scholarly journals Influence of Resveratrol on the Cardiovascular Health Effects of Chronic Kidney Disease

2020 ◽  
Vol 21 (17) ◽  
pp. 6294 ◽  
Author(s):  
Jenn-Yeu Song ◽  
Ta-Chung Shen ◽  
Yi-Chou Hou ◽  
Jia-Feng Chang ◽  
Chien-Lin Lu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Cardiovascular Health ◽  
Mineral Metabolism ◽  
Vascular Dysfunction ◽  
Cvd Risk ◽  
Term Survival ◽  
Beneficial Effects ◽  
Gut Microbe

Cardiovascular disease (CVD) is closely related to chronic kidney disease (CKD), and patients with CKD have a high risk of CVD-related mortality. Traditional CVD risk factors cannot account for the higher cardiovascular risk of patients with CKD, and standard CVD interventions cannot reduce the mortality rates among patients with CKD. Nontraditional factors related to mineral and vitamin-D metabolic disorders provide some explanation for the increased CVD risk. Non-dialyzable toxins, indoxyl sulfate (IS) and p-cresol sulfate (PCS)—produced in the liver by colonic microorganisms—cause kidney and vascular dysfunction. Plasma trimethylamine-N-oxide (TMAO)—a gut microbe-dependent metabolite of dietary L-carnitine and choline—is elevated in CKD and related to vascular disease, resulting in poorer long-term survival. Therefore, the modulation of colonic flora can improve prospects for patients with CKD. Managing metabolic syndrome, anemia, and abnormal mineral metabolism is recommended for the prevention of CVD in patients with CKD. Considering nontraditional risk factors, the use of resveratrol (RSV), a nutraceutical, can be helpful for patients with CVD and CKD. This paper discusses the beneficial effects of RSV on biologic, pathophysiological and clinical responses, including improvements in intestinal epithelial integrity, modulation of the intestinal microbiota and reduction in hepatic synthesis of IS, PCS and TMAO in patients with CVD and CKD.

scholarly journals Vascular dysfunction and atherosclerosis in chronic kidney disease; A distinct entity

2019 ◽  
Vol 8 (2) ◽  
pp. 17-17 ◽  
Author(s):  
Eranga Harshani Silva ◽  
Chandima Madhu Wickramatilake ◽  
Sarath Lekamwasam ◽  
Lakmini Kumari Boralugoda Mudduwa ◽  
Ranjuka Arushana Ubayasiri
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Vascular Dysfunction ◽  
Therapeutic Interventions ◽  
Cvd Risk ◽  
Unexplored Area ◽  
Calcium And Phosphate Metabolism ◽  
Conventional Risk Factors

Cardiovascular disease (CVD) is prevalent among patients with chronic kidney disease (CKD) and its occurrence and severity cannot be fully defined by the conventional cardiovascular risk factors namely age, hypertension, dyslipidaemia, diabetes mellitus and obesity. Contemporary studies have examined the role of non-conventional risk factors such as anemia, hyperhomocysteinemia, calcium and phosphate metabolism, vascular stiffness due to endothelial dysfunction ( ED), oxidative injury, and inflammation in the causation of CVD in CKD. Therapeutic interventions used in non-CKD patients are found to be less effective on patients with CKD. The purpose of this review was to gather available evidence on the CVD risk among CKD patients. Numerous mechanisms have been postulated to describe the increased atherogenicity in CKD patients. We discuss these mechanisms especially arterial stiffness, ED and inflammation in detail. In conclusion, CVD in CKD is still an unexplored area which needs further studies to uncover the possible mechanisms. Identifying newer therapies to improve health among this group of patients is of paramount importance.

scholarly journals Vitamin D Receptor Activators and Clinical Outcomes in Chronic Kidney Disease

2011 ◽  
Vol 2011 ◽  
pp. 1-13 ◽  
Author(s):  
Luciana Gravellone ◽  
Maria Antonietta Rizzo ◽  
Valentina Martina ◽  
Nicoletta Mezzina ◽  
Anna Regalia ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Vitamin D ◽  
Kidney Disease ◽  
Vitamin D Receptor ◽  
Mineral Metabolism ◽  
Controlled Trial ◽  
Protective Role ◽  
Hemodialysis Patients ◽  
Vitamin D Metabolites ◽  
Beneficial Effects

Vitamin D deficiency appears to be an underestimated risk factor for cardiovascular disease in patients with chronic kidney disease. Evidence from both basic science and clinical studies supports the possible protective role of vitamin D beyond its effect on mineral metabolism. Toxicity of pharmacologic doses of active vitamin D metabolites, in particular calcitriol, is mainly due to the possibility of positive calcium and phosphorus balance. Therefore, vitamin D analogs have been developed, which suppress PTH secretion and synthesis with reduced calcemic and phosphatemic effects. Observational studies suggest that in hemodialysis patients the use of a vitamin D receptor (VDR) activator, such as calcitriol, doxercalciferol, paricalcitol, or alfacalcidol, is associated with a reduced mortality when compared with nonusers of any VDR activator. In this article the existing literature on the topic is reviewed, although a more robust answer to the question of whether or not VDR activators have beneficial effects in hemodialysis patients will hopefully come from a randomized controlled trial.

scholarly journals Cardiovascular Risk Factors in Pre-dialysis Chronic Kidney Disease patients of Nepal

2020 ◽  
Vol 9 (2) ◽  
pp. 47-53
Author(s):  
Kashyap Dahal ◽  
A. Baral ◽  
K.K. Sah ◽  
J.R. Shrestha ◽  
A. Niraula ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Kidney Disease ◽  
Multiple Logistic Regression Analysis ◽  
Multiple Logistic Regression ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Traditional Risk Factors

Background and Aims: Cardiovascular disease (CVD) is the commonest cause of morbidity and mortality in patients with chronic kidney disease (CKD) due to increased prevalence of traditional and nontraditional CVD risk factors. Our study aimed to evaluate these risk factors in pre-dialysis Nepalese CKD patients. Methods: This was a cross-sectional study conducted in Department of Nephrology, Bir hospital. Total 100 consecutive pre-dialysis CKD patients were enrolled. Ten traditional and six nontraditional CVD risk factors were analyzed and compared between CKD stages. Descriptive statistics was used to illustrate the socio-demographic and clinical characteristics, chi square test for categorical variables and multiple logistic regression analysis was done to determine the risk factors of CVD in CKD patients. p-value<0.05 was considered to be statistically significant. Results: Mean patient age was 52.03}13.64 years with majority (60%) of the patients being male. Comparison of traditional risk factors in different stages depicted similar trend except for old age in Stage 3 CKD (p=0.002). Anemia (p<0.001), hyperphosphatemia (p=0.01), hyperparathyroidism (p<0.01) and cumulative nontraditional risk factors were significantly higher (p=0.01) in stage 5 CKD. The predicted CVD events by Framingham risk score showed high risk in 37% with no significant difference among the stages. Multiple logistic regression analysis showed increased body mass index, low serum albumin and increased serum phosphate as the three significant predictors for left ventricular hypertrophy. Conclusion: Our study shows that the CVD risk factors were prevailing along the various stages of CKD. The occurrence of non-traditional risk factors increased with increasing stage of CKD.

scholarly journals Nontraditional Biomarkers for Cardiovascular Disease in Patients With Chronic Kidney Disease

2020 ◽  
Vol 43 (2) ◽  
pp. 51-60
Author(s):  
Ittikorn Spanuchart ◽  
Arkom Nongnuch ◽  
Youg Liu
Keyword(s):  
Cardiovascular Disease ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Arterial Stiffness ◽  
Mineral Metabolism ◽  
Uremic Toxins ◽  
Calcium Balance ◽  
The Novel ◽  
Cvd Risk ◽  
Chd Risk

Cardiovascular disease (CVD) is the leading cause of death among patients who have chronic kidney disease (CKD). Nowadays, CKD per se is considered one of the coronary heart disease (CHD) risk equivalents. Apart from traditional CVD risk factors, there are several possible determinants for CVD in patients with CKD, for example, uremic toxins, increased inflammatory stage, abnormal bone mineral metabolism, and positive calcium balance. In this narrative review, we offer a summary of the extensively studied biomarkers for CVD in patients with CKD, including uremic toxins (p-cresol, indoxyl sulfate, and advanced glycated end products), and a novel indicator of arterial stiffness, cardio-ankle vascular index (CAVI), which is an independent prognostic predictor for CVD. For the uremic toxins, we reviewed their metabolisms, particularly, how the reduced renal function in CKD patients affect their clearance and their clearance with dialysis. Also, we pay attention to the recent evidence on how those uremic toxins contribute to CVD and their clinical associations. We do not include the possible treatment targeting at those uremic toxins. As for the novel indicator of arterial stiffness, we reviewed the clinical application of CAVI in comparison to the standard indicator for arterial stiffness, pulse wave velocity.  

scholarly journals Psychosocial determinants of cardiovascular events among black Americans with chronic kidney disease or associated risk factors in the Jackson heart study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Nrupen A. Bhavsar ◽  
Clemontina A. Davenport ◽  
Lexie Zidanyue Yang ◽  
Sarah Peskoe ◽  
Julia J. Scialla ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Psychosocial Factors ◽  
Principal Component ◽  
Coping Resources ◽  
Jackson Heart Study ◽  
Cvd Risk ◽  
Heart Study ◽  
Increased Risk

Abstract Background Individuals with chronic kidney disease (CKD), hypertension (HTN), or diabetes mellitus (DM) are at increased risk for cardiovascular disease (CVD). The extent to which psychosocial factors are associated with increased CVD risk within these individuals is unclear. Black individuals experience a high degree of psychosocial stressors due to socioeconomic factors, environment, racism, and discrimination. We examined the association between psychosocial factors and risk of CVD events among Black men and women with CKD and CKD risk factors in the Jackson Heart Study. Methods and Results We identified 1919 participants with prevalent CKD or CKD risk factors at baseline. We used rotated principal component analysis - a form of unsupervised machine learning that may identify constructs not intuitively identified by a person - to describe five groups of psychosocial components (including negative moods, religiosity, discrimination, negative outlooks, and negative coping resources) based on a battery of questionnaires. Multiple imputation by chained equation (MICE) was used to impute missing covariate data. Cox models were used to quantify the association between psychosocial components and incident CVD, defined as a fatal coronary heart disease event, myocardial infarction, cardiac procedure (angiography or revascularization procedure), or stroke. Of the 929 participants in the analysis, 67% were female, 28% were current/former smokers with mean age of 56 years and mean BMI of 33 kg/m2. Over a median follow-up of 8 years, 6% had an incident CVD event. In multivariable models, each standard deviation (SD) increase in the religiosity component was associated with an increased hazard for CVD event (hazard ratio [HR] = 1.52, 95% CI: 1.09–2.13). Conclusions Religiosity was associated with CVD among participants with prevalent CKD or CKD risk factors. Studies to better understand the mechanisms of this relationship are needed.

Abstract P370: Risk Factors for Progression of Coronary Artery Calcification in Patients with Chronic Kidney Disease

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Joshua D Bundy ◽  
Lawrence J Appel ◽  
Matthew Budoff ◽  
Jing Chen ◽  
Alan S Go ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Coronary Artery ◽  
Kidney Disease ◽  
Cystatin C ◽  
Coronary Artery Calcification ◽  
Lipid Lowering ◽  
Cvd Risk Factors ◽  
Cvd Risk

Introduction: Coronary artery calcification (CAC) is prevalent among patients with chronic kidney disease (CKD) and predicts the risk of cardiovascular disease (CVD). Risk factors for the progression of CAC in patients with CKD have not been well studied. Hypothesis: We assessed the hypothesis that several established and novel CVD risk factors are associated with progression of CAC among patients with CKD. Methods: In a random subsample of 1,123 participants from the Chronic Renal Insufficiency Cohort (CRIC) Study, CAC was measured at baseline and the follow-up visit using electron beam computed tomography (CT) or multidetector CT. CAC progression was defined as an increase of Agatston score ≥100 units during follow-up. Multiple logistic regression and mixed-effects regression models were used to assess risk factors for progression of CAC. Results: Over an average of 3-year follow-up, 332 (29.6%) participants developed CAC progression. After adjusting for age, sex, race, clinical site, total cholesterol, HDL-cholesterol, systolic blood pressure, antihypertensive treatment, diabetes, and current smoking in the multivariable models, history of CVD (odds ratio [OR] 1.53, 95% CI 1.09-2.15, p=0.02), lipid-lowering treatment (OR 1.81, 95% CI 1.28-2.55, p<0.001), higher serum phosphate (OR 1.37, 95% CI 1.17-1.61, p<0.001), hemoglobin A1c (OR 1.32, 95% CI 1.10-1.58, p=0.002), and cystatin C (OR 1.24, 95% CI 1.06-1.45, p=0.007), and lower estimated-glomerular filtration rate (eGFR) (OR 1.32, 95% CI 1.10-1.56, p=0.002) were associated with CAC progression. In addition, lower physical activity, lipid-lowering treatment, body-mass index, LDL-cholesterol, lower serum calcium, phosphate, total parathyroid hormone, fibrinogen, interleukin-6, tumor necrosis factor-α, fibroblast growth factor-23, lower eGFR, cystatin C, and 24-hour urine albumin were associated with square root transformed change in CAC score from baseline in multiple-adjusted models. These findings persisted after additional adjustment for baseline CAC score. Conclusions: In conclusion, these data suggest that reduced kidney function, calcium and phosphate metabolic disorders and inflammation, in addition to established CVD risk factors, might play a role in CAC progression among patients with CKD.

scholarly journals Product of Serum Calcium and Phosphorus (Ca x Pi) as a Predictor of Cardiovascular Disease Risk in Patients with Chronic Kidney Disease

2020 ◽  
Vol 8 (1) ◽  
pp. 23-26
Author(s):  
Rojina Bakhunchhen ◽  
Raju Kumar Dubey ◽  
Archana Jayan ◽  
Santosh Kumar Shah ◽  
Prabin Khatri
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Serum Calcium ◽  
Cvd Risk ◽  
Group 3 ◽  
Calcium And Phosphorus ◽  
Group 2 ◽  
Group 1

INTRODUCTION: Most of the chronic kidney disease (CKD) patients develop cardiovascular disease (CVD) in their later stages. Various traditional CVD risk factors are highly prevalent in CKD but mortality of these patients cannot be fully justified by these CVD markers. So this study was designed to determine serum calcium and phosphorus product (Ca×Pi) to predict CVD risk in CKD patients. MATERIAL AND METHODS We followed the guidelines of NKF-KDOQI for CKD diagnosis and staging. Further the patients were classified into 3 different groups based on Ca×Pi product; <40 mg2/dl2 (group 1), 40-55 mg2/dl2 (group 2) and >55 mg2/dl2 (group 3). We then evaluated CVD risk by various traditional risk factors like age, BMI, BP, smoking history, dyslipidemia, previous history of CVD, LVH, arrhythmia, VHD, cardiomyopathy, and IHD. RESULTS: Higher level of Ca×Pi was associated with presence of LVH (32.30% in group 1, 31.42% in group 2 and 46.66% in group 3), Arrythemia (13.84% in group 1, 28.57% in group 2 and 46.67% in group 3), VHD (5.71% in group 2 and 10.00% in group 3), Cardiomyopathy (1.53% in group 1, 8.57% I group 2 and 6.66% in group 3), IHD (6.15% in group1, 11.42% in group 2 and 13.33% in group 3) and hypercholesterolemia, hypertriglyceridemia and increased LDLc. CONCLUSION: This study found that higher Ca×Pi increases with decline in glomerular filtration rate (GFR) and associated with CVD risks and CVD. So, this study raise a potential need to evaluate the level of calcium and phosphorus in all CKD patients and the level should be monitored more thoroughly to prevent CVD.

scholarly journals Cardiovascular calcification in chronic kidney disease: Risk factors and effect of α-keto acid tablets

2021 ◽  
Vol 20 (11) ◽  
pp. 2451-2457
Author(s):  
Ning Xiang ◽  
Haijun Liao ◽  
Zichen Zhai ◽  
Jingwen Gong
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Disease Risk ◽  
Mineral Metabolism ◽  
Symptomatic Treatment ◽  
Study Groups ◽  
Study Group ◽  
Keto Acid ◽  
Significant Difference

Purpose: To investigate the effect of α-keto acid tablets, and risk factors for cardiovascular calcification in patients with chronic kidney disease (CKD).Methods: A total of 128 CKD patients were enrolled in this study. They were randomly assigned to study and control groups, each with 64 patients. Control patients received symptomatic treatment, while the study group patients received α-keto acid tablets plus. Indices of cardiovascular calcification, blood lipids and mineral metabolism were determined in the 2 groups of patients and compared. Risk factors for cardiovascular calcification were also analyzed.Results: After treatment, the two groups had decreased CACS scores and reduced serum FGF-23levels, with lower values in patients in the study group. Levels of Klotho and fetuin-A were significantly elevated after treatment, with higher values observed in study group patients. The degree of cardiovascular calcification was markedly lower in study group than that in controls. There was no significant difference in blood Ca level between the control and study groups before and after treatment. Logistic multivariate analysis demonstrated that hyperlipidemia, hyperphosphatemia, hypercalcemia, hypertension and diabetes put patients at risk for cardiovascular calcification.Conclusion: Compound α-keto acid tablets delay cardiovascular calcification in patients with CKD, and alleviate symptoms of related risk factors for cardiovascular calcification.

scholarly journals Predictive Value of Creatinine-based Equations of Kidney Function in the Long-term Prognosis in United Arab Emirates Patients

2021 ◽  
Vol 36 (1) ◽  
pp. e217-e217
Author(s):  
Saif Al-Shamsi ◽  
Romona D. Govender ◽  
Jeffrey King
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Kidney Function ◽  
Mortality Prediction ◽  
The Body ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Cox Regression Analysis ◽  
All Cause Mortality

Objectives: Chronic kidney disease (CKD) is an independent predictor of mortality. Several creatinine-based equations are used to assess the estimated glomerular filtration rate or creatinine clearance and mortality prediction in various ethnic populations. Similarly, renal insufficiency is associated with poor prognosis of UAE nationals with cardiovascular disease (CVD) risk factors. However, the equation that best assesses prognosis among these patients is unknown. This study aimed to compare the prognostic abilities of different creatinine-based kidney function equations for predicting all-cause mortality in UAE nationals with vascular comorbidities. Methods: This retrospective observational study analyzed 1186 patients (54.0% men) with CVD risk factors. Multivariable Cox regression analysis was used to evaluate the associations of categorical renal function stages with all-cause mortality. Measures of performance in each equation assessed with respect to all-cause mortality were evaluated and compared to the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation by calculating the C-index, net reclassification index (NRI), and integrated discrimination index. Results: Over a median follow-up of 8.9 years, the cumulative incidence of all-cause mortality was 9.4% (n = 112). After multivariable adjustment, the discriminative ability for all-cause mortality was significantly higher in the body surface area-adjusted Cockcroft-Gault (BSA-CG) formula than in the CKD-EPI equation (C-indices: 0.869 vs. 0.861, respectively, p =0.037). NRI was significantly positive and favored the BSA-CG formula (0.54; 95% confidence interval: 0.35–0.64) compared to the CKD-EPI equation. Conclusions: Our findings suggest that the BSA-CG equation may have the potential to slightly improve mortality prediction compared to the CKD-EPI equation in UAE nationals with vascular risk. Further large multicenter studies are warranted to confirm our findings.

Abstract P300: Cardiovascular Risk Inequality in Subjects with Chronic Kidney Disease by Age, Race and Ethnicity in the United States

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Longjian Liu
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Risk Factor ◽  
Kidney Disease ◽  
Race And Ethnicity ◽  
Kidney Diseases ◽  
The United States ◽  
Excess Risk ◽  
Cvd Risk ◽  
Race Ethnicity

Objectives: Adults with chronic kidney disease (CKD) carry an extraordinarily excess risk for cardiovascular disease (CVD). The present study aimed to test two hypotheses: (1) Non-Hispanic black (NHB) with CKD have significantly higher CVD risk profiles than non-Hispanic white (NHW). (2) This difference significantly contributes to the excess risk of CVD in NHB versus NHW. Methods: A total of 3,939 participants aged 21-74 years old in the baseline Chronic Renal Insufficiency Cohort Study, a multiethnic population-based study supported by the National Institute of Diabetes and Digestive and Kidney Diseases, were analyzed. CKD was classified using estimate glomerular filtration rate. A sum weighted CVDRisk score was developed from multiple CVD risk factors. Differences in CVDRisk score by race/ethnicity were tested using quantile regression (QR), a novel data mining approach to identify distribution of risk factors and outcomes. Results: The prevalence of CVD was 30.7 and 38.2% in NHW and NHB with CKD (p<0.001). The means (SD) of CVDRisk score were 12.6 (5.7) in NHW and 14.6 (6.4) in NHB (p<0.001). QR analysis indicated that NHB had significantly higher CVDRisk score in all quantile (Qs) of CVDRisk score than NHW. This race/ethnicity difference was even worse among younger NHB (aged <65). An estimated 32% of the excess CVD prevalence for NHB versus NHW may be attributable to a higher CVDRisk score in those aged<65 years old. Conclusion: The study highlights an excess and disproportionate distribution of CVD risk factor profile in subjects with CKD for NHB versus NHW. An estimated one third of the excess CVD prevalence in younger NHB with CKD could be explained by their higher CVD risk factor profiles.

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