scholarly journals Left ventricular geometric patterns in end-stage kidney disease: Determinants and course over time

2018 ◽  
Vol 22 (3) ◽  
pp. 359-368 ◽  
Author(s):  
Menso J. Nubé ◽  
Tiny Hoekstra ◽  
Volkan Doganer ◽  
Michiel L. Bots ◽  
Peter J. Blankestijn ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Left Ventricular ◽  
End Stage Kidney Disease ◽  
Geometric Patterns ◽  
End Stage ◽  
Over Time

scholarly journals SP550LONG TERM CHANGES OF CARDIAC LEFT VENTRICULAR GEOMETRIC PATTERNS IN PATIENTS WITH END STAGE KIDNEY DISEASE

2017 ◽  
Vol 32 (suppl_3) ◽  
pp. iii318-iii318
Author(s):  
Muriel Grooteman ◽  
Volkan Doganer ◽  
Michiel Bots ◽  
Peter Blankestijn ◽  
Marinus van den Dorpel ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Left Ventricular ◽  
End Stage Kidney Disease ◽  
Geometric Patterns ◽  
End Stage

scholarly journals Left-sided heart disease and risk of death in patients with end-stage kidney disease receiving haemodialysis: an observational study

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Anna Axelsson Raja ◽  
Peder E. Warming ◽  
Ture L. Nielsen ◽  
Louis L. Plesner ◽  
Mads Ersbøll ◽  
...  
Keyword(s):  
Heart Disease ◽  
Kidney Disease ◽  
Left Ventricular ◽  
Valve Disease ◽  
Left Ventricular Ejection ◽  
Clinical Consequence ◽  
End Stage Kidney Disease ◽  
Risk Of Death ◽  
Echocardiographic Assessment ◽  
End Stage

Abstract Background Cardiovascular disease is the most common cause of death in patients with end-stage kidney disease on haemodialysis. The potential clinical consequence of systematic echocardiographic assessment is however not clear. In an unselected, contemporary population of patients on maintenance haemodialysis we aimed to assess: the prevalence of structural and functional heart disease, the potential therapeutic consequences of echocardiographic screening and whether left-sided heart disease is associated with prognosis. Methods Adult chronic haemodialysis patients in two large dialysis centres had transthoracic echocardiography performed prior to dialysis and were followed prospectively. Significant left-sided heart disease was defined as moderate or severe left-sided valve disease or left ventricular ejection fraction (LVEF) ≤40%. Results Among the 247 included patients (mean 66 years of age [95%CI 64–67], 68% male), 54 (22%) had significant left-sided heart disease. An LVEF ≤40% was observed in 31 patients (13%) and severe or moderate valve disease in 27 (11%) patients. The findings were not previously recognized in more than half of the patients (56%) prior to the study. Diagnosis had a potential impact on management in 31 (13%) patients including for 18 (7%) who would benefit from initiation of evidence-based heart failure therapy. After 2.8 years of follow-up, all-cause mortality among patients with and without left-sided heart disease was 52 and 32% respectively (hazard ratio [HR] 1.95 (95%CI 1.25–3.06). A multivariable adjusted Cox proportional hazard analysis showed that left-sided heart disease was an independent predictor of mortality with a HR of 1.60 (95%CI 1.01–2.55) along with age (HR per year 1.05 [95%CI 1.03–1.07]). Conclusion Left ventricular systolic dysfunction and moderate to severe valve disease are common and often unrecognized in patients with end-stage kidney failure on haemodialysis and are associated with a higher risk of death. For more than 10% of the included patients, systematic echocardiographic assessment had a potential clinical consequence.

scholarly journals Death From Stroke in End-Stage Kidney Disease

Stroke ◽  
2019 ◽  
Vol 50 (2) ◽  
pp. 487-490 ◽  
Author(s):  
Nicole L. De La Mata ◽  
Philip Masson ◽  
Rustam Al-Shahi Salman ◽  
Patrick J. Kelly ◽  
Angela C. Webster
Keyword(s):  
Kidney Disease ◽  
General Population ◽  
Standardized Mortality Ratio ◽  
Stroke Mortality ◽  
End Stage Kidney Disease ◽  
Mortality Ratio ◽  
Standardized Mortality Ratios ◽  
Using Data ◽  
End Stage ◽  
Over Time

Background and Purpose— People with end-stage kidney disease (ESKD) are at greater risk of stroke. We aimed to compare stroke mortality between the ESKD population and the general population. Methods— We included all patients with incident ESKD in Australia, 1980 to 2013, and New Zealand, 1988 to 2012. The primary cause of death was ascertained using data linkage with national death registers. We produced standardized mortality ratios for stroke deaths, by age, sex, and calendar year. Results— We included 60 823 patients with ESKD, where 941 stroke deaths occurred during 381 874 person-years. Patients with ESKD had >3× the stroke deaths compared with the general population (standardized mortality ratio, 3.4; 95% CI, 3.2–3.6), markedly higher in younger people and women. The greatest excess was in intracerebral hemorrhages (standardized mortality ratio, 5.2; 95% CI, 4.5–5.9). Excess stroke deaths in patients with ESKD decreased over time, although were still double in 2013 (2013 standardized mortality ratio, 2.1; 95% CI, 1.5–2.9). Conclusions— People with ESKD experience much greater stroke mortality with the greatest difference for women and younger people. However, mortality has improved over time.

Left ventricular stiffness in paediatric patients with end-stage kidney disease

2020 ◽  
Vol 35 (6) ◽  
pp. 1051-1060
Author(s):  
Ann Wing-man Choi ◽  
Nai-chung Fong ◽  
Vivian Wing-yi Li ◽  
Tsz-wai Ho ◽  
Eugene Yu-hin Chan ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Left Ventricular ◽  
End Stage Kidney Disease ◽  
Paediatric Patients ◽  
Left Ventricular Stiffness ◽  
End Stage

scholarly journals The cardiovascular determinants of physical function in patients with end-stage kidney disease on haemodialysis

2020 ◽  
Author(s):  
Sherna F. Adenwalla ◽  
Roseanne E. Billany ◽  
Daniel S. March ◽  
Gaurav S. Gulsin ◽  
Hannah M. L. Young ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Ejection Fraction ◽  
Physical Function ◽  
Left Ventricular ◽  
End Stage Kidney Disease ◽  
Exercise Interventions ◽  
Native T1 ◽  
Dialysis Vintage ◽  
Lv Ejection Fraction ◽  
End Stage

AbstractPatients with end-stage kidney disease (ESKD) are often sedentary and decreased functional capacity associates with mortality. The relationship between cardiovascular disease (CVD) and physical function has not been fully explored. Understanding the relationships between prognostically relevant measures of CVD and physical function may offer insight into how exercise interventions might target specific elements of CVD. 130 patients on haemodialysis (mean age 57 ± 15 years, 73% male, dialysis vintage 1.3 years (0.5, 3.4), recruited to the CYCLE-HD trial (ISRCTN11299707), underwent cardiovascular phenotyping with cardiac MRI (left ventricular (LV) structure and function, pulse wave velocity (PWV) and native T1 mapping) and cardiac biomarker assessment. Participants completed the incremental shuttle walk test (ISWT) and sit-to-stand 60 (STS60) as field-tests of physical function. Linear regression models identified CV determinants of physical function measures, adjusted for age, gender, BMI, diabetes, ethnicity and systolic blood pressure. Troponin I, PWV and global native T1 were univariate determinants of ISWT and STS60 performance. NT pro-BNP was a univariate determinant of ISWT performance. In multivariate models, NT pro-BNP and global native T1 were independent determinants of ISWT and STS60 performance. LV ejection fraction was an independent determinant of ISWT distance. However, age and diabetes had the strongest relationships with physical function. In conclusion, NT pro-BNP, global native T1 and LV ejection fraction were independent CV determinants of physical function. However, age and diabetes had the greatest independent influence. Targeting diabetic care may ameliorate deconditioning in these patients and a multimorbidity approach should be considered when developing exercise interventions.

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