The heart in uremia: Role of hypertension, hypotension, and sleep apnea

Santo, Natale G. De; Cirillo, Massimo; Perna, Alesssandra; Santo, Luca Salvatore De; Anastasio, Pietro; Pollastro, Maria Rosa; Santo, Rosa Maria De; Iorio, Luigi; Cotrufo, Maurizio; Rossi, Francesco

doi:10.1053/ajkd.2001.27395

Cited by 12 publications

(5 citation statements)

References 29 publications

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“…Patients with stage 5 (CKD5) develop an end-stage renal disease (ESRD) and advanced CVD. Hypertension is found in about 70% of CKD and 80–90% of end-stage renal disease (ESRD) patients [ 5 , 6 ]. At early CKD stages, the likelihood of developing CVD increases two to three-fold due to deterioration of kidney function [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Mass Spectrometry-Based Lipidomics Reveals Differential Changes in the Accumulated Lipid Classes in Chronic Kidney Disease

et al. 2021

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Chronic kidney disease (CKD) is characterized by the progressive loss of functional nephrons. Although cardiovascular disease (CVD) complications and atherosclerosis are the leading causes of morbidity and mortality in CKD, the mechanism by which the progression of CVD accelerates remains unclear. To reveal the molecular mechanisms associated with atherosclerosis linked to CKD, we applied a shotgun lipidomics approach fortified with standard laboratory analytical methods and gas chromatography-mass spectrometry technique on selected lipid components and precursors to analyze the plasma lipidome in CKD and classical CVD patients. The MS-based lipidome profiling revealed the upregulation of triacylglycerols in CKD and downregulation of cholesterol/cholesteryl esters, sphingomyelins, phosphatidylcholines, phosphatidylethanolamines and ceramides as compared to CVD group and controls. We have further observed a decreased abundance of seven fatty acids in CKD with strong inter-correlation. In contrast, the level of glycerol was elevated in CKD in comparison to all analyzed groups. Our results revealed the putative existence of a functional causative link—the low cholesterol level correlated with lower estimated glomerular filtration rate and kidney dysfunction that supports the postulated “reverse epidemiology” theory and suggest that the lipidomic background of atherosclerosis-related to CKD is unique and might be associated with other cellular factors, i.e., inflammation.

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Section: Introductionmentioning

confidence: 99%

Mass Spectrometry-Based Lipidomics Reveals Differential Changes in the Accumulated Lipid Classes in Chronic Kidney Disease

et al. 2021

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“…C-reactive protein) and thrombogenic factors (such as fibrinogen) also are elevated. Furthermore, recent studies have shown that hemodialysis patients have a higher prevalence of sleep disorders, including apnea, that might contribute to the elevated risk for CVD 9 .…”

Section: Introductionmentioning

confidence: 99%

Towards cardiovascular risks in children with chronic kidney disease: a prospective cohort study

et al. 2018

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Background:Children with chronic kidney disease (CKD) are at substantially high risk of morbidity and mortality from cardiovascular disease (CVD). Although this issue has been extensively studied in adults, little is known whether similar associations exist in the paediatric population. We therefore aimed to evaluate the cardiac structure and function in children with CKD, and investigate the factors that contribute to the development of CVD.Methods:A prospective cohort was established following 40 children with CKD treated in the nephrology unit at a high-volume, tertiary, teaching hospital and compared to age- and gender-matched controls of the same number. We reviewed the patients’ medical records, assessed growth parameters, measured blood pressure, took blood samples, and performed echocardiography.Results:More than half of the CKD patients are hypertensive (N = 22; 55%) and were found to have a higher proportion of increased left ventricular mass index (LVMI) (75.5%; P = 0.001). In contrast, we did not find any significant association between CKD and both valvular calcification & left ventricular (LV) fractional shortening (FS) in children (P = 0.314). Furthermore, high LVMI is found to be correlated well with the following: anaemia, hypertension, CKD duration > one year, hyperparathyroidism, estimated glomerular filtration rate (eGFR) < 15ml/minute/1.73 m2and death (P < 0.05).Conclusions:Despite the fact that LV systolic function is preserved and valvular calcification is usually absent, left ventricular hypertrophy (LVH) is common in children with CKD. Hypertension, anaemia, hyperparathyroidism, as well as the severity and duration of renal impairment, are amongst the additional risk factors that predispose to LVH. We contribute this study to the growing information of the review articles regarding the association between CKD and CVD in paediatrics.

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“…Hypertension (HA) is one of the main causes of chronic kidney disease and is present in 70 % of CKD patients and in 80–90 % of dialyzed patients [4, 5]. Also, dyslipidemia is highly prevalent among patients with CKD [6, 7].…”

Section: Introductionmentioning

confidence: 99%

The risk of atherosclerosis in patients with chronic kidney disease

Olechnowicz-Tietz

Gluba²,

Paradowska³

et al. 2013

Int Urol Nephrol

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BackgroundChronic kidney disease (CKD) is becoming a serious health problem; the number of people with impaired renal function is rapidly rising, especially in industrialized countries. A major complication of CKD is cardiovascular disease. Accelerated atherosclerosis has been observed in early stages of renal dysfunction. The purpose of this study was to examine the relationship between the degree of renal insufficiency and both the prevalence and intensity of coronary artery disease (assessed on the basis of number of vessels with stenosis).Methods446 individuals with both serum creatinine >120 μmol/l (men) or >96 μmol/l (women) and acute coronary syndrome were included in the study. All patients included in this analysis underwent urgent coronarography. Data concerning glomerular filtration rate (GFR), number of vessels with stenosis, hypertension, lipid disorders, creatinine concentration, C-reactive protein, glucose and lipid profile were analyzed.ResultsThis study confirmed that moderate to severe renal impairment is associated with accelerated atherosclerosis. Moreover, patients with GFR values below 60 ml/min/1.73 m2 are predisposed to accelerated, multivessel cardiovascular disease.ConclusionsGFR seems to be an independent risk factor for multivessel cardiovascular disease. Due to the fact that patients with renal dysfunction are at high risk of cardiovascular events, they should obtain optimal treatment resulting not only in kidney protection but also in the elimination of cardiovascular risk factors.

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The heart in uremia: Role of hypertension, hypotension, and sleep apnea

Cited by 12 publications

References 29 publications

Mass Spectrometry-Based Lipidomics Reveals Differential Changes in the Accumulated Lipid Classes in Chronic Kidney Disease

Mass Spectrometry-Based Lipidomics Reveals Differential Changes in the Accumulated Lipid Classes in Chronic Kidney Disease

Towards cardiovascular risks in children with chronic kidney disease: a prospective cohort study

The risk of atherosclerosis in patients with chronic kidney disease

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