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Cardiovascular Events and Clinical Priorities in Chronic Kidney Disease

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Nephrology & Urology".

Deadline for manuscript submissions: closed (25 May 2022) | Viewed by 8960

Special Issue Editor


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Guest Editor
CNR-IFC, Clinical Epidemiology of Renal Diseases and Hypertension, Reggio Cal Unit, Reggio Calabria, Italy
Interests: cardio-vascular complications in hemodialysis patients; clinical hypertension; physical activity in dialysis patients; salt intake in CKD patients; sleep apnea in dialysis; sleep apnea in kidney transplanted patients; 24 h ABPM in dialysis patients

Special Issue Information

Dear Colleagues,

This Special Issue will deal with CV involvement in chronic kidney disease patients. The reason for focusing on this field is the still scarce importance given to the topic, which deserves due attention since CV death is one of the main causes of death in CKD patients. The scope of the Special Issue ranges from hereditary kidney diseases and their CV complications to the systemic aspects of urolithiasis, such as kidney stones. The diagnosis of heart failure in CKD is another hot topic which is worth addressing. PROMs, which is the acronym for Patient-Reported Outcome Measures, is a new frontier in medical science. 

PROMs are scientific tools that reflect the perspectives and experiences of people with chronic diseases in relation to their treatment or disease condition, giving value and quality to the information that comes from the people themselves. Other articles may focus on the impact of CV on two different types of dialysis treatment while a close look at nutrients in CKD with a special insight on salt intake will conclude this journey around the complex world of CV complications in chronic kidney diseases.

We hope that you will appreciate this SI and enjoy reading it.

Prof. Dr. Francesca Mallamaci
Guest Editor

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Keywords

  • CV complications
  • CKD
  • PROMs
  • dialysis treatments
  • salt

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Published Papers (3 papers)

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Research

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11 pages, 1121 KiB  
Article
Atrial Fibrillation and Chronic Kidney Disease—A Risky Combination for Post-Contrast Acute Kidney Injury
by Łukasz Kuźma, Anna Tomaszuk-Kazberuk, Anna Kurasz, Małgorzata Zalewska-Adamiec, Hanna Bachórzewska-Gajewska, Sławomir Dobrzycki, Marlena Kwiatkowska and Jolanta Małyszko
J. Clin. Med. 2021, 10(18), 4140; https://doi.org/10.3390/jcm10184140 - 14 Sep 2021
Cited by 2 | Viewed by 2302
Abstract
Atrial fibrillation (AF) symptoms may mimic coronary artery disease (CAD) which reflects the difficulties in qualifying AF patients for invasive diagnostics. A substantial number of coronary angiographies may be unnecessary or even put patients at risk of post-contrast acute kidney injury (PC-AKI), especially [...] Read more.
Atrial fibrillation (AF) symptoms may mimic coronary artery disease (CAD) which reflects the difficulties in qualifying AF patients for invasive diagnostics. A substantial number of coronary angiographies may be unnecessary or even put patients at risk of post-contrast acute kidney injury (PC-AKI), especially patients with chronic kidney disease (CKD). We aimed to investigate the hypothesis indicating higher prevalence of PC-AKI in patients with AF scheduled for coronary angiography. The study population comprised of 8026 patients referred for elective coronarography including 1621 with AF. In the comparison of prevalence of PC-AKI in distinguished groups we can see that kidney impairment was twice more frequent in patients with AF in both groups with CKD (CKD (+)/AF (+) 6.24% vs. CKD (+)/AF (−) 3.04%) and without CKD (CKD (−)/AF (+) 2.32% vs. CKD (−)/AF (−) 1.22%). In our study, post-contrast acute kidney disease is twice more frequent in patients with AF, especially in subgroup with chronic kidney disease scheduled for coronary angiography. Additionally, having in mind results of previous studies stating that AF is associated with non-obstructive coronary lesions on angiography, patients with AF and CKD may be unnecessarily exposed to contrast agent and possible complications. Full article
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12 pages, 1690 KiB  
Article
Does Statin Therapy Reduce the Risks of Mortality and Major Adverse Cardiac and Cerebrovascular Events in Young Adults with End-Stage Renal Disease? Population-Based Cohort Study
by Ya-Lien Cheng, Huang-Yu Yang, Chao-Yi Wu, Chung-Ying Tsai, Chao-Yu Chen, Ching-Chung Hsiao, Hsiang-Hao Hsu, Ya-Chung Tian and Chieh-Li Yen
J. Clin. Med. 2021, 10(10), 2097; https://doi.org/10.3390/jcm10102097 - 13 May 2021
Cited by 8 | Viewed by 2641
Abstract
Among hemodialysis patients aged more than 40 years old, previous large-scale studies showed statin treatment had no effect on reducing cardiovascular adverse events. However, young-adult-onset end-stage renal disease (ESRD) patients have different physicosocial factors compared to older ESRD patients. The benefit of statins [...] Read more.
Among hemodialysis patients aged more than 40 years old, previous large-scale studies showed statin treatment had no effect on reducing cardiovascular adverse events. However, young-adult-onset end-stage renal disease (ESRD) patients have different physicosocial factors compared to older ESRD patients. The benefit of statins in such a specific group has not been well evaluated. Through the use of Taiwan’s National Health Insurance Research Database (NHIRD), young adult patients aged 20–40 with incident ESRD requiring permanent dialysis between 1 January 2003 and 31 December 2015 were identified. The enrollees were further divided into two groups depending on whether they received statin therapy for more than 90 days (statin group) or never received any statin (nonstatin group) in the first year after initiation of dialysis. Propensity score weighting (PSW) was used to balance the baseline characteristics between the two groups. After PSW, the statin group (n = 771) exhibited a higher rate of major adverse cardiac and cerebrovascular events (MACCEs) (2.65% vs. 1.44%, hazard ratio (HR): 1.87, 95% confidence interval (CI): 1.43–2.45), and acute myocardial infarction (1.51% vs. 0.30%, HR: 5.34, 95% CI: 3.40–8.39) compared to the nonstatin group (n = 1709). The risk of all-cause mortality, cardiovascular (CV) death. and stroke did not significantly differ between the two groups. Similar to older patients, this study demonstrated that statin therapy cannot offer any protective effects in reducing CV outcomes among young adult ESRD patients undergoing dialysis. Full article
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Review

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12 pages, 938 KiB  
Review
Nephrolithiasis: A Red Flag for Cardiovascular Risk
by Alessia Gambaro, Gianmarco Lombardi, Chiara Caletti, Flavio Luciano Ribichini, Pietro Manuel Ferraro and Giovanni Gambaro
J. Clin. Med. 2022, 11(19), 5512; https://doi.org/10.3390/jcm11195512 - 20 Sep 2022
Cited by 6 | Viewed by 3256
Abstract
Epidemiological evidence shows that nephrolithiasis is associated with cardiovascular (CV) morbidities. The association between nephrolithiasis and CV disease is not surprising because both diseases share conditions that facilitate their development. Metabolic conditions, encompassed in the definition of metabolic syndrome (MS), and habits that [...] Read more.
Epidemiological evidence shows that nephrolithiasis is associated with cardiovascular (CV) morbidities. The association between nephrolithiasis and CV disease is not surprising because both diseases share conditions that facilitate their development. Metabolic conditions, encompassed in the definition of metabolic syndrome (MS), and habits that promote nephrolithiasis by altering urine composition also promote clinical manifestations of CV disease. By inducing oxidative stress, these conditions cause endothelial dysfunction and increased arterial stiffness, which are both well-known predictors of CV disease. Furthermore, the subtle systemic metabolic acidosis observed in stone formers with CV disease may have a pathogenic role by increasing bone turnover and leading to reduced mineral content and osteoporosis/osteopenia. Heart valves and/or coronary artery and aortic calcifications are frequently associated with reduced mineral density. This is known as the ‘calcification paradox’ in osteoporosis and has also been observed in subjects with calcium nephrolithiasis. Evidence supports the hypothesis that osteoporosis/osteopenia is an independent risk factor for the development of CV calcifications. In the long term, episodes of renal stones may occur from the onset of metabolic derangements/MS to arterial stiffness/atherosclerosis and CV morbidities. These episodes should be considered a warning sign of an ongoing and silent atherosclerotic process. The evaluation of cardiometabolic risk factors and MS components should be routine in the assessment of renal stone formers. This would allow for treatment and prevention of the development of CV complications, which are much more severe for the patient and for public health. Full article
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