Urinary sodium excretion is the main determinant of mineralocorticoid excretion rates in patients with chronic kidney disease

McQuarrie, Emily P.; Freel, E. Marie; Mark, Patrick B.; Fraser, Robert; Connell, John; Jardine, Alan G.

doi:10.1093/ndt/gft007

Cited by 14 publications

(9 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…28 There is also an association between urinary protein and sodium excretion and LV mass on CMR, independent of blood pressure that requires explanation. 29 Further work to examine associations and investigate possible mechanisms is required.…”

Section: Discussionmentioning

confidence: 99%

Diffuse Interstitial Fibrosis and Myocardial Dysfunction in Early Chronic Kidney Disease

Edwards

Moody

Yuan

et al. 2015

The American Journal of Cardiology

100

View full text Add to dashboard Cite

Early-stage chronic kidney disease (CKD) is an under-recognized highly prevalent cardiovascular (CV) risk factor. Despite a clustering of conventional atherosclerotic risk factors, it is hypothesized that nonatherosclerotic processes, including left ventricular (LV) hypertrophy and fibrosis, account for a significant excess of CV risk. This cross-sectional observational study of 129 age- (mean age 57±10 years) and gender-matched subjects examined: nondiabetic CKD stages 2 to 4 (mean glomerular filtration rate 50±22 ml/min/1.73 m2) with no history of CV disease, subjects who are hypertensive with normal renal function, and healthy controls. Cardiac magnetic resonance imaging was performed for assessment of LV volumes and systolic function (myocardial deformation). Diffuse myocardial fibrosis was assessed using T1 mapping for native myocardial T1 times before contrast and myocardial extracellular volume (ECV) after gadolinium administration in combination with standard late gadolinium enhancement techniques for detection of coarse fibrosis. Patients with CKD had increased native T1 times (986±37 ms) and ECV (0.28±0.04) compared with controls (955±30 ms, 0.25±0.03) and subjects who are hypertensive (956±31 ms, 0.25±0.02, p<0.05). Both T1 times and ECV were correlated with impaired systolic function as assessed by global longitudinal systolic strain (r=-0.22, p<0.05, and r=-0.43, p<0.01, respectively). There were no differences in LV volumes, ejection fraction, or LV mass. T1 times and ECV did not correlate with conventional CV risk factors. In conclusion, diffuse myocardial fibrosis is increased in early CKD and is associated with abnormal global longitudinal strain, an early feature of uremic cardiomyopathy and a key indicator of adverse CV prognosis.

show abstract

Section: Discussionmentioning

confidence: 99%

Diffuse Interstitial Fibrosis and Myocardial Dysfunction in Early Chronic Kidney Disease

Edwards

Moody

Yuan

et al. 2015

The American Journal of Cardiology

100

View full text Add to dashboard Cite

show abstract

“…However, there are studies demonstrating that hypertension is not responsible alone . For example, there is a relation between urinary protein excretion and LV mass independent from blood pressure . Different responses given to the different antihypertensive medications as well suggest that mechanisms independent of blood pressure play a role in this process.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of potential long‐term changes in endothelial functions and basic echocardiographic parameters in unilateral nephrectomy patients

et al. 2017

View full text Add to dashboard Cite

In conclusion, 50% decrease in nephron mass due to unilateral nephrectomy may result in decreased eGFR, impaired endothelial functions and cardiac hypertrophy. What triggers endothelial dysfunction and cardiac hypertrophy in the event of mild decrease in GFR when creatinine has not been elevated yet remains unclear, but uric acid may be playing a role in this process necessitating large-scaled studies.

show abstract

“…The renin angiotensin aldosterone system is over-activated in CKd, with patients having inappropriately elevated aldosterone production relative to their fluid status. 47 Therefore, aldosterone antagonism with spironolactone represents a therapeutic strategy for intervention: this approach reduces blood pressure and proteinuria, both predictors of progression to esRd and death in CKd patients. 48 furthermore, it has been shown that spironolactone can reduce lvm and aortic stiffness in a randomised clinical trial in CKd patients.…”

Section: Lipids and Ckdmentioning

confidence: 99%

What Happens to the Heart in Chronic Kidney Disease?

Rutherford

Mark

2017

Journal of the Royal College of Physicians of Edinburgh

View full text Add to dashboard Cite

Cardiovascular disease is common in patients with chronic kidney disease. The increased risk of cardiovascular disease seen in this population is attributable to both traditional and novel vascular risk factors. Risk of sudden cardiac or arrhythmogenic death is greatly exaggerated in chronic kidney disease, particularly in patients with end stage renal disease where the risk is roughly 20 times that of the general population. The reasons for this increased risk are not entirely understood and while atherosclerosis is accelerated in the presence of chronic kidney disease, premature myocardial infarction does not solely account for the excess risk. Recent work demonstrates that the structure and function of the heart starts to alter early in chronic kidney disease, independent of other risk factors. The implications of cardiac remodelling and hypertrophy may predispose chronic kidney disease patients to heart failure, arrhythmia and myocardial ischaemia. Further research is needed to minimise cardiovascular risk associated with structural and functional heart disease associated with chronic kidney disease.

show abstract

Urinary sodium excretion is the main determinant of mineralocorticoid excretion rates in patients with chronic kidney disease

Cited by 14 publications

References 18 publications

Diffuse Interstitial Fibrosis and Myocardial Dysfunction in Early Chronic Kidney Disease

Diffuse Interstitial Fibrosis and Myocardial Dysfunction in Early Chronic Kidney Disease

Evaluation of potential long‐term changes in endothelial functions and basic echocardiographic parameters in unilateral nephrectomy patients

What Happens to the Heart in Chronic Kidney Disease?

Contact Info

Product

Resources

About