scholarly journals Differential Impact of Chronic Kidney Disease on Coronary Calcification and Atherosclerosis in Asymptomatic Individuals with or without Diabetes: Analysis from a Coronary Computed Tomographic Angiography Registry

2018 ◽  
Vol 8 (3) ◽  
pp. 228-236 ◽  
Author(s):  
Ik Jun Choi ◽  
Sungmin Lim ◽  
Eun-Ho Choo ◽  
Jin-Jin Kim ◽  
Byung-Hee Hwang ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Function ◽  
Coronary Artery ◽  
Kidney Disease ◽  
Normal Renal Function ◽  
Coronary Atherosclerosis ◽  
Coronary Calcification ◽  
Developmental Pattern ◽  
Diabetes Status ◽  
Asymptomatic Individuals

Aim: The aim of this study was to assess the combined effects of chronic kidney disease (CKD) and diabetes on the extent and developmental pattern of coronary artery disease (CAD). Methods: A total of 3,017 self-referred asymptomatic individuals without known CAD who underwent 64-channel dual-source coronary computed tomography angiography between 2006 and 2010 were enrolled. The patients were divided into six groups based on their diabetes status (nondiabetic or diabetic) and estimated glomerular filtration rate (eGFR) (eGFR > 90 mL/min/1.73 m2, normal renal function; eGFR 60–89, mild CKD; or eGFR 30–59, moderate CKD). We compared the coronary artery calcium score (CACS), segment stenosis score (SSS), and ≥50% obstructive CAD among the groups. Results: In nondiabetics, whereas SSS and ≥50% obstructive CAD were not different as renal function deteriorated, after adjusting for cardiovascular risk factors, CACS showed a unique developmental pattern: no CACS increase until mild CKD, but abrupt increase from the stage of moderate CKD (moderate vs. normal renal function, adjusted OR 5.118, 95% CI 1.293–20.262, p = 0.020). In diabetics, patients from the stage of mild CKD were more likely to have ≥50% obstructive CAD (p = 0.004), higher CACS (p = 0.020), and SSS (p = 0.001) in multivariable analysis. Conclusions: The presence of CKD did not have a significant impact on the development of coronary atherosclerosis, but affected the progression of coronary calcification more markedly from the stage of moderate CKD in nondiabetics. However, in diabetics, the deterioration of renal function was significantly associated with the development of coronary atherosclerosis and calcification from the stage of mild CKD.

scholarly journals Renal function trajectories in hepatitis C infection: differences between renal healthy and chronic kidney disease individuals

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Cheng-Kai Hsu ◽  
Tai-Shuan Lai ◽  
Yih-Ting Chen ◽  
Yi-Ju Tseng ◽  
Chin-Chan Lee ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Function ◽  
Hepatitis C ◽  
Kidney Disease ◽  
Normal Renal Function ◽  
Elderly Women ◽  
Hcv Infection ◽  
Diabetic Patients ◽  
Subgroup Analyses ◽  
Egfr Decline

AbstractAssociations between hepatitis C virus (HCV) and chronic kidney disease (CKD) have been reported; however, differences of renal progression between general and CKD population remain to be elucidated in prospective studies. A total of 1179 participants, who have tested for anti-HCV antibody, were enrolled and prospectively followed for 3 years. The risks associated with HCV infection, in terms of incidence of CKD, annual estimated glomerular filtration rate (eGFR) changes and 50% decline of eGFR at 3-year from baseline, were compared between normal renal function subjects and CKD patients. Overall, 111 of 233 (47.6%) CKD patients and 167 of 946 (17.7%) non-CKD subjects had HCV infection. The crude incidence rates of CKD were 226.9 per 1000 person-years and 14.8 per 1000 person-years in in HCV and non-HCV infected patients, respectively. The adjusted hazard ratio of HCV infection for incident CKD was 7.9 (95% CI 5–12.7). The HCV-infected normal renal function subjects were independently associated with increased risks of eGFR decline in the 1-year, 2-year and 3-year, respectively. The risk associations remained significant in 50% decline of eGFR at 3 years models and in different subgroup analyses. The increases of risks of eGFR decline were also notorious among overall HCV-infected CKD patients. However, the risk associations were less prominent in subgroup analyses (elderly, women and diabetic patients). The findings highlighted the importance of viral diagnosis with not only prognostic but also public health implications for preserving kidney function.

Statin Use and Incidence of Chronic Kidney Disease in Hypercholesterolemia Patients with Normal Renal Function

2021 ◽  
pp. 1-9
Author(s):  
Hyo-Sun You ◽  
Sang-Jun Shin ◽  
Joungyoun Kim ◽  
Hee-Taik Kang
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Function ◽  
Risk Factor ◽  
Kidney Disease ◽  
Normal Renal Function ◽  
Hazard Ratios ◽  
Statin Usage ◽  
Incidence Of Ckd ◽  
Cox Proportional Hazard Regression ◽  
Statin Use

<b><i>Introduction:</i></b> Dyslipidemia is a known risk factor for chronic kidney disease (CKD). The effects of statins on CKD have already been studied in patients with CKD; however, data on the general population are limited. This study aimed to determine the relationship between statin use and the incidence of CKD in patients with hypercholesterolemia having normal renal function. <b><i>Methods:</i></b> A total of 7,856 participants aged 40–79 years at baseline (2009–2010) were included in the final analyses. The participants were divided into statin users (<i>n</i> = 4,168) and statin nonusers (<i>n</i> = 3,668), according to the statin usage. The Cox proportional hazard regression model was used to evaluate the adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) for CKD. <b><i>Results:</i></b> The median follow-up duration was 5.8 years. A total of 543 cases of CKD (285 cases in males and 258 cases in females) occurred during the study period. The estimated cumulative incidence of CKD was significantly different between male statin nonusers and users (<i>p</i> &#x3c; 0.001), while it was not statistically significant between female statin nonusers and users (<i>p</i> = 0.126). Compared with statin nonusers, the fully adjusted HRs (95% CIs) for CKD in statin users were 1.014 (0.773–1.330) in males and 1.117 (0.843–1.481) in females. <b><i>Conclusion:</i></b> Dyslipidemia is an obvious risk factor for CKD; however, statin use in patients with hypercholesterolemia having normal renal function does not demonstrate a clear relationship with the incidence of CKD.

scholarly journals High and low sodium intakes are associated with incident chronic kidney disease in patients with normal renal function and hypertension

2018 ◽  
Vol 93 (4) ◽  
pp. 921-931 ◽  
Author(s):  
Chang-Yun Yoon ◽  
Juhwan Noh ◽  
Jinae Lee ◽  
Youn Kyung Kee ◽  
Changhwan Seo ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Function ◽  
Kidney Disease ◽  
Normal Renal Function ◽  
Low Sodium ◽  
Incident Chronic Kidney Disease

Arterial stiffness and declines in individuals with normal renal function/early chronic kidney disease

2010 ◽  
Vol 212 (1) ◽  
pp. 345-350 ◽  
Author(s):  
Hirofumi Tomiyama ◽  
Hirofumi Tanaka ◽  
Hideki Hashimoto ◽  
Chisa Matsumoto ◽  
Mari Odaira ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Function ◽  
Kidney Disease ◽  
Arterial Stiffness ◽  
Normal Renal Function

scholarly journals Urinary endothelin-1 in chronic kidney disease and as a marker of disease activity in lupus nephritis

2009 ◽  
Vol 296 (6) ◽  
pp. F1477-F1483 ◽  
Author(s):  
Neeraj Dhaun ◽  
Pajaree Lilitkarntakul ◽  
Iain M. MacIntyre ◽  
Eline Muilwijk ◽  
Neil R. Johnston ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Function ◽  
Kidney Disease ◽  
Disease Activity ◽  
Normal Renal Function ◽  
Renal Involvement ◽  
Creatinine Ratio ◽  
Renal Inflammation ◽  
Endothelin 1 ◽  
The Impact

Chronic inflammation contributes to the development and progression of chronic kidney disease (CKD). Identifying renal inflammation early is important. There are currently no specific markers of renal inflammation. Endothelin-1 (ET-1) is implicated in the pathogenesis of CKD. Thus, we investigated the impact of progressive renal dysfunction and renal inflammation on plasma and urinary ET-1 concentrations. In a prospective study, plasma and urinary ET-1 were measured in 132 subjects with CKD stages 1 to 5, and fractional excretion of ET-1 (FeET-1) was calculated. FeET-1, serum C-reactive protein (CRP), urinary ET-1:creatinine ratio, and urinary albumin:creatinine ratio were also measured in 29 healthy volunteers, 85 subjects with different degrees of inflammatory renal disease but normal renal function, and in 10 subjects with rheumatoid arthritis without renal involvement (RA). In subjects with nephritis associated with systemic lupus erythematosus (SLE), measurements were done before and after 6 mo of treatment. In subjects with CKD, plasma ET-1 increased linearly as renal function declined, whereas FeET-1 rose exponentially. In subjects with normal renal function, FeET-1 and urinary ET-1:creatinine ratio were higher in SLE subjects than in other groups (7.7 ± 2.7%, 10.0 ± 3.0 pg/μmol, both P < 0.001), and correlated with CRP, and significantly higher than in RA subjects (both P < 0.01) with similar CRP concentrations. In SLE patients, following treatment, FeET-1 fell to 3.6 ± 1.4% ( P < 0.01). Renal ET-1 production increases as renal function declines. In subjects with SLE, urinary ET-1 may be a useful measure of renal inflammatory disease activity while measured renal function is still normal.

Relationship of coronary artery calcification with renal function decline and mortality in predialysis chronic kidney disease patients

2018 ◽  
Vol 34 (10) ◽  
pp. 1715-1722 ◽  
Author(s):  
Michelle C Lamarche ◽  
Wilma M Hopman ◽  
Jocelyn S Garland ◽  
Christine A White ◽  
Rachel M Holden
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Function ◽  
Coronary Artery ◽  
Kidney Disease ◽  
Coronary Artery Calcification ◽  
Mineral And Bone Disorder ◽  
Renal Function Decline ◽  
Urine Albumin ◽  
End Stage ◽  
Relationship Of

Abstract Background Patients with chronic kidney disease (CKD) have higher levels of coronary artery calcification (CAC) compared with the general population. The role of CAC in renal function decline is not well understood. Methods In this prospective cohort study of Stages 3–5 CKD patients with CAC scores kidney function decline, development of end-stage kidney disease (ESKD) and all-cause mortality were determined at 5 and 10 years. Baseline variables included markers of CKD and chronic kidney disease mineral and bone disorder (CKD-MBD), demographics and comorbidities. Multivariable analyses identified predictors of outcomes, and survival curves demonstrated the association of CAC score with ESKD and mortality. Results One hundred and seventy-eight patients were enrolled between 2005 and 2007. Independent predictors of ESKD at 5 years were estimated glomerular filtration rate (eGFR) and urine albumin–creatinine ratio (UACR); at 10 years, eGFR was no longer a predictor, but CAC was now significant. Those who developed ESKD at the fastest rate either had the highest CAC score (≥400 AU) or were youngest and had the lowest calcidiol, and highest serum phosphate, UACR and percentage change in CAC per year. Predictors of eGFR decline over 5 years were UACR, parathyroid hormone and CAC score. Predictors of mortality at 5 years were age, diabetes and eGFR and at 10 years also included CAC score. Conclusions In Stages 3–5 CKD patients, CAC is an independent predictor of both ESKD and mortality at 10 years. Those who developed ESKD at the fastest rate either had the highest CAC score or the worst CKD-MBD derangements.

Sign in / Sign up

Export Citation Format

Share Document