Download or read book Vascular Calcification and Cardiovascular Risk in Chronic Kidney Disease written by Ana Paula Andrade da Silva and published by . This book was released on 2018 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Cardiovascular disease is the primary cause of morbidity and mortality in chronic kidney disease (CKD) population, particularly in end stage renal disease (ESRD). This could be explained in part due to the presence of traditional cardiovascular risk factors, such as older age, hypertension, dyslipidemia and diabetes, but is also associated with nontraditional cardiovascular risk factors related to CKD, like inflammation, anemia, abnormal calcium and phosphate metabolism and extracellular fluid volume overload, which may contribute to intimal or medial wall arterial calcification. Vascular calcification (VC) is a dynamic process, resulting from the dysregulation of the balance of molecules that promote and those that inhibit this course. It is important for clinicians to both acknowledge and recognize the pathways and risk factors of VC in order to improve cardiovascular health in CKD patients. This chapter will focus on the biology of VC, the association with CKD, risk factor modification, screening and prevention of VC and cardiovascular disease in CKD patients.
Download or read book Calcium Calcification and Cardiovascular Risk in Chronic Kidney Disease written by and published by . This book was released on 2009 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Vascular calcification (VC), induced by imbalances of mineral metabolism, is a major precipitant to cardiovascular (CV) disease in patients with chronic kidney disease (CKD). VC has intimate interactions with bone mineralization and is associated with enhanced bone resorption. Arterial stiffness represents the functional disturbance of VC and is also greater in CKD than the general population. Both VC and arterial stiffness can be measured and monitored through non-invasive techniques involving computed tomography (CT), ultrasound, echocardiography, and pulse wave velocity (PWV). Management of these complications in CKD is difficult but detection, prevention and treatment is crucial to reduce CV mortality. This thesis examines the area of VC and CV risk in patients with CKD, with the use of different imaging modalities to determine and measure VC and arterial stiffness and different interventions to address the progression of these surrogate markers of CV disease. Using CT scans, the extent of VC in the aorta, superficial femoral arteries and arteriovenous fistulae has been studied, the latter vascular site never reported in the literature previously with regards to VC. The use of bone densitometry or dual-energy X-ray absorptiometry (DXA) to determine VC is also explored, with the first reports of its potential use in measuring VC in the aorta of CKD patients. Associations of VC and arterial stiffness are also presented with analyses of risk factors for these predictors of CV morbidity and mortality in the Australian CKD population. This thesis outlines the significant prevalence of VC and arterial stiffness in CKD patients in Australia, which has never been reported previously. The relationship between bone mineral density (BMD) and VC is strongly highlighted and the use (benefits and limitations) of DXA scans in patients with CKD is explored. With limited interventions reported to prevent the progression of VC in CKD, this thesis examines the use of bisphosphonat.
Download or read book Calcium Calcification and Cardiovascular Risk in Chronic Kidney Disease written by Nigel David Toussaint and published by . This book was released on 2009 with total page 832 pages. Available in PDF, EPUB and Kindle. Book excerpt: Vascular calcification (VC), induced by imbalances of mineral metabolism, is a major precipitant to cardiovascular (CV) disease in patients with chronic kidney disease (CKD). VC has intimate interactions with bone mineralization and is associated with enhanced bone resorption. Arterial stiffness represents the functional disturbance of VC and is also greater in CKD than the general population. Both VC and arterial stiffness can be measured and monitored through non-invasive techniques involving computed tomography (CT), ultrasound, echocardiography, and pulse wave velocity (PWV). Management of these complications in CKD is difficult but detection, prevention and treatment is crucial to reduce CV mortality. This thesis examines the area of VC and CV risk in patients with CKD, with the use of different imaging modalities to determine and measure VC and arterial stiffness and different interventions to address the progression of these surrogate markers of CV disease. Using CT scans, the extent of VC in the aorta, superficial femoral arteries and arteriovenous fistulae has been studied, the latter vascular site never reported in the literature previously with regards to VC. The use of bone densitometry or dual-energy X-ray absorptiometry (DXA) to determine VC is also explored, with the first reports of its potential use in measuring VC in the aorta of CKD patients. Associations of VC and arterial stiffness are also presented with analyses of risk factors for these predictors of CV morbidity and mortality in the Australian CKD population. This thesis outlines the significant prevalence of VC and arterial stiffness in CKD patients in Australia, which has never been reported previously. The relationship between bone mineral density (BMD) and VC is strongly highlighted and the use (benefits and limitations) of DXA scans in patients with CKD is explored. With limited interventions reported to prevent the progression of VC in CKD, this thesis examines the use of bisphosphonates to reduce VC and atherosclerosis, as well as to reduce loss of BMD. Experimental studies report the benefits of bisphosphonates to treat extra-osseous calcification, however there are few reported clinical studies in CKD. A randomised placebo-controlled trial is presented showing no significant effect of bisphosphonates on VC in CKD patients with moderate to severe renal impairment (not yet on dialysis). Another randomised study in his thesis addresses the impact of regular exercise as a further intervention to reduce CV risk. The use of intra-dialytic exercise is assessed showing an improvement of arterial compliance in haemodialysis patients with this strategy.Finally, this thesis also examines the impact of dialysate calcium for haemodialysis patients and the effect that differing concentrations may have on bone and CV complications. Particular emphasis is on dialysate calcium in nocturnal haemodialysis patients, given limited literature in this area, and the importance of this exogenous calcium load on the development of VC in CKD as well as the beneficial effect that longer and more frequent dialysis may have on CV outcomes. [Author edited abstract].
Download or read book Chronic Kidney Disease written by Thomas Rath and published by BoD – Books on Demand. This book was released on 2018-02-21 with total page 307 pages. Available in PDF, EPUB and Kindle. Book excerpt: Known worldwide, chronic kidney disease (CKD) is a disease that affects up to 4% of the population with increasing figures also in the developing countries. Life expectancy of patients affected by CKD is shortened compared to the overall population, and only a minority of patients reach end-stage renal disease (ESRD) with the need for dialysis or renal transplantation; death overtakes dialysis. In the 13 chapters, this book sheds light on the different aspects related to pathophysiology and clinical aspects of CKD, providing interesting insights into not only inflammation and cardiovascular risk but also the interplay of hormones and the functional aspects of endothelial function. In addition, chapters dealing with genetic aspects of polycystic kidney disease and also the clinical handling of patients with CKD and peritoneal dialysis will be beneficial for the open-minded reader.
Download or read book Cardiovascular Calcification written by Michael Henein and published by Springer. This book was released on 2022-09-22 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: The book systematically describes the clinical and scientific aspects of cardiovascular calcification. Chapters detail the mechanisms associated with arterial and valve calcification, relevant risk factors, pathophysiology and the latest therapeutic techniques. Recent diagnostic technological developments including how computed tomography (CT) scanning can be utilized along with Agatston score to quantify coronary arterial calcification when investigating whether a patient for sub-clinical atherosclerosis are covered. The correlation with the presence of arterial calcification and extent of coronary stenosis is also explored. Cardiovasular Calcification details relevant aspects of the basic science and reviews the latest pathological and therapeutic techniques used in treating patients with cardiovascular calcification. It is therefore an essential resource for practicing cardiologists, cardiac surgeons, vascular specialists and radiologists.
Download or read book Nolph and Gokal s Textbook of Peritoneal Dialysis written by Ramesh Khanna and published by Springer Science & Business Media. This book was released on 2009-05-28 with total page 927 pages. Available in PDF, EPUB and Kindle. Book excerpt: Nolph and Gokal's Text Book of Peritoneal Dialysis, Third Edition, covers advances made in the field for the past 30 years. During the past two decades, the time during which this therapy has been increasingly utilized, this text has continued to be recognized as the major source of the discipline's base knowledge. The evolution of this text to its newest edition parallels the growth of peritoneal dialysis from Continuous Ambulatory Peritoneal Dialysis in the eighties to the current therapy that encompasses manual and automated therapies with full emphasis on adequacy of dialysis dose. Peritoneal dialysis represents an intracorporeal technique for blood purification. This unique dialysis system represents one of many human attempts to manipulate nature for sustenance of life. The past few years of advances have focused on further improvement of the technique. Areas that have fueled the interest of researchers include: (1) Physiology of high transporters (and the role of genetics and inflammation); (2) Continued debate over the most appropriate adequacy indices (small solute clearances, large solute clearances, clinical assessment etc.); (3) Understanding, preventing and treating the MIA syndrome in PD patients ( including the roles of leptin, and adiponectin); (4) Pathogenesis and newer management strategies of vascular calcification; (5) Continued improvements in infectious complications including peritonitis; (6) Further improvements in catheter technology; (7) Automated techniques; (8) Explaining and correcting PD underutilization; (9) Rationale and applications of newer dialysis solutions; (10) New understanding and approaches to management of osteodystrophy; (11) Refinements in anemia management including new insights in iron metabolism in PD patients; (12) Further definition of indications for PD; (13) The ideal time to initiate dialysis. Newer insight into host defense mechanisms have also made the past decade of advances in the field more meaningful for clinicians. This text also covers the knowledge gained from animal models of peritoneal dialysis. Nolph and Gokal's Textbook of Peritoneal Dialysis, Third Edition is a compilation of the latest knowledge in the field. It cites and describes in great detail, the new discoveries and the evolution of understanding the subject of these discoveries.
Download or read book Comorbidities in Chronic Kidney Disease CKD written by Joachim Jankowski and published by MDPI. This book was released on 2021-03-02 with total page 184 pages. Available in PDF, EPUB and Kindle. Book excerpt: With a mean worldwide prevalence of 13%, chronic kidney disease imposes a massive health burden on our society. In addition to reduced kidney function, patients with chronic kidney disease increasingly suffer from cardiovascular diseases affecting the heart and vasculature. Cardiovascular diseases account for around half of the deaths of patients with advanced chronic kidney disease. However, therapeutic options are highly insufficient. The pathological mechanisms that underlie increased cardiovascular risk in patients with chronic kidney disease remain largely unknown. This Special Issue provides insights into comorbidities in CKD patients, mainly focused on increased cardiovascular risk, and summarizes current knowledge of underlying pathophysiological mechanisms.
Download or read book Cardiovascular Disorders in Hemodialysis written by Claudio Ronco and published by Karger Medical and Scientific Publishers. This book was released on 2005-01-01 with total page 377 pages. Available in PDF, EPUB and Kindle. Book excerpt: Hemodialysis therapy has become a well-established form of renal replacement, and due to continuous improvements in technology, a series of new biomaterials and techniques for the clinical routine have been developed. Nevertheless, cardiovascular disorders in hemodialysis and uremia represent one of the most important aspects of modern nephrological care. This publication is therefore dedicated to cardiovascular risk factors, the role of the endothelium, problems related to mineral disorders and finally to the possible impact of new technologies on the final outcome in hemodialysis. Being a state-of-the-art appraisal of today's technology and current issues in hemodialysis with special regard to cardiovascular disorders and risk factors, this book is a synthesis between an educational effort aimed at the newer generations of physicians and nurses in the field of hemodialysis and a state-of-the-art description of the most advanced technologies in this field. At the same time, the lessons learned from large international trials, either already completed or to be completed in the years to come, are presented.
Download or read book Cardio Nephrology written by Janani Rangaswami and published by Springer. This book was released on 2017-07-31 with total page 426 pages. Available in PDF, EPUB and Kindle. Book excerpt: Extending from the outpatient management of cardiovascular and kidney disease, to hospital-based decision making in patients with cardio-renal disease and complex interfaces such as hemodialysis in patients with ventricular assist device support, this book serves as a single reference point for cardiology and nephrology clinicians and researchers dealing with the significant overlap areas between these two specialties. Chapters cover the physiology, biomarkers, therapeutic agents and full spectrum of these comorbidities and feature separate sections on cardiovascular and CKD evaluations, stratification of kidney transplant patients, lipid management in CKD, interventional strategies and hypertension. Leaders in cardiology, nephrology, hypertension and lipidology bring together the latest evidence with their collective clinical experience into this invaluable resource.This textbook is an essential resource for physicians and allied professionals practicing cardiology, nephrology, students and physician trainees, to deepen their understanding of this crucial field.
Download or read book Prevalence and Associations of Coronary Artery Calcification in Patients with Stages 3 5 Chronic Kidney Disease Without Cardiovascular Disease written by and published by . This book was released on 2004 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Background: Coronary artery calcification (CAC) is common in chronic kidney disease (CKD) patients, and is demonstrable in fifty percent of incident dialysis patients. Therefore, the process of CAC initiation likely occurs in the pre-dialysis period. Pre-dialysis CKD patients have been shown to have a substantially higher burden of CAC than age and sex matched controls from the general population. Consequently, the hypothesis that CKD itself is a risk factor for CAC occurrence is biologically plausible. Objective: 1) To quantify the relationship between CKD and CAC in stage three to five CKD patients without known cardiovascular disease. 2) To estimate the strengths of associations between traditional cardiovascular disease risk factors, non- traditional cardiovascular disease risk factors and CAC in this patient population. Methods: This cross-sectional study investigated one hundred and nineteen CKD patients (excluding dialysis) receiving care at a single hospital in Kingston, Ontario, Canada. For the primary objective, correlational analyses were performed to evaluate associations between a priori selected variables of kidney function and CAC scores, as well as other a priori chosen variables of interest. Results: Mean and median CAC scores were 566.5 SD: 1108 and 111 (inter-quartile range 2 to 631.5) respectively. CAC correlated with age (r = 0.44, p
Download or read book Cardiovascular Calcification and Bone Mineralization written by Elena Aikawa and published by Springer Nature. This book was released on 2020-07-01 with total page 564 pages. Available in PDF, EPUB and Kindle. Book excerpt: The book covers the basic science and clinical aspects of cardiovascular calcification and bone mineralization. Cardiovascular calcification is the leading predictor of cardiovascular morbidity and mortality, with a predictive value more significant than blood lipid levels. The presence of calcific mineral in cardiovascular tissues alters biomechanical performance, increasing workload on the heart and potentiating atherosclerotic plaque rupture and subsequent heart attack and stroke. This book examines the role of calcification in cardiovascular disease covering topics such as calcification in the atherosclerotic plaques and aortic valves arteries and valves, aortic valve replacement, peripheral artery disease, imaging of early calcification and target discovery. In addition, various forms of ectopic calcification as well as mechanisms of bone mineralization are discussed. Cardiovascular Calcification and Bone Mineralization is an essential resource for clinicians, researchers, and other medical professionals in cardiology, pathology, and biomedical engineering.
Download or read book Early Vascular Aging EVA written by Pedro Guimarães Cunha and published by Elsevier. This book was released on 2024-02-29 with total page 772 pages. Available in PDF, EPUB and Kindle. Book excerpt: Early Vascular Aging (EVA): New Directions in Cardiovascular Protection, Second Edition continues to be the most comprehensive and authoritative resource on premature alterations in artery structure and function. The book presents a novel approach to the problem of cardiovascular disease, showing it in relation to great vessels disease and revealing a comprehensive approach to the problem of increased rigidity of the great vessels, its causes, and further consequences. This second edition contains completely updated content with expanded coverage of basic and translational research, systematic reviews of the most prominent literature, discussion of applicability of new evidence and more. Written by an international team of clinicians and researchers, this is a valuable resource to basic and translational scientists, clinical researchers and clinicians in the cardiovascular field interested in prevention, diagnosis and treatment of EVA. Contains all the relevant information available on the main paradigm shifts in vascular aging research, from different fields of knowledge (from basic biology to epidemiology) Reviews the most prominent evidence produced on early vascular aging (EVA), highlighting recent research advances, clinical applications, and research opportunities Formulates, in each chapter, a set of research questions that need to be addressed, challenging the vast research community to take on new directions and collaborations
Download or read book Phosphate Metabolism written by Shaul Massry and published by Springer Science & Business Media. This book was released on 2013-11-21 with total page 611 pages. Available in PDF, EPUB and Kindle. Book excerpt: We present to our readers the proceedings of the Second International Workshop on Phosphate. A short account of the history of the effort led to the Phosphate Workshops is appro priate and can be of interest to the reader. The idea for Phosphate Workshops was born in the early days of November, 1974. One of us (S. G. M. ) suggested the thought to a group of scientists gathered for a luncheon in one of the attrac tive small restaurants in Weisbaden, Germany. The purpose of the workshop was to bring together interested scientists to discuss the newer developments and the recent advances in the field of phosphate metabolism and the other related minerals. An Organizing Committee made of Shaul G. Massry (USA), Louis V. Avioli (USA), Philippe Bordier (France), Herbert Fleisch (Switzerland), and Eduardo Slatopolsky (USA) was formed. The First Workshop was held in Paris during June 5-6, 1975 and was hosted by Dr. Philippe Bordier. Its proceeding was already published. The Second Workshop took place in Heidelberg during June 28-30, 1976 and was hosted by Dr. Eberhard Ritz. Both of these workshops were extremely successful scientific endeavors, and the need for them was demonstrated by the great interest they generated among the scientific community. The Or ganizing Committee, therefore, decided to continue with the tradi tion to hold additional Workshops annually or every other year.
Download or read book Chronic Kidney Disease written by Monika Göőz and published by BoD – Books on Demand. This book was released on 2012-03-16 with total page 460 pages. Available in PDF, EPUB and Kindle. Book excerpt: Chronic kidney disease is an increasing health and economical problem in our world. Obesity and diabetes mellitus, the two most common cause of CKD, are becoming epidemic in our societies. Education on healthy lifestyle and diet is becoming more and more important for reducing the number of type 2 diabetics and patients with hypertension. Education of our patients is also crucial for successful maintenance therapy. There are, however, certain other factors leading to CKD, for instance the genetic predisposition in the case of polycystic kidney disease or type 1 diabetes, where education alone is not enough.
Download or read book Vitamin D in Chronic Kidney Disease written by Pablo A. Ureña Torres and published by Springer. This book was released on 2016-09-21 with total page 583 pages. Available in PDF, EPUB and Kindle. Book excerpt: Vitamin D deficiency, circulating levels lower than 15 ng/ml, is an epidemic disease worldwide with more than a billion people suffering of it in the beginning of the 21-century. Besides its impact on mineral and bone metabolism, these low vitamin D levels are also associated with a diversity of non-skeletal complications, among them cardiovascular disease, diabetes mellitus, multiple sclerosis, cancer, tuberculosis, and immune system dysfunction. Chronic Kidney Disease is also a very common disease, affecting more than 10% of the world population, ranging from stage 1 to stage 5 before dialysis. Approximately 1% of the population in industrialized countries is affected by end-stage renal disease (ESRD), needing a renal replacement therapy either hemodialysis or peritoneal dialysis, and ultimately by renal transplantation. Those CKD patients are more susceptible to exhibit reduced vitamin D stocks. Consequently, more than eighty percent of CKD patients have either insufficient or deficient vitamin D levels for multiple reasons.
Download or read book Uraemic Vascular Damage and Calcification in Children with Chronic Kidney Disease written by R. Shroff and published by . This book was released on 2009 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Of thesis: Cardiovascular disease is the most common cause of death in patients with chronic kidney disease. Structural and functional vascular abnormalities and arterial calcification begins early in the course of renal decline and can be found even in children, contributing to their high mortality risk. Through clinical and laboratory studies, this thesis sought to investigate the causes of uraemic vascular damage and calcification in children with chronic kidney disease and on dialysis. Dysregulated mineral metabolism, manifested by hyperparathyroidism and high phosphate, in association with low vitamin D levels, is key to the pathophysiology of ectopic vascular and soft tissue calcification. In addition, a number of treatment- related factors can potentially lead to a high calcium load, contributing to an increased risk of calcification. Importantly, these are modifiable risk factors and have been associated with an increased mortality risk in adult dialysis patients. Using established surrogate measures of vascular damage, carotid artery intima media thickness, pulse wave velocity and multi-slice CT scan, I have studied a cohort of children on chronic dialysis, and shown that those with mean parathyroid hormone levels above twice the upper limit of normal had increased vascular thickness, stiffer vessels and a higher prevalence of coronary artery calcification, whereas those with lower levels had vascular measures that were similar to age-matched controls. Also, a higher vitamin D dosage was associated with thicker vessels and coronary calcification. To explore this association, in a further study I have measured the levels of 25-hydroxy and 1,25-dihydroxy vitamin D and shown that both low and high levels of 1,25-dihydroxy vitamin D are associated with thicker vessels and calcification. Also, 1,25-dihydroxy vitamin D showed a strong inverse association with high sensitivity CRP, and we speculate that vitamin D's influence on calcium-phosphate homeostasis and inflammation may be lead to this bimodal effect. Levels of the circulating calcification inhibitors, fetuin-A, osteoprotegerin and Matrix Gla-protein, may influence an individual patients' susceptibility to calcify, and but have not been described in children. I found that these levels influenced vascular stiffness and calcification, and that there may be a protective upregulation of fetuin-A in the early stages of exposure to a pro-calcific and pro-inflammatory uraemic environment. In a subsequent translational study I have sought to find direct evidence of vascular damage and calcification in the vessels. Using intact human arteries removed at the time of routine surgery, I have shown that calcium accumulation begins pre-dialysis, but dialysis induced vascular smooth muscle cell apoptosis coupled with osteo/chondrocytic transformation and a loss of the normal calcification inhibitors leads to overt calcification. Our currently available clinical measures are not sensitive enough to detect the earliest stages of calcification. On in vitro culture in calcifying media, dialysis but not control vessels showed accelerated time-dependent calcification, suggesting that these vessels had lost their smooth muscle cell defence mechanisms and were primed to undergo rapid calcification. Apoptotic cell death was a key event that triggerred calcification, and this was a vesicle mediated process, possibly involving oxidative DNA damage. This thesis investigates the role of modifiable risk factors in uraemic vascular damage and calcification in children with CKD and explores the earliest changes in the pathophysiology of uraemic medial calcification in intact human vessels.
Download or read book Calcific Aortic Valve Disease written by Elena Aikawa and published by BoD – Books on Demand. This book was released on 2013-06-12 with total page 544 pages. Available in PDF, EPUB and Kindle. Book excerpt: Due to population aging, calcific aortic valve disease (CAVD) has become the most common heart valve disease in Western countries. No therapies exist to slow this disease progression, and surgical valve replacement is the only effective treatment. Calcific Aortic Valve Disease covers the contemporary understanding of basic valve biology and the mechanisms of CAVD, provides novel insights into the genetics, proteomics, and metabolomics of CAVD, depicts new strategies in heart valve tissue engineering and regenerative medicine, and explores current treatment approaches. As we are on the verge of understanding the mechanisms of CAVD, we hope that this book will enable readers to comprehend our current knowledge and focus on the possibility of preventing disease progression in the future.
