Prognostic Cardiovascular Markers in Chronic Kidney Disease

Chen, Szu-Chia; Huang, Jiun-Chi; Su, Ho‐Ming; Chiu, Yi‐Wen; Chang, Jer‐Ming; Hwang, Shang‐Jyh; Chen, Hung‐Chun

doi:10.1159/000492953

Cited by 50 publications

(40 citation statements)

References 146 publications

(185 reference statements)

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“…In patients with CKD, remodeling of the myocardium and blood vessels leads to several cardiovascular complications such as cardiomyopathy, atherosclerosis, arterial stiffness, calcification, and subsequent ischemic heart disease, heart failure, cerebrovascular and cardiovascular death, and progression of renal disease including ESRD (Chen et al, 2018). However, CKD patients present a high incidence of cardiovascular morbidity and mortality that is not fully accounted for by traditional risk factors and those mutual to CVDs and CKD such as age, hypertension, diabetes mellitus, obesity, hyperuricemia, dyslipidemia, tobacco use, family history, and male gender.…”

Section: Increased Risk For Cvds In Renal Patients the Current Statementioning

confidence: 99%

Mechanisms of Cardiovascular Disorders in Patients With Chronic Kidney Disease: A Process Related to Accelerated Senescence

Carracedo

Alique

Vida

et al. 2020

Front. Cell Dev. Biol.

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Cardiovascular diseases (CVDs), especially those involving a systemic inflammatory process such as atherosclerosis, remain the leading cause of morbidity and mortality in patients with chronic kidney disease (CKD). CKD is a systemic condition affecting approximately 10% of the general population. The prevalence of CKD has increased over the past decades because of the aging of the population worldwide. Indeed, CVDs in patients with CKD constitute a premature form of CVD observed in the general population. Multiple studies indicate that patients with renal disease undergo accelerated aging, which precipitates the appearance of pathologies, including CVDs, usually associated with advanced age. In this review, we discuss several aspects that characterize CKD-associated CVDs, such as etiopathogenic elements that CKD patients share with the general population, changes in the cellular balance of reactive oxygen species (ROS), and the associated process of cellular senescence. Uremiaassociated aging is linked with numerous changes at the cellular and molecular level. These changes are similar to those observed in the normal process of physiologic aging. We also discuss new perspectives in the study of CKD-associated CVDs and epigenetic alterations in intercellular signaling, mediated by microRNAs and/or extracellular vesicles (EVs), which promote vascular damage and subsequent development of CVD. Understanding the processes and factors involved in accelerated senescence and other abnormal intercellular signaling will identify new therapeutic targets and lead to improved methods of diagnosis and monitoring for patients with CKD-associated CVDs.

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Section: Increased Risk For Cvds In Renal Patients the Current Statementioning

confidence: 99%

Mechanisms of Cardiovascular Disorders in Patients With Chronic Kidney Disease: A Process Related to Accelerated Senescence

Carracedo

Alique

Vida

et al. 2020

Front. Cell Dev. Biol.

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“…CKD was associated with accelerated risk and high event rate of CV disease, and was considered as a CV disease equivalent 19 . Patients with CKD had several risk factors that were related to atherosclerosis, such as hypertension, diabetes mellitus, dyslipidemia, smoking, and so on 20 . These risk factors could cause remodeling of the myocardium and blood vessels and lead to arterial stiffness and atherosclerosis, cardiomyopathy, and subsequently to ischemic heart disease, heart failure, CV death, rapid deterioration of renal function, and finally progression to ESRD 19 .…”

Section: Discussionmentioning

confidence: 99%

Using CHADS2 and CHA2DS2-VASc scores for mortality prediction in patients with chronic kidney disease

Hsu

Lee

Chen

et al. 2020

Sci Rep

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Chronic kidney disease (CKD) is a public health issue and is associated with high morbidity and mortality. How to identify the high-risk CKD patients is very important to improve the long-term outcome. CHADS2 and CHA2DS2-VASc scores are clinically useful scores to evaluate the risk of stroke in patients with atrial fibrillation. However, there was no literature discussing about the usefulness of CHADS2 and CHA2DS2-VASc scores for cardiovascular (CV) and all-cause mortality prediction in CKD patients. This longitudinal study enrolled 437 patients with CKD. CHADS2 and CHA2DS2-VASc scores were calculated for each patient. CV and all-cause mortality data were collected for long-term outcome prediction. The median follow-up to mortality was 91 (25th–75th percentile: 59–101) months. There were 66 CV mortality and 165 all-cause mortality. In addition to age and heart rate, CHADS2 and CHA2DS2-VASc scores (both P value < 0.001) were significant predictors of CV and all-cause mortality in the multivariate analysis. Besides, in direct comparison of multivariate model, basic model + CHA2DS2-VASc score had a better additive predictive value for all-cause mortality than basic model + CHADS2 score (P = 0.031). In conclusion, our study showed both of CHADS2 and CHA2DS2-VASc scores were significant predictors for long-term CV and all-cause mortality in CKD patients and CHA2DS2-VASc score had a better predictive value than CHADS2 score for all-cause mortality in direct comparison of multivariate model. Therefore, using CHADS2 and CHA2DS2-VASc scores to screen CKD patients may be helpful in identifying the high-risk group with increased mortality.

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“…Although advances in pharmaceutical and imaging technology improve precision of disease treatment and diagnosis, cardiovascular (CV) disease remains the major cause of morbidity and mortality among patients with end-stage renal disease (ESRD) [1][2][3]. The risk factors for CV disease in ESRD include traditional and nontraditional elements, such as diabetes, hypertension, dyslipidemia, fluid overload, endothelial dysfunction, inflammation, and vascular calcification [4][5][6][7][8]. Compared to the general population, patients with ESRD have a higher prevalence of vascular calcification [9,10], and it has prognostic significance for CV outcomes in ESRD patients [11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Progression of Aortic Arch Calcification Is Associated with Overall and Cardiovascular Mortality in Hemodialysis

Chung

Shih

et al. 2020

Disease Markers

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Background. Vascular calcification is common and associated with unfavorable outcomes among patients with end-stage renal disease (ESRD). Nevertheless, little is known whether the progression of vascular calcification outweighs the baseline calcification in association with overall and cardiovascular (CV) mortality in hemodialysis (HD) patients. Methods. This study included 140 maintenance HD patients. Vascular calcification was assessed using the aortic arch calcification (AoAC) score measured from chest radiographs at the baseline and the second year of follow-up. Progression of vascular calcification (ΔAoAC) was defined as the difference between the two measurements of AoAC. The association of ΔAoAC with overall and CV mortality was evaluated using multivariate Cox regression analysis. Results. During the mean follow-up period of 5.8 years, there were 49 (35%) overall mortality and 27 (19.3%) CV mortality. High brachial-ankle pulse wave velocity was positively correlated with ΔAoAC, whereas old age was negatively correlated with ΔAoAC. In multivariate adjusted Cox analysis, increased ΔAoAC (per 1 unit), but not baseline AoAC, was significantly associated with overall mortality (HR, 1.183; 95% CI, 1.056–1.327; p=0.004) and CV mortality (HR, 1.194; 95% CI, 1.019–1.398; p=0.028). Conclusion. Progression of AoAC outperformed the baseline AoAC in association with increased risk of overall and CV mortality in HD patients. A regular follow-up of chest radiograph and AoAC score assessments are simple and cost-effective to identify the high-risk individuals of unfavorable outcomes in maintenance HD patients.

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Prognostic Cardiovascular Markers in Chronic Kidney Disease

Cited by 50 publications

References 146 publications

Mechanisms of Cardiovascular Disorders in Patients With Chronic Kidney Disease: A Process Related to Accelerated Senescence

Mechanisms of Cardiovascular Disorders in Patients With Chronic Kidney Disease: A Process Related to Accelerated Senescence

Using CHADS2 and CHA2DS2-VASc scores for mortality prediction in patients with chronic kidney disease

Progression of Aortic Arch Calcification Is Associated with Overall and Cardiovascular Mortality in Hemodialysis

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