Selected cardiovascular risk factors in early stages of chronic kidney disease

Jagieła, Joanna; Bartnicki, Piotr; Rysz, Jacek

doi:10.1007/s11255-019-02349-1

Cited by 8 publications

(5 citation statements)

References 106 publications

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“…Oxidative stress in chronic kidney disease is mediated by multiple factors, mainly due to impaired antioxidant mechanisms and increased production of reactive oxygen species (ROS) ( Düsing et al, 2021 ). To achieve redox homeostasis under physiological conditions, highly active antioxidant mediators [including catalase (CAT), glutathione peroxidase (GPX), and the free radical scavenger superoxide dismutase (SOD)] are present in the glomerulus ( Siems et al, 2002 ; Jagiela et al, 2020 ). The excessive production of ROS negatively affects various components of the renal unit, impairing the glomerular microcirculation and leading to glomerular ischemia in the long term ( Luczak et al, 2011 ).…”

Section: Oxidative Stress Mechanisms Parallel To Inflammationmentioning

confidence: 99%

Inflammation and Cardiovascular Disease Associated With Hemodialysis for End-Stage Renal Disease

Wang

Gao

2022

Front. Pharmacol.

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Chronic kidney disease (CKD) and cardiac insufficiency often co-exist, particularly in uremic patients on hemodialysis (HD). The occurrence of abnormal renal function in patients with cardiac insufficiency is often indicative of a poor prognosis. It has long been established that in patients with cardiac insufficiency, poorer renal function tends to indicate poorer cardiac mechanics, including left atrial reserve strain, left ventricular longitudinal strain, and right ventricular free wall strain (Unger et al., Eur J Heart Fail, 2016, 18(1), 103–12). Similarly, patients with chronic kidney disease, particularly uremic patients on HD, often have cardiovascular complications in addition to abnormal endothelial function with volume overload, persistent inflammatory states, calcium overload, and imbalances in redox responses. Cardiac insufficiency due to uremia is therefore mainly due to multifaceted non-specific pathological changes rather than pure renal insufficiency. Several studies have shown that the risk of adverse cardiovascular events is greatly increased and persistent in all patients treated with HD, especially in those who have just started HD treatment. Inflammation, as an important intersection between CKD and cardiovascular disease, is involved in the development of cardiovascular complications in patients with CKD and is indicative of prognosis (Chan et al., Eur Heart J, 2021, 42(13), 1244–1253). Therefore, only by understanding the mechanisms underlying the sequential development of inflammation in CKD patients and breaking the vicious circle between inflammation-mediated renal and cardiac insufficiency is it possible to improve the prognosis of patients with end-stage renal disease (ESRD). This review highlights the mechanisms of inflammation and the oxidative stress that co-exists with inflammation in uremic patients on dialysis, as well as the mechanisms of cardiovascular complications in the inflammatory state, and provides clinical recommendations for the anti-inflammatory treatment of cardiovascular complications in such patients.

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Section: Oxidative Stress Mechanisms Parallel To Inflammationmentioning

confidence: 99%

Inflammation and Cardiovascular Disease Associated With Hemodialysis for End-Stage Renal Disease

Wang

Gao

2022

Front. Pharmacol.

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“…Antioxidants 2024, 13, x FOR PEER REVIEW 2 of 20 urinary tract obstructions. It is noteworthy that some of these risk factors are modifiable, offering opportunities to delay or prevent the advancement of kidney failure [3][4][5][6].…”

Section: Uremic Toxinsmentioning

confidence: 99%

“…Other risk factors include smoking, excessive alcohol consumption, obesity, genetics, age, certain medications (such as NSAIDs and antibiotics), as well as recurrent kidney stones or urinary tract obstructions. It is noteworthy that some of these risk factors are modifiable, offering opportunities to delay or prevent the advancement of kidney failure [ 3 , 4 , 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

Role of Uremic Toxins, Oxidative Stress, and Renal Fibrosis in Chronic Kidney Disease

Frąk,

Dąbek,

Balcerczyk-Lis

et al. 2024

Antioxidants

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Affecting millions of people worldwide, chronic kidney disease is a serious medical problem. It results in a decrease in glomerular filtration rate below 60 mL/min/1.73 m, albuminuria, abnormalities in urine sediment and pathologies detected by imaging studies lasting a minimum of 3 months. Patients with CKD develop uremia, and as a result of the accumulation of uremic toxins in the body, patients can be expected to suffer from a number of medical consequences such as progression of CKD with renal fibrosis, development of atherosclerosis or increased incidence of cardiovascular events. Another key element in the pathogenesis of CKD is oxidative stress, resulting from an imbalance between the production of antioxidants and the production of reactive oxygen species. Oxidative stress contributes to damage to cellular proteins, lipids and DNA and increases inflammation, perpetuating kidney dysfunction. Additionally, renal fibrogenesis involving the accumulation of fibrous tissue in the kidneys occurs. In our review, we also included examples of forms of therapy for CKD. To improve the condition of CKD patients, pharmacotherapy can be used, as described in our review. Among the drugs that improve the prognosis of patients with CKD, we can include: GLP-1 analogues, SGLT2 inhibitors, Finerenone monoclonal antibody—Canakinumab and Sacubitril/Valsartan.

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“…Thus, the cardiovascular morbidity in those patients is substantially high, even in the early stages [ 4 , 5 ]. Myocardial stiffening due to hyperglycemia and hyperfiltration already appears and advances in early CKD, resulting in imperceptible subclinical diastolic dysfunction of heart without alteration in morphology [ 6 – 8 ]. These observations underscore the necessity for assessing and managing the subclinical diastolic dysfunction of type 2 diabetic CKD patients in the early stages, when the best possibility of effective treatment exists.…”

Section: Introductionmentioning

confidence: 99%

Vector flow mapping analysis of left ventricular vortex performance in type 2 diabetic patients with early chronic kidney disease

Chen,

Qiu,

Wang

et al. 2023

BMC Cardiovasc Disord

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Background Diabetes is the leading cause of chronic kidney disease (CKD) and contributes to an elevated incidence of diastolic dysfunction in the early stages of CKD. Intracardiac vortex is a novel hemodynamic index for perceiving cardiac status. Here, we visualized left ventricular (LV) vortex characteristics using vector flow mapping (VFM) in type 2 diabetic patients with early CKD. Methods This cross-sectional study included 67 controls and 89 type 2 diabetic patients with stages 2-3a CKD. All subjects underwent transthoracic echocardiographic examination. LV anterior vortex during early diastole (E-vortex), atrial contraction (A-vortex) and systole (S-vortex) were assessed using VFM in the apical long-axis view. Its relation to glycemia or LV filling echocardiographic parameters were further analyzed using correlation analysis. Results Type 2 diabetic patients with early CKD had a small area (439.94 ± 132.37 mm2 vs. 381.66 ± 136.85 mm2, P = 0.008) and weak circulation (0.0226 ± 0.0079 m2/s vs. 0.0195 ± 0.0070 m2/s, P = 0.013) of E-vortex, but a large area (281.52 ± 137.27 mm2 vs. 514.83 ± 160.33 mm2, P ˂ 0.001) and intense circulation (0.0149 ± 0.0069 m2/s vs. 0.0250 ± 0.0067 m2/s, P < 0.001) of A-vortex compared to controls. CKD patients with poorly controlled hyperglycemia had stronger A-vortex (area: 479.06 ± 146.78 mm2 vs. 559.96 ± 159.27 mm2, P = 0.015; circulation: 0.0221 ± 0.0058 m2/s vs. 0.0275 ± 0.0064 m2/s, P < 0.001) and S-vortex (area: 524.21 ± 165.52 mm2 vs. 607.87 ± 185.33 mm2, P = 0.029; circulation: 0.0174 ± 0.0072 m2/s vs. 0.0213 ± 0.0074 m2/s, P = 0.015), and a longer relative duration of S-vortex (0.7436 ± 0.0772 vs. 0.7845 ± 0.0752, P = 0.013) than those who had well-controlled hyperglycemia. Glycemia, and E/A (a LV filling parameter) were respectively found to had close correlation to the features of A-vortex and S-vortex (all P < 0.05). Conclusions Abnormal LV vortices were detected in type 2 diabetic patients with early CKD using VFM, especially in those who neglected hyperglycemic control. LV vortex might be a promising parameter to slow or halt the hyperglycemia-induced diastolic dysfunction in early CKD.

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Selected cardiovascular risk factors in early stages of chronic kidney disease

Cited by 8 publications

References 106 publications

Inflammation and Cardiovascular Disease Associated With Hemodialysis for End-Stage Renal Disease

Inflammation and Cardiovascular Disease Associated With Hemodialysis for End-Stage Renal Disease

Role of Uremic Toxins, Oxidative Stress, and Renal Fibrosis in Chronic Kidney Disease

Vector flow mapping analysis of left ventricular vortex performance in type 2 diabetic patients with early chronic kidney disease

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