Should We Consider the Cardiovascular System While Evaluating CKD-MBD?

Rroji, Merita; Figurek, Andreja; Spasovski, Goce

doi:10.3390/toxins12030140

Cited by 7 publications

(5 citation statements)

References 145 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Renal transplantation also improved cardiac structure and function, with significant improvements in LVEF, left ventricular mass, left ventricular end‐diastolic size and right ventricular systolic pressure 49 . Of note, in the presence of severe LV systolic dysfunction even mild renal impairment is independently associated with increased risk for all‐cause mortality 50 …”

Section: Discussionmentioning

confidence: 98%

Association between CRT(D)/ICD and renal insufficiency: A systematic review and meta‐analysis

Liu

Sun

Zhu

et al. 2020

Seminars in Dialysis

View full text Add to dashboard Cite

Renal insufficiency and heart disease are two challenging conditions for the current health-care system. More than 660,000 Americans suffer from end-stage kidney disease (ESKD) and have reached the point of intervention, with 468,000 receiving dialysis therapy. 1 Moreover, in a Duke Electrophysiology Genetic and Genomic Studies (EPGEN) study, estimated glomerular filtration rate (eGFR) decreased by 10 ml/min/1.73 m 2 and mortality increased by 48% (p < 0.001) 2 and major cardiac events account for nearly 50% of deaths in patients with chronic kidney disease (CKD). 3 Renal insufficiency is a common complication of cardiovascular diseases and is a strong independent risk factor for mortality. 4 CKD has been reported in up to 40% of chronic heart failure patients. 5 Moreover, progressive heart failure can lead to renal hypoperfusion and activation of inflammatory factors, and further result in the deterioration of renal function. 5 Similarly, arrhythmia is also a common cause of death in dialysis patients, accounting for 26% and 25% of hemodialysis and peritoneal dialysis deaths respectively. 6 Cardiac resynchronization therapy (CRT) can improve clinical symptoms and left ventricular ejection fraction (LVEF) and reduce

show abstract

Section: Discussionmentioning

confidence: 98%

Association between CRT(D)/ICD and renal insufficiency: A systematic review and meta‐analysis

Liu

Sun

Zhu

et al. 2020

Seminars in Dialysis

View full text Add to dashboard Cite

show abstract

“…In addition, abnormal calcium-phosphorus metabolism is often observed in CKD patients. It has been suggested that disturbances in bone and mineral metabolism contribute to the excessively high CVD morbidity and mortality among CKD patients ( 27 ). The KDIGO guidelines for CKD-MBD ( 6 ) suggest restricting the dose of calcium containing phosphate binders in the presence of arterial calcification in patients with CKD stages 3–5D and hyperphosphatemia.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and Correlates of Cardiovascular Calcification and Its Prognostic Effects Among Patients With Chronic Kidney Disease: Results From the C-STRIDE Study

Wang

Cheng

Zou

et al. 2022

Front. Public Health

View full text Add to dashboard Cite

Background and Aims: The purpose of this study was to identify the characteristics and risk factors for cardiovascular calcification, and its relationship to prognosis, in patients with chronic kidney disease (CKD) stages 1–4.Methods: Cardiovascular calcification was evaluated at baseline by lateral abdominal radiography to detect abdominal aortic calcifications (AAC), and by echocardiogram to detect cardiac valvular calcifications (CVC), respectively. Demographic and laboratory data were collected and analyzed. Univariate and multivariable logistic regression model was used to explore the factors associated with the indicators of cardiovascular calcification, while Cox proportional hazards regression was used to examine the association between AAC/CVC and incidence of cardiovascular events and all-cause mortality.Results: A subgroup of 2,235 patients with measurement of AAC in the C-STRIDE study and a subgroup of 2,756 patients with CVC were included in the analysis. AAC was present in 206 patients (9.22%) and CVC was present in 163 patients (5.91%). Age, gender, history of cardiovascular diseases, smoking, hypertension, diabetes, levels of hemoglobin, low-density lipoprotein cholesterol, and uric acid were associated with prevalence of AAC, while only age, history of cardiovascular diseases, levels of serum albumin and low-density lipoprotein cholesterol were associated with prevalence of CVC (all p < 0.05).Survival analyses showed that cardiovascular events and all-cause mortality were significantly greater in patients with AACor with CVC (all p-values for log-rank tests <0.05). After adjustment for age, sex and estimated glomerular filtration rate (eGFR), AAC was associated with increased risk of all-cause mortality (hazard ratio = 1.67[95% confidence interval: 0.99, 2.79]), while CVC associated with that of cardiovascular events only among patients with comparatively normal eGFR (≥45 ml/min/1.73m2) (hazard ratio = 1.99 [0.98, 4.03]).Conclusion: Demographic and traditional cardiovascular risk factors were associated with cardiovascular calcification, especially AAC. AAC may be associated with risk of death for patients CKD of any severity, while CVC as a possible risk factor for cardiovascular disease only among those with mild to moderate CKD. Assessments of vascular calcification are need to be advanced to patients in the early and middle stages of chronic kidney disease and to initiate appropriate preventive measures earlier.

show abstract

“…Elevated PTH levels are also expected in uremic patients much earlier than hyperphosphatemia. PTH stimulates calcitriol synthesis that further contributes to increased serum calcium [41]. In contrast with the physiologic state where FGF23 acts on the parathyroid gland by diminishing gene expression and secretion in CKD in the absence of Klotho, the parathyroid gland shows resistance to FGF23, enhancing PTH secretion.…”

Section: Phosphate Homeostasis In the Physiological Milieu And Ckdmentioning

confidence: 99%

Phosphate in the Context of Cognitive Impairment and Other Neurological Disorders Occurrence in Chronic Kidney Disease

Rroji

Figurek

Viggiano

et al. 2022

IJMS

Self Cite

View full text Add to dashboard Cite

The nervous system and the kidneys are linked under physiological states to maintain normal body homeostasis. In chronic kidney disease (CKD), damaged kidneys can impair the central nervous system, including cerebrovascular disease and cognitive impairment (CI). Recently, kidney disease has been proposed as a new modifiable risk factor for dementia. It is reported that uremic toxins may have direct neurotoxic (astrocyte activation and neuronal death) and/or indirect action through vascular effects (cerebral endothelial dysfunction, calcification, and inflammation). This review summarizes the evidence from research investigating the pathophysiological effects of phosphate toxicity in the nervous system, raising the question of whether the control of hyperphosphatemia in CKD would lower patients’ risk of developing cognitive impairment and dementia.

show abstract

Should We Consider the Cardiovascular System While Evaluating CKD-MBD?

Cited by 7 publications

References 145 publications

Association between CRT(D)/ICD and renal insufficiency: A systematic review and meta‐analysis

Association between CRT(D)/ICD and renal insufficiency: A systematic review and meta‐analysis

Prevalence and Correlates of Cardiovascular Calcification and Its Prognostic Effects Among Patients With Chronic Kidney Disease: Results From the C-STRIDE Study

Phosphate in the Context of Cognitive Impairment and Other Neurological Disorders Occurrence in Chronic Kidney Disease

Contact Info

Product

Resources

About