo QT e suscetibilidades às arritmias ventriculares.…”

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Electrocardiographic findings in chronic hemodialysis patients

Bignotto¹,

Kallás²,

Djouki³

et al. 2012

Jornal Brasileiro De Nefrologia

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“…1,2 Vascular calcification, which results in increased vascular stiffness, is a common pathological feature of hemodialysis patients 1,3 and is accompanied by left ventricular hypertrophy (LVH) and diastolic dysfunction. 4,5 Vascular calcification is an active process controlled by a balance of serum calcification inhibitors and enhancers.…”

Section: Introductionmentioning

confidence: 99%

The balance of fetuin-A and osteoprotegerin is independently associated with diastolic dysfunction in hemodialysis patients

et al. 2011

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Fetuin-A and osteoprotegerin (OPG) are arterial calcification regulators, which are related to cardiovascular survival in hemodialysis patients. We hypothesized that a balance of these calcification regulators might mediate the progression of left ventricular (LV) diastolic dysfunction in hemodialysis patients. We recruited 63 hemodialysis patients and measured their serum fetuin-A, OPG, arterial stiffness, aortic calcification and echocardiographic parameters, including the transmitral early diastolic velocity/tissue Doppler mitral annular early diastolic velocity ratio (E/E¢), and analyzed the relationships between these variables. Fetuin-A levels were significantly and negatively correlated with the ankle-brachial pulse wave velocity (baPWV), aortic calcification score (AOCS), left atrial volume index (LAVI), LV mass index (LVMI) and E/E¢. OPG levels and the ratio of OPG to fetuin-A levels were significantly and positively correlated with the baPWV, AOCS, LAVI and E/E¢. A stepwise multiple regression analysis revealed that E/E¢ was independently correlated with fetuin-A levels (b¼À0.334, P¼0.02), OPG levels (b¼0.367, P¼0.01) and the ratio of OPG to fetuin-A (b¼0.295, P¼0.04). Categorizing the patients according to their serum fetuin-A and OPG levels revealed that patients with low fetuin-A and high OPG levels had the highest LAVI, LVMI and E/E¢ values after adjusting for potential confounders. Serum fetuin-A levels negatively reflected, whereas OPG levels and the ratio of OPG to fetuin-A positively reflected an increase in vascular and ventricular stiffness, leading to the aggravation of diastolic dysfunction. Therefore, based on our results, the balance of the tissue calcification regulators fetuin-A and OPG could mediate the progression of LV diastolic dysfunction in hemodialysis patients.

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Cardiovascular Disease and CKD: Core Curriculum 2010

Cited by 63 publications

References 0 publications

Lipid Abnormalities in Patients with Chronic Kidney Disease: Implications for the Pathophysiology of Atherosclerosis

Lipid Abnormalities in Patients with Chronic Kidney Disease: Implications for the Pathophysiology of Atherosclerosis

Electrocardiographic findings in chronic hemodialysis patients

The balance of fetuin-A and osteoprotegerin is independently associated with diastolic dysfunction in hemodialysis patients

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