Emperor’s syndrome in the COVID-19 era: Time for patient-centered nephrology?

Bacharaki, Dimitra; Diamandopoulos, Athanasios

doi:10.5527/wjn.v10.i1.1

Cited by 1 publication

(1 citation statement)

References 44 publications

(28 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Treatment failure, targeting “traditional” RF and nontraditional RF (hyperphosphatemia, CKD- MBD parameters) stems probably from the fact that there is no stratification management that would guide a precision or personalized medicine. Nephrology practice seems to be in a state of involuntary blindness as the crowd that pretends to see the clothes of the naked Emperor in Hans Christian Andersen’s tale[ 30 ]. In order to find a solution we propose the following 4 steps: (1) Gather the wisdom of the past in the form of personalized medicine; (2) adapt precision medicine from today’s lessons from corona virus disease 19 (COVID-19); (3) sepsis; and (4) look into the future with the aid of the big data.…”

Section: The Solution: Precision and Personalized Medicinementioning

confidence: 99%

Redefying the therapeutic strategies against cardiorenal morbidity and mortality: Patient phenotypes

Bacharaki¹,

Petrakis²,

Stylianou³

2023

World J Cardiol

Self Cite

View full text Add to dashboard Cite

Chronic kidney disease (CKD) patients face an unacceptably high morbidity and mortality, mainly from cardiovascular diseases. Diabetes mellitus, arterial hypertension and dyslipidemia are highly prevalent in CKD patients. Established therapeutic protocols for the treatment of diabetes mellitus, arterial hypertension, and dyslipidemia are not as effective in CKD patients as in the general population. The role of non-traditional risk factors (RF) has gained interest in the last decades. These entail the deranged clinical spectrum of secondary hyperparathyroidism involving vascular and valvular calcification, under the term “CKD-mineral and bone disorder” (CKD-MBD), uremia per se , inflammation and oxidative stress. Each one of these non-traditional RF have been addressed in various study designs, but the results do not exhibit any applied clinical benefit for CKD-patients. The “crusade” against cardiorenal morbidity and mortality in CKD-patients is in some instances, derailed. We propose a therapeutic paradigm advancing from isolated treatment targets, as practiced today, to precision medicine involving patient phenotypes with distinct underlying pathophysiology. In this regard we propose two steps, based on current stratification management of corona virus disease-19 and sepsis. First, select patients who are expected to have a high mortality, i.e. , a prognostic enrichment. Second, select patients who are likely to respond to a specific therapy, i.e. , a predictive enrichment.

show abstract

Section: The Solution: Precision and Personalized Medicinementioning

confidence: 99%