Heart Failure in Patients with Chronic Kidney Disease

Xanthopoulos, Andrew; Papamichail, Adamantia; Briasoulis, Alexandros; Loritis, Konstantinos; Bourazana, Angeliki; Magouliotis, Dimitrios E.; Sarafidis, Pantelis; Stefanidis, Ioannis; Skoularigis, John; Triposkiadis, Filippos

doi:10.3390/jcm12186105

Cited by 9 publications

(2 citation statements)

References 125 publications

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“…Kidney function is closely linked to heart function. Renal dysfunction/disease may initiate, accentuate, or precipitate cardiac dysfunction/disease, and vice versa [37].…”

Section: Chronic Effect Of Exercise In Pre-dialysis Ckd Patients With...mentioning

confidence: 99%

Renal Rehabilitation: Present and Future Perspectives

Kohzuki

2024

JCM

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Chronic kidney disease (CKD) is a global health problem. In patients with CKD, exercise endurance is decreased, especially as renal dysfunction advances. This is due to the combined effects of protein-energy wasting, uremic acidosis, and inflammatory cachexia, which lead to sarcopenia and are aggravated by a sedentary lifestyle, resulting in a progressive downward spiral of deconditioning. Renal rehabilitation (RR) is a coordinated, multifaceted intervention designed to optimize a patient’s physical, psychological, and social functioning, as well as to stabilize, slow, or even reverse the progression of renal deterioration, improving exercise tolerance and preventing the onset and worsening of heart failure, thereby reducing morbidity and mortality. This review focused on the history and benefits of RR in patients with CKD. Based on current evidence, RR is an effective, feasible, and safe secondary prevention strategy in CKD. RR is a promising model for a new field of rehabilitation. Therefore, efforts to increase RR implementation rates are urgently needed.

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“…Kidney function is closely linked to heart function. Renal dysfunction/disease may initiate, accentuate, or precipitate cardiac dysfunction/disease, and vice versa [37].…”

Section: Chronic Effect Of Exercise In Pre-dialysis Ckd Patients With...mentioning

confidence: 99%

Renal Rehabilitation: Present and Future Perspectives

Kohzuki

2024

JCM

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“…Dysfunction / disease of the kidney may initiate, accentuate, or precipitate of the cardiac dysfunction / disease and vice versa, contributing to a negative spiral. Further, the reciprocal association between the heart and the kidney may occur on top of other entities, usually diabetes, hypertension, and atherosclerosis, simultaneously affecting the two organs [3].…”

Section: Introductionmentioning

confidence: 99%

Erythropoietin Syntesis in Patients With Chronic Heart Failure Depending on Comorbid Pathology

Pavliukovych,

Husak,

Pavliukovych

et al. 2023

Clin. and prev. med.

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Introduction. Decreased production of erythropoietin by the kidneys plays crucial role in the development of anemia in patients with chronic heart failure, especially on the background of comorbid diabetes mellitus type 2. In diabetic patients due to early damage of the kidney vessels and following erythropoietin deficiency anemia develops much earlier than clinically significant decrease of glomerular filtration rate. The aim of the study was to find out possible dependence of changes in the erythropoietinsynthesizing function of the kidneys on the degree of severity of anemic hypoxia in elderly and senile patients with chronic heart failure, including those with comorbid type 2 diabetes mellitus. Materials and methods. 120 patients with chronic heart failure of ischemic origin, type 2 diabetes mellitus and mild and moderate anemia were examined. Control group comprised 12 people with chronic heart failure without comorbid pathology. The examined groups were comparable in terms of gender and age, differing in the presence of comorbid diabetes mellitus and degree of severity of anemic syndrome. The level of erythropoietin in blood serum was determined by standard enzymelinked immunosorbent assay. Results. Type 2 diabetes mellitus in patients with chronic heart failure results in a significant decrease in erythropoietin production by 25 % compared to the control group (p<0,05). Comorbid to heart failure anemia leads to an increase in the level of erythropoietin by 74,4 % (р<0,05), and in the case of chronic heart failure and type 2 diabetes mellitus on the background of concomitant anemia – only by 39,5 % (р<0,05). As the severity of anemia in patients with chronic heart failure without diabetes progresses, the severity of the compensatory response of the kidneys to chronic anemic hypoxia is significantly higher than in patients with heart failure and comorbid type 2 diabetes. Conclusions. Diabetic nephropathy in patients with chronic heart failure and comorbid anemia leads to a significant deterioration of the erythropoietin-synthesizing function of the kidneys, complicating the course of both main and comorbid diseases.

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IL‐2Rα is a potential biomarker for heart failure diagnosis of patients with end‐stage renal disease and haemodialysis

Lv,

Wang,

Suo

et al. 2024

ESC Heart Failure

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AimsHeart failure (HF) is a leading cause of mortality in patients with end‐stage renal disease (ESRD) undergoing haemodialysis. Identifying novel predictors of HF is essential for improving diagnostic precision and enhancing patient outcomes.MethodsThis study included 68 participants from the Haemodialysis Centre at the Second Hospital of Tianjin Medical University. Clinical characteristics and echocardiographic data were collected and analysed. We measured the plasma of 44 cytokines to investigate their correlation with cardiac function and their potential as HF biomarkers.ResultsIn the HF with reduced ejection fraction (HFrEF) group, the levels of several cytokines, including stem cell growth factor‐β (SCGF‐β), C–X–C motif chemokine 10 (CXCL10), interleukin‐1α (IL‐1α), interleukin‐6 (IL‐6), interleukin‐8 (IL‐8), interleukin‐16 (IL‐16), interleukin‐1 receptor antagonist protein (IL‐1Ra), interferon‐γ (IFN‐γ), tumour necrosis factor‐α (TNF‐α), leukaemia inhibitory factor (LIF), C–C motif chemokine 3 (CCL3), interleukin‐10 (IL‐10), interleukin‐2 receptor subunit alpha (IL‐2Rα), tumour necrosis factor ligand superfamily member 10 (TNFSF10), macrophage colony‐stimulating factor (M‐CSF), granulocyte colony‐stimulating factor (G‐CSF) and stem cell factor (SCF), were significantly increased, while C–C motif chemokine 11 (CCL11)/eotaxin levels were decreased compared with those in the control group (P < 0.05). Receiver operating characteristic (ROC) curve analysis highlighted TNF‐α [area under the ROC curve (AUC) = 0.85, odds ratio (OR) = 1.080, 95% confidence interval (CI): 1.033–1.128, P = 0.001], IFN‐γ (AUC = 0.84, OR = 1.836, 95% CI: 1.289–2.615, P = 0.003) and IL‐2Rα (AUC = 0.82, OR = 1.022, 95% CI: 1.009–1.035, P = 0.001) as excellent predictors for HFrEF in haemodialysis patients with ESRD, and they outperformed soluble suppression of tumourigenicity‐2 (sST2) but slightly underperformed N‐terminal pro‐brain natriuretic peptide (NT‐proBNP). IL‐2Rα (AUC = 0.77, OR = 1.018, 95% CI: 1.007–1.030, P = 0.001) demonstrated superior diagnostic capabilities when distinguishing patients with HF with left ventricular ejection fraction (LVEF) <50% from controls. IL‐2Rα emerged as a robust biomarker for left ventricular HF, while TNF‐α (AUC = 0.89, OR = 1.140, 95% CI: 1.039–1.250, P = 0.005) showed promise in assessing HF severity in patients with ESRD. IL‐2Rα (AUC = 0.80, OR = 1.017, 95% CI: 1.007–1.027, P = 0.001) also significantly predicted right ventricular systolic dysfunction. During a median follow‐up of 14 months, 10 patients (14.7%) experienced all‐cause mortality. Multivariate Cox regression analysis confirmed that plasma IL‐2Rα was an independent predictor of all‐cause death [hazard ratio (HR): 1.010, 95% CI: 1.001–1.020, P = 0.039] after adjusting for other variables.ConclusionsThis study underscores the potential of IL‐2Rα as a valuable biomarker for HF diagnosis and management in haemodialysis patients with ESRD and contributes to our understanding of this high‐risk population.

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Heart Failure in Patients with Chronic Kidney Disease

Cited by 9 publications

References 125 publications

Renal Rehabilitation: Present and Future Perspectives

Renal Rehabilitation: Present and Future Perspectives

Erythropoietin Syntesis in Patients With Chronic Heart Failure Depending on Comorbid Pathology

IL‐2Rα is a potential biomarker for heart failure diagnosis of patients with end‐stage renal disease and haemodialysis

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