Chronic Kidney Disease and Arrhythmias: Conclusions From a Kidney Disease: Improving Global Outcomes (Kdigo) Controversies Conference

Carrero, Juan-Jesús; Clase, Catherine M.; Deo, Rajat; Herzog, Charles A.; Kasner, Scott E.; Passman, Rod; Pécoits-Filho, Roberto; Reinecke, Holger; Shrof, Gautam R.; Zaręba, Wojciech; Cheung, Michael; Wheeler, David C.; Winkelmayer, Wolfgang C.; Wanner, Christoph; Turakhia, Mintu P.

doi:10.24884/1561-6274-2019-23-2-18-40

Cited by 5 publications

(1 citation statement)

References 183 publications

(187 reference statements)

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“…Ведущее эффекторное звено ренин-ангиотензин-альдостероновой системы (РААС) АТ II регулирует транспорт натрия с помощью эпителиоцитов кишечника и почек [3]. Следует отметить также, что локально продуцированный АТ II вызывает воспаление, пролиферацию клеток, митоз, апоптоз, миграцию и дифференцирование клеток, регулирует генную экспрессию биоактивных веществ и активирует множественные внутриклеточные сигнальные пути, многие из которых способствуют повреждению органов и тканей [4]. В развитии и прогрессировании хронической болезни почек (ХБП) огромную роль играет также гиперактивация локальной РААС [5].…”

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Role of angiotensin-converting enzyme inhibitors in reducing cardiovascular and cerebral complications in chronic kidney disease: focus perindopril

Муркамилов

2021

Klinicist

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In the development of renocardial relationships in chronic kidney disease, an important role is given to the activation of the renin-angiotensin-aldosterone system (RAAS), as the main component of the progression and development of cardiovascular complications..The presented review is devoted to the analysis of modern scientific data on the effect of high RAAS activity in chronic kidney disease on the course and prognosis of cardiovascular complications, as well as the protective capabilities of angiotensin-converting enzyme inhibitors, in particular perindopril. The results of scientific research on the role of the RAAS in the progression of chronic kidney disease are summarized. Data on chronic kidney disease as a risk factor for cardiovascular and cerebral complications are presented. Attention is focused on the possibilities of prolonging the pre-dialysis period of chronic kidney disease when using angiotensin-converting enzyme inhibitors. The role of perindopril as a lipophilic angiotensin-converting enzyme inhibitor with a high affinity for tissue RAAS was emphasized in reducing cardiovascular and cerebral risk in chronic kidney disease.

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Role of angiotensin-converting enzyme inhibitors in reducing cardiovascular and cerebral complications in chronic kidney disease: focus perindopril

Муркамилов

2021

Klinicist

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Atrial fibrillation and chronic kidney disease: main clinical characteristics of patients in selected subjects of the Russian Federation

Druzhilov,

Kuznetsova,

Druzhilova

et al. 2023

Cardiovasc Ther Prev

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Aim. To compare clinical characteristics of patients with atrial fibrillation (AF) depending on renal filtration function based on a retrospective analysis of data in individual subjects of the Russian Federation (RF).Material and methods. The information was taken from the Webiomed predictive analytics platform, including 80775 patients with AF (men, 42,5%, mean age, 70,0±14,3 years) who underwent outpatient and/or inpatient treatment in medical organizations in 6 Russian subjects in 2016-2019 with data on blood creatinine levels. For comparative analysis, the ranges of estimated glomerular filtration rate (eGFR) were selected: ≥60 ml/min/1,73 m2, 30–59 ml/min/1,73 m2, and <30 ml/min/1,73 m2.Results. The analysis showed that 45128 (55,9%) patients were characterized by eGFR <60 ml/min/1,73 m2, of which in 35212 (78%) patients eGFR was in the range of 30-59 ml/min/1,73 m2, in 9916 (22%) — <30 ml/min/1,73 m2. Patients with eGFR <60 ml/min/1,73 m2 compared with those with eGFR ≥60 ml/min/1,73 m2 were older (75,4±10,9 vs 63,0±15,2 years, p<0,001), had higher incidence of ischemic stroke (IS) (10,9 vs 6,5%, p<0,001), myocardial infarction (MI) (11,5 vs 7,7%, p<0,001) and intracranial hemorrhage (ICH) (1,0 vs 0,7%, p<0,01), as well as higher rate of anticoagulant therapy (ACT) (47,0 vs 33,2%, p<0,001). Men and women with eGFR of 30-59 and <30 ml/min/1,73 m2 in the age ranges ≤64 years and 65-74 years had a higher incidence of IS and MI compared with patients with eGFR ≥60 ml/min/173 m2. The frequency of ICH on warfarin compared with direct oral anticoagulants was significantly higher in the subgroup with eGFR of 30-59 ml/min/1,73 m2 (1,1 vs 0,7%, p<0,01).Conclusion. Patients with AF and eGFR <60 ml/min/1,73 m2 are characterized by greater comorbidity, a higher incidence of IS, MI and ICH compared with patients with AF and eGFR ≥60 ml/min/1,73 m2, while ACT prescription rate as of 2016-2019 in some Russian subjects was unsatisfactory. This emphasizes the need to optimize risk stratification, ACT and algorithms for the prevention of atherothrombotic events, as well as the development of nephroprotective strategies to reduce the rate of progression of renal dysfunction in this cohort of patients.

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Atrial fibrillation in patients with chronic kidney disease: features of pathogenesis and treatment

Bakulina,

Scherbakov,

Anikonova

2023

Cardiac Arrhythmias

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Atrial fibrillation (AF) is the most commonly diagnosed cardiac arrhythmia in adults, the frequency of which increases in patients with chronic kidney disease (CKD). The substrate for the development of AF is atrial cardiomyopathy, which includes structural, electrophysiological and molecular remodeling of the atria. AF, in turn, can initiate and accelerate the progression of CKD. Such a bidirectional relationship causes a frequent combination of these two conditions, leading to both a prothrombotic state and an increased risk of bleeding. In patients with CKD, the pharmacokinetics of drugs used in AF are changing, what limits their use in CKD S4/S5. If previously patients with CKD S4-5 were excluded from randomized clinical trials (RCTs) on treatment strategies for AF, a number of such studies on their management have been published to date. The purpose of the article is to review existing ideas about the features of the pathogenesis of AF in CKD and strategies of recent years for the treatment of AF with advanced stages of CKD.

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Chronic Kidney Disease and Arrhythmias: Conclusions From a Kidney Disease: Improving Global Outcomes (Kdigo) Controversies Conference

Cited by 5 publications

References 183 publications

Role of angiotensin-converting enzyme inhibitors in reducing cardiovascular and cerebral complications in chronic kidney disease: focus perindopril

Role of angiotensin-converting enzyme inhibitors in reducing cardiovascular and cerebral complications in chronic kidney disease: focus perindopril

Atrial fibrillation and chronic kidney disease: main clinical characteristics of patients in selected subjects of the Russian Federation

Atrial fibrillation in patients with chronic kidney disease: features of pathogenesis and treatment

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