Chronic kidney disease and cardiovascular risk: epidemiology, mechanisms, and prevention

Gansevoort, Ron T.; Correa‐Rotter, Ricardo; Hemmelgarn, Brenda R.; Jafar, Tazeen H.; Heerspink, Hiddo J.L.; Mann, Johannes F.E.; Matsushita, Kunihiro; Wen, Chi Pang

doi:10.1016/s0140-6736(13)60595-4

Cited by 1,678 publications

(1,283 citation statements)

References 110 publications

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“…It is known that a decline in kidney function is associated with a progressive increase in cardiovascular risk 38. In addition, in patients with impaired renal function, cardiovascular risk factors, including hypertension, diabetes, albuminuria, anemia, vascular stiffness, metabolic acidosis, and dyslipidemia are common 38, 39.…”

Section: Discussionmentioning

confidence: 99%

Dietary Approach to Stop Hypertension (DASH) diet and risk of renal function decline and all-cause mortality in renal transplant recipients

Osté

Gomes-Neto

Corpeleijn

et al. 2018

American Journal of Transplantation

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Renal transplant recipients (RTR) are at risk of decline of graft function and premature mortality, with high blood pressure as an important risk factor for both. To study the association of the Dietary Approach to Stop Hypertension (DASH) diet with these adverse events, we conducted a prospective cohort study of adult RTR. Dietary data were collected using a validated 177‐item food frequency questionnaire and an overall DASH‐score was obtained. We included 632 stable RTR (mean ± standard deviation age 53.0 ± 12.7 years, 57% men). Mean DASH score was 23.8 ± 4.7. During median follow‐up of 5.3 (interquartile range, 4.1‐6.0) years, 119 (18.8%) RTR had renal function decline, defined as a combined endpoint of doubling of serum creatinine and death‐censored graft failure, and 128 (20.3%) died. In Cox‐regression analyses, RTR in the highest tertile of the DASH score had lower risk of both renal function decline (hazard ratio [HR] = 0.57; 95% confidence interval [CI], 0.33‐0.96, P = .03) and all‐cause mortality (HR = 0.52; 95%CI, 0.32‐0.83, P = .006) compared to the lowest tertile, independent of potential confounders. Adherence to a DASH‐style diet is associated with lower risk of both renal function decline and all‐cause mortality. These results suggest that a healthful diet might benefit long‐term outcome in RTR.

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Section: Discussionmentioning

confidence: 99%

Dietary Approach to Stop Hypertension (DASH) diet and risk of renal function decline and all-cause mortality in renal transplant recipients

Osté

Gomes-Neto

Corpeleijn

et al. 2018

American Journal of Transplantation

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“…[7][8][9] Patients in whom the eGFR continues to be less than 60 for 3 months or longer due to causes related to these factors (CKD stage ≥3) are defined as a CKD high-risk group. In this group, multiple factors shown above are present, and the condition progressively deteriorates.…”

Section: From This Viewpoint Maioli Et Al Compared a Group In Whichmentioning

confidence: 99%

The Prevention of Renal Dysfunction in High-risk CKD Patients Undergoing Carotid Artery Stenting

Hatsuda¹,

Nakajima²,

Tanimoto³

et al. 2016

JNET

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Objective: Contrast-induced acute kidney injury is more likely to result in various morbidities than to develop into renal dysfunction. To prevent acute kidney injury from occurring, we performed hydration therapy and administered reduced contrast medium concentrations for patients with preexisting high-risk chronic kidney disease (CKD; stage 3 or 4). The objective of this study was to evaluate the effectiveness of these procedures.Methods: Fifty-one sites underwent carotid artery stenting. We divided the patients into two groups by CKD stage (group A: stage 1-2, group B: stage 3-4) and reduced the dose of contrast medium during the intervention for the patients in group B.Furthermore, intravenous hydration peri-intervention was performed in patients with CKD stage 3b or 4. The differences in the estimated glomerular filtration rate (eGFR) between before and after therapy, were retrospectively assessed. Results:There was a significant difference in the two groups in terms of the dose of contrast medium administered (group A: 58.3 ml ± 18.5 ml, group B: 32.8 ml ± 21.5 ml, p <0.01). Moreover, there was a significant difference between the two groups in terms of the difference in eGFR before and after the intervention (group A: -4.87 ml ± 8.23 ml, group B: 1.03 ml ± 6.07 ml, p <0.05). Conclusion:Our findings indicate the effectiveness of a reduction in the dose contrast medium and hydration for the prevention of renal dysfunction in high-risk CKD patients undergoing carotid artery stenting.Keywords▶ carotid artery stenting, chronic kidney disease, low dose of contrast medium, hydration, contrast-induced acute kidney injury

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“…5 Without an age-adapted definition, the prevalence of CKD is overestimated, with a high proportion of the elderly in stage 3a. 6 Prognosis is now considered as a key feature of CKD classification; however, it has been shown that remaining life expectancy is not different between individuals in CKD stage 3a versus those with normal kidney function (see the second figure in Gansevoort et al 7 ).…”

Section: The Myth Of the Future Burden Of Ckd In United Statesmentioning

confidence: 99%

The Myth of the Future Burden of CKD in United States

Delanaye

Nahas

Glassock

2015

American Journal of Kidney Diseases

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Chronic kidney disease and cardiovascular risk: epidemiology, mechanisms, and prevention

Cited by 1,678 publications

References 110 publications

Dietary Approach to Stop Hypertension (DASH) diet and risk of renal function decline and all-cause mortality in renal transplant recipients

Dietary Approach to Stop Hypertension (DASH) diet and risk of renal function decline and all-cause mortality in renal transplant recipients

The Prevention of Renal Dysfunction in High-risk CKD Patients Undergoing Carotid Artery Stenting

The Myth of the Future Burden of CKD in United States

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