Sudden cardiac death and chronic kidney disease: From pathophysiology to treatment strategies

Lullo, Luca Di; Rivera, Rodolfo; Barbera, Vincenzo; Bellasi, Antonio; Cozzolino, Mario; Russo, Domenico; Pascalis, Antonio De; Banerjee, Debasish; Floccari, Fulvio; Ronco, Claudio

doi:10.1016/j.ijcard.2016.04.170

Cited by 82 publications

(74 citation statements)

References 125 publications

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“…Additionally, myocardial structural changes, endothelial dysfunction, and vascular calcification, combined with dialytic and electrolyte changes, result in a 14-fold increase in sudden cardiac death [11,13,14]. On the other hand, platelet dysfunction combined with excess dosing of antiplatelet and antithrombotic medication in patients with renal insufficiency results in increased morbidity and mortality [15].…”

Section: Discussionmentioning

confidence: 99%

Revascularization versus Medical Management of Coronary Artery Disease in Prerenal Transplant Patients: A Meta-Analysis

Kamran¹,

Kupferstein²,

Sharma³

et al. 2018

Cardiorenal Med

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Introduction: End-stage renal disease requiring renal transplantation comprises a growing patient population at risk for cardiovascular disease (CVD) morbidity and mortality in large part due to accelerated atherosclerosis. Consequently, these patients are at even higher risk of major surgical CVD mortality. A paucity of research has addressed the posttransplantation CVD outcomes related to different treatment strategies in this patient population and therefore, there are no specific preoperative guidelines regarding management of coronary artery disease in this high-risk population undergoing renal transplantation. Objective: Through meta-analysis we compare coronary revascularization to medical management prior to renal transplantation in patients who are found to have significant obstructive coronary artery disease. Results: A total of 6 studies were deemed suitable out of 777 articles reviewed. This included 260 patients who received medical management and 338 who received coronary revascularization. There were 36 events in the revascularization and 57 events in the medical management group. One study only reported hazard ratios but no CVD outcomes. Comprehensive Meta-Analysis software was used to calculate pooled odds ratio with 95% confidence intervals (CI) for the fixed effects. The data is presented as forest plots. The pooled odds ratio This work is sponsored in part by the Brooklyn Health Disparities Center NIH grant #P20 MD006875. DOI: 10.1159/000487763 193 Cardiorenal Med 20188:192-198 with 95% CI for the fixed effects was 1.415 (95% CI 0.885-2.263), p = 0.147, indicating that there is no difference in CVD outcomes between pretransplant treatment strategy. This observation suggests that the CVD outcomes posttransplantation are not affected when optimal medical therapy is used instead of coronary revascularization.

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Section: Discussionmentioning

confidence: 99%

Revascularization versus Medical Management of Coronary Artery Disease in Prerenal Transplant Patients: A Meta-Analysis

Kamran¹,

Kupferstein²,

Sharma³

et al. 2018

Cardiorenal Med

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“…CKD patients, especially those undergoing dialysis treatment, are more prone to develop arrhythmias, especially atrial fibrillation and ventricular tachyarrhythmias. Almost half of cardiovascular deaths in the end-stage kidney disease population are related to cardiac arrhythmia or sudden death [42] . The increased risk for sudden death seems to be particularly related to longer dialytic intervals in subjects undergoing thrice weekly hemodialysis treatment because of extreme shifts of electrolytes and fluids [42] .…”

Section: Crs Type 4 (Chronic Crs)mentioning

confidence: 99%

Cardiorenal Syndrome in Western Countries: Epidemiology, Diagnosis and Management Approaches

Ronco

Lullo

2016

Kidney Dis

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Background: It is well established that a large number of hospitalized patients present various degrees of heart and kidney dysfunction; primary disease of the heart or kidney often involves dysfunction or injury to the other. Summary: Based on above-cited organ cross-talk, the term cardiorenal syndrome (CRS) was proposed. Although CRS was usually referred to as abruption of kidney function following heart injury, it is now clearly established that it can describe negative effects of an impaired renal function on the heart and circulation. The historical lack of clear syndrome definition and complexity of diseases contributed to a waste of precious time especially concerning diagnosis and therapeutic strategies. The effective classification of CRS proposed in a Consensus Conference by the Acute Dialysis Quality Group essentially divides CRS into two main groups, cardiorenal and renocardiac CRS, on the basis of primum movens of disease (cardiac or renal); both cardiorenal and renocardiac CRS are then divided into acute and chronic according to disease onset. Type 5 CRS integrates all cardiorenal involvement induced by systemic disease. Key Messages: Prevalence and incidence data show a widespread increase of CRS also due to an increasing incidence of acute and chronic cardiovascular disease, such as acute decompensated heart failure, arterial hypertension and valvular heart disease. Patients with chronic kidney disease present various degrees of cardiovascular involvement especially due to chronic inflammatory status, volume and pressure overload and secondary hyperparathyroidism leading to a higher incidence of calcific heart disease. The following review will focus on the main aspects (epidemiology, risk factors, diagnostic tools and protocols, therapeutic approaches) of CRS in Western countries (Europe and United States).

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“…A hemodiálise em si, embora utilizada mundialmente e indispensável para manutenção da vida em pacientes com DRC estágio 5, pode ser, por si só, um risco adicional de morte (5,18), principalmente na população incidente. …”

Section: Avaliação Vascularunclassified

“…Nome: Low heart rate variability (HRV), a measure of autonomic nervous system, in the 65 setting of end-stage renal disease (ESRD), is associated with higher cardiovascular 66 mortality [3][4][5]. Albeit reduction of HRV may be related to alterations in cardiovascular 67 structure, it is also associated with changes in hemodynamic profile during hemodialysis 68 [5].…”

Section: Etiquetamentioning

confidence: 99%

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Variação do índice tornozelo-braquial pré e pós-hemodiálise: correlação com água corporal, cálcio do dialisato e sistema nervoso autônomo

Jimenez¹

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"Não me troque pela saudade... Pense, acredite que a cada momento vazio, eu estou ao seu lado, sempre te protegendo e te amando. " (Gabriel Petrone) ...Aos meus amados filhos Santiago e Benjamin que trazem tanta luz para minha vida, um amor especial....Ao meu querido esposo Juan Carlos, por acompanhar-me nesta longa jornada, não desanimando nos momentos difíceis."Talvez não tenha conseguido fazer o melhor, mas lutei para que o melhor fosse feito. Não sou o que deveria ser, mas Graças a Deus, não sou o que era antes".(Marthin Luther King) AGRADECIMENTOS ivPrimeiramente à Deus, pela sua presença constante em todos os momentos e em todos os passos da minha vida, iluminando e guiando meu caminho ou por tantas graças alcançadas.À minha orientadora, Profa. Dra. Rosilene, pelo apoio irrestrito em todos os momentos do meu doutorado. Por ter confiado em mim e no meu trabalho, pelo grande ensinamento como pessoa e pesquisadora. Descritores: diálise renal; índice tornozelo braço; frequência cardíaca; sistema nervoso autônomo; água corporal; cálcio. LISTA DE ABREVIATURAS E SIGLAS LISTA DE TABELAS

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Sudden cardiac death and chronic kidney disease: From pathophysiology to treatment strategies

Cited by 82 publications

References 125 publications

Revascularization versus Medical Management of Coronary Artery Disease in Prerenal Transplant Patients: A Meta-Analysis

Revascularization versus Medical Management of Coronary Artery Disease in Prerenal Transplant Patients: A Meta-Analysis

Cardiorenal Syndrome in Western Countries: Epidemiology, Diagnosis and Management Approaches

Variação do índice tornozelo-braquial pré e pós-hemodiálise: correlação com água corporal, cálcio do dialisato e sistema nervoso autônomo

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