Готові списки джерел за темами / End stage renal failure; cardiovascular imaging

Добірка наукової літератури з теми "End stage renal failure; cardiovascular imaging"

Автор: Grafiati

Опубліковано: 10 грудня 2022

Оновлено: 28 січня 2023

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Статті в журналах з теми "End stage renal failure; cardiovascular imaging"

Myerson, Saul G. "Can cardiac magnetic resonance imaging reclassify uremic cardiomyopathy in patients with end-stage renal failure?" Nature Clinical Practice Cardiovascular Medicine 4, no. 1 (January 2007): 22–23. http://dx.doi.org/10.1038/ncpcardio0717.

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Brown, J. H., N. P. Vites, H. J. Testa, M. C. Prescott, L. P. Hunt, R. Gokal, and N. P. Mallick. "25. Prospective screening of patients with end-stage renal failure for asymptomatic cardiovascular disease using thallium myocardial imaging." Nuclear Medicine Communications 13, no. 4 (April 1992): 215. http://dx.doi.org/10.1097/00006231-199204000-00027.

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de Lemos, J. A., and L. D. Hillis. "Diagnosis and management of coronary artery disease in patients with end-stage renal disease on hemodialysis." Journal of the American Society of Nephrology 7, no. 10 (October 1996): 2044–54. http://dx.doi.org/10.1681/asn.v7102044.

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Cardiovascular disease accounts for almost half of the total mortality in patients with ESRD. Ischemic heart disease is responsible for many cardiovascular deaths, with myocardial infarction accounting for approximately 15% and sudden cardiac death or severe left ventricular dysfunction accounting for much of the remainder. The markedly increased prevalence of atherosclerotic cardiovascular disease in patients with ESRD is influenced, at least in part, by numerous risk factors for atherosclerosis, with hypertension, diabetes mellitus, and hypercholesterolemia being particularly important. Because atherosclerotic coronary artery disease (CAD), whether symptomatic or asymptomatic, is associated with an increased incidence of allograft failure and mortality, the results of this study suggest the need for careful evaluation for the presence of CAD in those persons who are under consideration for renal transplantation. Candidates with angina pectoris, previous myocardial infarction, or congestive heart failure are at particularly high risk of a cardiac event, and, therefore, should routinely undergo pretransplant coronary angiography and subsequent surgical revascularization if angina is refractory to medical therapy or CAD is extensive. In contrast, although young, nondiabetic transplant candidates without symptoms or electrocardiographic evidence of CAD have an increased relative risk of cardiac death when compared with age-matched control subjects, their absolute risk of such an event is very low. As a result, they do not require a cardiac evaluation before transplantation. For the remaining transplant candidates at neither low nor high risk of a fatal or nonfatal cardiac event (i.e., those at intermediate risk), the authors of this study routinely perform (1) thallium imaging with dipyridamole or (2) two-dimensional echocardiography with intravenous dobutamine. If the result of these investigations are normal, transplantation proceeds; if abnormal, coronary angiography is performed, followed by surgical revascularization if CAD is extensive. Percutaneous transluminal coronary angioplasty is not recommended in patients with ESRD because it appears to be accompanied by a high likelihood of acute and chronic complications. Although it is hoped that surgical revascularization before renal transplantation improves allograft and patient survival, prospectively obtained data proving that this, in fact, is true do not exist.

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Stewart, Graham A., Patrick B. Mark, Nicola Johnston, John E. Foster, Michael Cowan, R. Stuart C. Rodger, Henry J. Dargie, and Alan G. Jardine. "Determinants of hypertension and left ventricular function in end stage renal failure: a pilot study using cardiovascular magnetic resonance imaging." Clinical Physiology and Functional Imaging 24, no. 6 (November 2004): 387–93. http://dx.doi.org/10.1111/j.1475-097x.2004.00583.x.

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Dalio, Marcelo Bellini, Matheus Bredarioli, Edwaldo Edner Joviliano, Jesualdo Cherri, Haylton Jorge Suaid, and Carlos Eli Piccinato. "Endovascular repair of an aorto-iliac aneurysm succeeded by kidney transplantation." Jornal Vascular Brasileiro 9, no. 3 (September 2010): 164–67. http://dx.doi.org/10.1590/s1677-54492010000300012.

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We present the case of aorto-iliac aneurysm in a patient with chronic renal failure requiring dialysis who were treated with an endovascular stent graft and, later on, submitted to kidney transplantation. A 53-year-old male with renal failure requiring dialysis presented with an asymptomatic abdominal aorto-iliac aneurysm measuring 5.0cm of diameter. He was treated with endovascular repair technique, being used an endoprosthesis Excluder®. After four months, he was successfully submitted to kidney transplantation (dead donor), with anastomosis of the graft renal artery in the external iliac artery distal to the endoprosthesis. The magnetic resonance imaging, carried out 30 days after the procedure, showed a good positioning of the endoprosthesis and adequate perfusion of the renal graft. In the follow-up, the patient presented improvement of nitrogenous waste, good positioning of the endoprosthesis without migration or endoleak. The endovascular repair of aorto-iliac aneurysm in a patient with end-stage renal failure under hemodialysis treatment showed to be feasible, safe and efficient, as it did not prevent the success of the posterior kidney transplantation.

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Gallo-Bernal, Sebastian, Nasly Patino-Jaramillo, Camilo A. Calixto, Sergio A. Higuera, Julian F. Forero, Juliano Lara Fernandes, Carlos Góngora, Michael S. Gee, Brian Ghoshhajra, and Hector M. Medina. "Nephrogenic Systemic Fibrosis in Patients with Chronic Kidney Disease after the Use of Gadolinium-Based Contrast Agents: A Review for the Cardiovascular Imager." Diagnostics 12, no. 8 (July 28, 2022): 1816. http://dx.doi.org/10.3390/diagnostics12081816.

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Gadolinium-enhanced cardiac magnetic resonance has revolutionized cardiac imaging in the last two decades and has emerged as an essential and powerful tool for the characterization and treatment guidance of a wide range of cardiovascular diseases. However, due to the high prevalence of chronic renal dysfunction in patients with cardiovascular conditions, the risk of nephrogenic systemic fibrosis (NSF) after gadolinium exposure has been a permanent concern. Even though the newer macrocyclic agents have proven to be much safer in patients with chronic kidney disease and end-stage renal failure, clinicians must fully understand the clinical characteristics and risk factors of this devastating pathology and maintain a high degree of suspicion to prevent and recognize it. This review aimed to summarize the existing evidence regarding the physiopathology, clinical manifestations, diagnosis, and prevention of NSF related to the use of gadolinium-based contrast agents.

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Garikapati, Kartheek, Daniel Goh, Shaun Khanna, and Krishna Echampati. "Uraemic Cardiomyopathy: A Review of Current Literature." Clinical Medicine Insights: Cardiology 15 (January 2021): 117954682199834. http://dx.doi.org/10.1177/1179546821998347.

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Uraemic Cardiomyopathy (UC) is recognised as an intricate and multifactorial disease which portends a significant burden in patients with End-Stage Renal Disease (ESRD). The cardiovascular morbidity and mortality associated with UC is significant and can be associated with the development of arrythmias, cardiac failure and sudden cardiac death (SCD). The pathophysiology of UC involves a complex interplay of traditional implicative factors such as haemodynamic overload and circulating uraemic toxins as well as our evolving understanding of the Chronic Kidney Disease-Mineral Bone Disease pathway. There is an instrumental role for multi-modality imaging in the diagnostic process; including transthoracic echocardiography and cardiac magnetic resonance imaging in identifying the hallmarks of left ventricular hypertrophy and myocardial fibrosis that characterise UC. The appropriate utilisation of the aforementioned diagnostics in the ESRD population may help guide therapeutic approaches, such as pharmacotherapy including beta-blockers and aldosterone-antagonists as well as haemodialysis and renal transplantation. Despite this, there remains limitations in effective therapeutic interventions for UC and ongoing research on a cellular level is vital in establishing further therapies.

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Ivan, Vlad Sabin, Nicolae Albulescu, Iuliana Roxana Albulescu, Adrian Apostol, Roxana Buzas, Adalbert Schiller, Romulus Timar, Daniel Lighezan, and Mihaela Viviana Ivan. "Predictive Value of Several Echo Parameters for Cardiovascular Events in Hemodialysis Patients with Mid-range and Preserved Ejection Fraction Heart Failure." Revista de Chimie 70, no. 4 (May 15, 2019): 1479–84. http://dx.doi.org/10.37358/rc.19.4.7154.

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Patients with end stage renal disease (ESRD) on hemodialysis (HD) are predisposed to higher rates of major cardiovascular events, through several well-known pathophysiological mechanisms. The rates of all-cause mortality are 6 to 10fold greater for these patients compared with general population. Furthermore, diabetes mellitus, history of cardiovascular disease, dialysis duration, and residual diuresis are factors related to cardiovascular events in hemodialysis. Whilst structural and functional echocardiographic abnormalities in dialyzed patients have been the surrogate for several survival studies, the predictive value of these echo parameters, are not clearly established in this field .In dialysis patients, it is still unclear which echo parameter is the best in determining cardiovascular outcome. The purpose of our study was to investigate the role of Doppler Echocardiography and Tissue Doppler Imaging (TDI) abnormalities, in providing predictive parameters for this particular population. The survival rates were analyzed by Kaplan�Meier curves and cardiac events predictors by Cox�s proportional-hazards model. We found correlations between several echo measurements and cardiovascular events, especially diastolic dysfunction and impaired left ventricular parameters. We strongly recommend the use of these echocardiographic parameters in early detection of patients at high risk in order to reduce morbidity and mortality.

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SOBKOWICZ, B., A. TOMASZUKKAZBERUK, J. MALYSZKO, M. KALINOWSKI, T. HRYSZKO, J. MALYSZKO, M. MYSLIWIEC, and W. MUSIAL. "1101 Value of the real-time myocardial contrast echocardiography for risk stratification in patients with end-stage renal failure." European Journal of Echocardiography 7 (December 2006): S191. http://dx.doi.org/10.1016/s1525-2167(06)60706-3.

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Aksu, Uğur, Derya Aksu, Oktay Gulcu, Kamuran Kalkan, Selim Topcu, Enbiya Aksakal, Emrah Aksakal, Serdar Sevimli, and Ibrahim Halil Tanboga. "The effect of dialysis type on left atrial functions in patients with end-stage renal failure: A propensity score-matched analysis." Echocardiography 35, no. 3 (December 11, 2017): 308–13. http://dx.doi.org/10.1111/echo.13774.

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Дисертації з теми "End stage renal failure; cardiovascular imaging"

Wang, Yee-moon Angela. "Utility of cardiac biomarkers in end-stage renal disease patients on maintenance peritoneal dialysis." Click to view the E-thesis via HKUTO, 2008. http://sunzi.lib.hku.hk/hkuto/record/B41508968.

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Wang, Yee-moon Angela, and 王依滿. "Utility of cardiac biomarkers in end-stage renal disease patients on maintenance peritoneal dialysis." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2008. http://hub.hku.hk/bib/B41508968.

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Capuano, Ermanno. "Assessment of Coronary Heart disease In Low Likelihood patients with End Stage kidney disease (ACHILLES) : comparison between Coronary Computed Tomography Angiography and Myocardial Perfusion Imaging." Thesis, Queen Mary, University of London, 2017. http://qmro.qmul.ac.uk/xmlui/handle/123456789/25810.

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Purpose: To evaluate the diagnostic performance of Coronary Computed Tomography Angiography (CCTA) in predicting Myocardial Perfusion Scintigraphy (MPS) perfusion defects in low likelihood patients with End Stage Renal Disease (ESRD) awaiting transplant. Materials and Methods: In total, 131 consecutive patients with ESRD awaiting transplant were prospectively enrolled in this study (86 men; 54±9years). All patients underwent MPS as per standard of care and in addition non-enhanced CT for calcium scoring (CAC score) and Coronary Computed Tomography Angiography (CCTA). Results: The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of CAC score in predicting MPS perfusion defects were 88%, 35%, 28% and 92%, respectively. The sensitivity, specificity, PPV and NPV of CCTA in predicting MPS perfusion defects at the patient level were 55%, 87%, 57% and 87%, respectively, and 48%, 92%, 41% and 94% at the vessel level. The diagnostic performance of CCTA in predicting MPS perfusion defects improved when patients with CAC score higher than 1000 (15/70, 21%) were excluded from the analysis. In patients with positive CAC score up to 1000 sensitivity, specificity, PPV and NPV at the patient level were 60%, 93%, 75% and 86% respectively. These were 53%, 91%, 36% and 95%, respectively, at the vessel level. Conclusion: Non-enhanced CT for CAC score and CCTA can be considered useful diagnostic tools in the ESRD population, particularly in identifying patients without coronary artery disease. This approach however had limitations in the presence of high CAC score.

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Dundon, Benjamin Kane. "Evaluation of alterations in cardiovascular structure and function in end-stage renal failure." Thesis, 2013. http://hdl.handle.net/2440/83535.

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Background: Chronic renal dysfunction is associated with myriad alterations in cardiovascular structure and function, resulting in markedly elevated rates of cardiac and vascular morbidity and mortality. Utilising advances in cardiovascular magnetic resonance imaging (CMR), we evaluated the cardiovascular sequelae of arterio-venous fistula formation in advanced chronic kidney disease, and the impact of elective arterio-venous fistula ligation following successful renal transplantation. Furthermore, we undertook to evaluate the diagnostic accuracy of dobutamine-stress CMR in the detection of haemodynamically‐significant coronary artery disease prior to renal transplantation. Finally, we invasively evaluated coronary endothelial function in the presence of advanced renal dysfunction, and compared this to subjects with preserved renal function. Methods / Results: Study 1: CMR was undertaken to evaluate cardiac structure and function, brachial artery endothelial function (as assessed by flow-mediated dilatation) and aortic distensibility in tweny‐four subjects at baseline, and 6‐months following, clinically indicated arterio‐venous fistula creation in preparation for the commencement of haemodialysis for end-stage renal failure. Following arterio‐venous fistula creation, mean cardiac output increased by 25.0% (p<0.0001), with substantial associated increases in left and right ventricular volumes, left and right atrial area and left ventricular mass (12.7% increase, p<0.0001). Peripheral endothelial function was significantly impaired at follow-up (9.0 ±9% vs. 3.0 ±6%, p=0.01). No significant change in aortic distensibility was identified. Study 2: Cardiac and vascular function were similarly assessed utilising CMR in eighteen subjects prior to, and 6‐months following, clinically indicated arterio-venous fistula ligation in the context of successful, stable renal transplantation. Following AVF-ligation, mean cardiac output fell by 15.6% (p=0.004), with significant attendant decreases in atrial and ventricular chamber dimensions. Notably, left ventricular mass fell by 9.7% (p=0.0001) at follow‐up. Aortic distensibility was unchanged following AVF‐ligation, though endothelial function improved significantly (2.5 ±6.5% vs. 8.0 ±5.9%, p=0.043). Study 3: Dobutamine-stress CMR was performed in twenty‐one subjects prior to clinically‐indicated invasive coronary angiography before potential renal transplantation. Dobutamine-stress CMR demonstrated 100% sensitivity and 93% specificity for the detection of angiographically significant coronary disease (≥70% stenosis severity). This compared favourably to results for the institutional‐standard (SPECT: sensitivity 67%, specificity 38%; p<0.0001 compared to CMR). Study 4: At invasive coronary angiography, endothelium‐dependent and endothelium–independent coronary endothelial and microvascular function were evaluated amongst eight pre‐renal transplant subjects with only minimal coronary artery disease (≤20% epicardial coronary stenoses). Utilising intra-coronary infusions of acetylcholine (10⁻⁷M and 10⁻⁶M), adenosine (48mcg) and glyceryl tri‐nitrate (100mcg), results were compared to thirteen control subjects with minimal coronary artery disease but comparatively preserved renal function. There was no significant difference in endothelium‐dependent or endothelium–independent coronary endothelial function between the cohorts. Microvascular function (as assessed by coronary flow reserve following adenosine administration) was markedly impaired in subjects with advanced renal impairment compared to controls (1.9 ±0.4 vs. 3.0 ±1.1, p=0.01). Conclusions: Chronic kidney disease is associated with substantial alterations in cardiovascular structure and function. Arterio‐venous fistulae, though necessary for the performance of haemodialysis, appear to contribute significantly to the high burden of cardiovascular maladaptation present in this condition. Recent advances in CMR and stress‐CMR may play a significant role in improving the detection of sub-clinical cardiovascular disease in these high‐risk patients.
Thesis (Ph.D.) -- University of Adelaide, School of Medicine, 2013

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Книги з теми "End stage renal failure; cardiovascular imaging"

V, Wizemann, Kramer W, and Schütterle G, eds. The heart in end-stage renal failure: Etiology, symptoms, and management of uremic heart disease. Basel: Karger, 1986.

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Joseph, Loscalzo, and London Gérard M, eds. Cardiovascular disease in end-stage renal failure. Oxford: Oxford University Press, 2000.

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London, Gerard M. Cardiovascular complications in end-stage renal disease patients. Edited by Jonathan Himmelfarb. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199592548.003.0268.

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Cardiovascular complications are the predominant cause of death in patients with end-stage renal disease (ESRD). The high incidence of cardiovascular complications results from pathology present before ESRD (generalized atherosclerosis, diabetes, hypertension) and an additive effect of multiple factors including haemodynamic overload and metabolic and endocrine abnormalities more or less specific to uraemia or its treatment modalities. These disorders are usually associated and can exacerbate each other. While ischaemic heart disease is a frequent cause of cardiac death, heart failure and sudden death are the most frequent causes of death in ESRD. Cardiomyopathy of overload with development of left ventricular hypertrophy and fibrosis are the most characteristic alterations and major determinants of prognosis. Left ventricular hypertrophy may result in systolic and/or diastolic dysfunction and is a risk factor for arrhythmias, sudden death, heart failure, and myocardial ischaemia. Arterial disease, whether due to atherosclerosis or arteriosclerosis (or both), represents a major contributory factor to the cardiovascular complications. Arterial disease may result in ischaemic complications (ischaemic heart disease, peripheral artery diseases) or arterial stiffening with direct consequences on left ventricular afterload, decreased coronary perfusion, and microvascular abnormalities (inward remodelling and microvessel rarefaction).

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Kramer, W., and V. Wizemann. The Heart in End-Stage Renal Failure: Etiology, Symptoms and Management of Uremic Heart Disease (Contributions to Nephrology). S Karger Pub, 1987.

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Kinsella, Sinead, and John Holian. The effect of chronic renal failure on critical illness. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0218.

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The incidence of chronic kidney disease (CKD) and end-stage kidney disease (ESKD) is increasing, reflecting an increase in the incidence and prevalence of hypertension and type 2 diabetes. Patients with CKD and ESKD frequently experience episodes of critical illness and require treatment in an intensive care unit (ICU)setting. Management requires specific consideration of their renal disease status together with their acute illness. Mortality in critically-ill patients with ESKD is frequently related to their co-morbid conditions, rather than their ESKD status. Illness severity scoring systems allocate high points for renal variables and tend to overestimate actual mortality. Patients with ESKD and CKD requiring ICU admission have better ICU and in-hospital survival than patients with denovo acute kidney injury requiring renal replacement therapy. Appropriately selected patients benefit from ICU admission and full consideration for ICU care should be given to these patients if required, despite their renal disease status. Cardiovascular disease and sepsis account for the majority of ICU admissions in this population and the aetiology of these conditions differs from that in patients without kidney disease. Optimal critical care management of patients with ESKD and CKD requires that these differences are recognized.

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Medicare: Millions in end-stage renal disease expenditures shifted to employer health plans : report to Congressional committees. Washington, D.C: The Office, 1992.

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Medicare: Millions in end-stage renal disease expenditures shifted to employer health plans : report to Congressional committees. Washington, D.C: The Office, 1992.

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Ather, Sameer, Ayman Farag, Vikas Bhatia, and Fadi G. Hage. Role of Imaging in Chronic Kidney Disease. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199392094.003.0017.

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Cardiovascular disease is highly prevalent in patients with chronic kidney disease (CKD) and is the biggest contributor of death in these patients. Myocardial perfusion imaging (MPI) is a validated tool for diagnosing coronary artery disease (CAD) and for predicting short and long term prognosis in this patient population. Non-invasive stress imaging, with MPI or other imaging modalities, is widely used for risk stratification in patients with end-stage renal disease (ESRD) being evaluated for kidney transplantation due to the paucity of donor organs and the high cardiovascular risk of patients on the transplant waiting list. In this Chapter we will review the data on diagnostic accuracy and risk stratification using MPI in patients with CKD and ESRD highlighting the special challenges that are unique to this population. We will also discuss novel indicators that have been used in these patients to improve risk stratification.

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Harper, Lorraine, and David Jayne. The patient with vasculitis. Edited by Giuseppe Remuzzi. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199592548.003.0160.

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The goals of treatment in renal vasculitis are to stop vasculitic activity and recover renal function. Subsequent strategies are required to prevent vasculitis returning and to address longer-term co-morbidities caused by tissue damage, drug toxicity, and increased cardiovascular and malignancy risk.Cyclophosphamide and high-dose glucocorticoids remain the standard induction therapy with alternative immunosuppressives, such as azathioprine, to prevent relapse. Plasma exchange improves renal recovery in severe presentations. Refractory disease resulting from a failure of induction or remission maintenance therapy requires alternative agents and rituximab has been particularly effective. Replacement of cyclophosphamide by rituximab for remission induction is supported by recent evidence. Methotrexate is effective in non-renal vasculitis but difficult to use in patients with renal impairment. Mycophenolate mofetil seems to be effective but there is less long-term evidence.Drug toxicity contributes to co-morbidity and mortality and has led to newer regimens with reduced cyclophosphamide exposure. Glucocorticoid toxicity remains a major problem with controversy over the rapidity with which glucocorticoids can be reduced or withdrawn.Disease relapse occurs in about 50% of patients. Early detection is less likely to lead to an adverse affect on outcomes. Rates of cardiovascular disease and malignancy are higher than in control populations but strategies to reduce their risk, apart from cyclophosphamide-sparing regimens, have not been developed. Thromboembolic events occur in 10% and may be linked to the recently identified autoantibodies to plasminogen and tissue plasminogen activator.Renal impairment at diagnosis is a strong predictor of patient survival and renal outcome. Other predictors include patient age, antineutrophil cytoplasmic antibody subtype, disease extent and response to therapy. Chronic kidney disease can stabilize for many years but the risks of end-stage renal disease are increased by acute kidney injury at presentation or renal relapse. Renal transplantation is successful with similar outcomes to other causes of end-stage renal disease.

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Rascher, Wolfgang. Treatment of hypertension in children. Edited by Neil Turner. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199592548.003.0219_update_001.

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Management of hypertension is dependent on the underlying cause and the magnitude of the blood pressure abnormality. Healthy behavioural changes are the primary management tool for treating primary hypertension in adolescents and other cardiovascular risk factors and obesity. In children and adolescents with renal hypertension, high blood pressure requires pharmacological treatment. There is randomized controlled trial evidence to support a blood pressure target for those with proteinuria of not higher than the 50th centile for age. The use of angiotensin-converting enzyme inhibitors is safe in patients with proteinuria, and assumed to be equally beneficial. For those without proteinuria, less stringent targets may be acceptable. Often a combination of two or three drugs is required to lower arterial blood pressure to the target blood pressures. In children and adolescents at or near end-stage renal failure, fluid removal by dialysis may be necessary to control hypertension.

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Частини книг з теми "End stage renal failure; cardiovascular imaging"

Delgado, Victoria. "Cardiovascular imaging in chronic kidney disease." In ESC CardioMed, edited by Christoph Wanner, 987–93. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198784906.003.0238.

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Chronic kidney disease (CKD) is associated with increased cardiovascular morbidity and mortality. Congestive heart failure, coronary artery disease (CAD), cardiac arrhythmias and valvular heart disease are the most prevalent cardiovascular diseases in patients with CKD and account for 50% of all-cause mortality of patients with end stage renal disease.1 Particularly, congestive heart failure is the most prevalent cardiovascular condition in CKD patients and its prevalence increases as the kidney function declines. Pressure overload, as a consequence of long-standing hypertension and vascular stiffness, volume overload and CKD-related non-hemodynamic factors, such as inappropriate activation of the renin-angiotensin system, inflammation and stimulation of pro-hypertrophic and profibrogenic factors, are the main pathophysiological drivers of congestive heart failure.1 These factors along with a greater prevalence of traditional risk factors have been also associated to the pathogenesis of coronary plaque formation and rupture and reduced coronary flow reserve, peripheral artery disease and stroke. For the clinical cardiologist, the evaluation of CKD patients comprises the following areas:1. Is there structural heart disease? 2. Is there CAD?3. Atrial fibrillation and associated risk of embolic stroke4. Risk of sudden cardiac death (SCD)This section provides an overview on the use of multimodality cardiovascular imaging to diagnose and manage these cardiovascular complications.

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"Renal failure." In Oxford Handbook of Palliative Care, edited by Max Watson, Rachel Campbell, Nandini Vallath, Stephen Ward, and Jo Wells, 547–60. Oxford University Press, 2019. http://dx.doi.org/10.1093/med/9780198745655.003.0018.

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This chapter describes the issues associated with providing palliative care to patients with renal failure, and covers initiation of renal replacement therapy, conservative treatment, symptom management for patients with advanced renal disease, and issues surrounding stopping renal replacement therapy. As obesity and diabetes increase, so does the incidence of chronic renal disease and end-stage renal failure. Determining the exact number of patients dying of renal failure is challenging. Often the cause of death will be ascribed to an associated contributing factor, e.g. diabetes mellitus, or the final acute event resulting in death, e.g. myocardial infarction. However, we know that renal failure is an independent risk factor for cardiovascular disease and is associated with a high all-cause mortality.¹ In addition, patients with end-stage renal failure have a significant symptom burden and therefore it is important that patients have access to palliative care services to assist with symptom management, advanced care planning, and, where appropriate, decisions around dialysis and transplantation.

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"Renal transplantation." In Oxford Desk Reference Nephrology, edited by Jonathan Barratt, Peter Topham, Sue Carr, Mustafa Arici, and Adrian Liew, 689–740. Oxford University Press, 2021. http://dx.doi.org/10.1093/med/9780198777182.003.0015.

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Kidney transplantation is the optimal treatment for end stage renal disease. However, there are risks both from early complications directly related to the surgical procedure, and from longer-term complications resulting from the effects of immunosuppression. This chapter describes the transplant process from the evaluation of patients with renal failure for suitability for transplantation, through the surgical procedure itself, the early and late management of recipients, and the management of the complications that can arise, including acute and chronic graft dysfunction, infection, malignancy, and cardiovascular disease. It also covers the short- and long-term outcomes of kidney transplantation. Since live kidney donors have become an increasingly important source of kidneys for renal transplantation, it also describes the work-up process for potential live donors and the long-term outcomes following donation. Finally, combined kidney/pancreas transplantation is included separately and includes a discussion around the selection and evaluation recipients, the surgical procedure, short- and long-term complications, and the outcomes.

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Mueller, Thomas F., and Valerie Luyckx. "Causes of death in renal disease." In ESC CardioMed, edited by Christoph Wanner, 981–84. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198784906.003.0236.

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Chronic kidney disease (CKD) encompasses a spectrum of diseases that are identified by a glomerular filtration rate below 90 mL/min/1.73m² or the presence of proteinuria, or both of these, persisting for over 3 months. In population-based studies, mortality in patients with CKD is consistently several-fold higher than that in patients without CKD, and the risk increases as the severity of renal function worsens. Mortality risk is, not surprisingly, highest among those with end-stage kidney disease. In developed countries, patients with CKD and end-stage kidney disease do not die of renal disease, but die primarily of non-renal causes, the relative proportions of which change across the spectrum of renal function. In the early stages of CKD, malignancy tends to be the predominant case of death; however, as renal function worsens, the proportion of deaths related to cardiovascular disease increases. Coronary artery disease contributes to most cardiac deaths in those with milder CKD. The proportions of cardiac and overall deaths from heart failure and sudden cardiac death increase progressively as renal function declines. Sudden cardiac death is a major cause of death among patients with end-stage kidney disease. Multiple factors including underlying coronary artery disease, left ventricular hypertrophy, valvular heart disease, arrhythmias, volume and electrolyte abnormalities, uraemia, and inflammation all likely contribute to the increased risk of cardiovascular death. Much work is needed to understand the pathophysiology and develop strategies to prevent cardiovascular deaths especially in the CKD population.

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Hussein, Wael F., and Austin G. Stack. "Pharmacologic Renal Protection." In Kidney Protection, edited by Vijay Lapsia, Bernard G. Jaar, and A. Ahsan Ejaz, 101–12. Oxford University Press, 2019. http://dx.doi.org/10.1093/med/9780190611620.003.0010.

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Chronic kidney disease (CKD) is a common condition associated with substantial morbidity and mortality. It is also associated with multiple complications that increase in frequency and severity as kidney function declines. The identification and treatment of factors that contribute to CKD progression offer huge opportunities to stem the growing tide of end-stage kidney disease. Control of hypertension is imperative to reduce risk of disease progression and cardiovascular complications. The prevention and reduction of proteinuria is an equally important goal to prevent the long-term risk of kidney failure. This review describes both existing and novel reno-protective strategies proven to slow or prevent CKD. The authors emphasize the potential benefit offered by newer pharmacologic agents in protecting kidney function. With the emergence of this global epidemic, it is now more important than ever before for the medical community to critically define factors that predict disease progression and determine the efficacy of targeted intervention strategies.

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Green, Darren, and Philip A. Kalra. "Cardiorenal syndrome." In Oxford Textbook of Medicine, edited by Jeremy Dwight, 3421–28. Oxford University Press, 2020. http://dx.doi.org/10.1093/med/9780198746690.003.0350.

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Concurrent renal and cardiovascular disease is common. Renal disease is a potent cardiovascular risk factor and consequently cardiovascular disease is the most important cause of mortality in patients with end-stage renal disease. This increased risk is mediated by vascular disease (coronary calcification, endothelial dysfunction, dyslipidaemia, and others), left ventricular hypertrophy, risk of arrhythmias, and left ventricular systolic and diastolic dysfunction. These interactions are further complicated by the presence of anaemia in advanced renal disease. The coexistence of renal disease and heart failure presents a major therapeutic challenge and requires careful attention to fluid status and renal function. Diuretic resistance is common and the important prognostic benefit of angiotensin-converting enzyme inhibition in this high-risk group is often neglected. Cardiovascular drugs, particularly antiarrhythmic agents such as digoxin, sotalol, and flecainide, should be used with caution in patients with renal disease.

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Waks, Jonathan W., Rulan S. Parekh, and Larisa G. Tereshchenko. "Cardiovascular Protection in Chronic Kidney Disease." In Kidney Protection, edited by Vijay Lapsia, Bernard G. Jaar, and A. Ahsan Ejaz, 295–308. Oxford University Press, 2019. http://dx.doi.org/10.1093/med/9780190611620.003.0030.

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Chronic kidney disease (CKD) affects over 15% of the US population, and over 650,000 people have end-stage renal disease requiring dialysis. Persons with CKD have an increased prevalence of all forms of cardiovascular disease, including coronary artery disease, cerebrovascular disease, hypertension, dyslipidemia, diabetes, congestive heart failure, and sudden cardiac death. CKD itself is also an independent risk factor for developing all forms of cardiovascular disease. The diagnosis of cardiovascular disease in persons with CKD presents unique difficulties, and many standard therapies for reducing cardiovascular morbidity and mortality, such as statins, also tend to be less successful in patients with severe CKD. This chapter will provide an overview of the epidemiology of cardiovascular disease in patients with CKD and will discuss strategies to diagnose cardiovascular disease and to reduce cardiovascular risk, morbidity, and mortality in this high-risk population.

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Kalra, P. A., and J. D. Firth. "Atherosclerotic renovascular disease." In Oxford Textbook of Medicine, 4078. Oxford University Press, 2010. http://dx.doi.org/10.1093/med/9780199204854.003.211009_update_002.

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Atherosclerotic renovascular disease (ARVD) refers to atheromatous narrowing of one or both renal arteries and frequently co-exists with atherosclerotic disease in other vascular beds. Patients with this condition are at high risk of adverse cardiovascular events, with mortality around 8% per year. Many patients with ARVD have chronic kidney disease, but only a minority progress to end-stage kidney disease (ESKD), suggesting that pre-existing hypertensive and/or ischaemic renal parenchymal injury is the usual cause of renal dysfunction. Many patients with ARVD are asymptomatic, but there can be important complications such as uncontrolled hypertension, rapid decline in kidney function and recurrent acute heart failure (flash pulmonary oedema)....

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Pahuja, Meera, and Peter Selwyn. "HIV/AIDS." In Oxford Textbook of Palliative Medicine, edited by Nathan I. Cherny, Marie T. Fallon, Stein Kaasa, Russell K. Portenoy, and David C. Currow, 949–63. Oxford University Press, 2021. http://dx.doi.org/10.1093/med/9780198821328.003.0089.

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AIDS has been transformed from a rapidly fatal, untreatable illness to a manageable chronic disease. Early in the AIDS epidemic, HIV care and palliative care were inseparable; over time, these two treatment paradigms diverged. Whereas palliative care for AIDS once focused primarily on end of life care and pain and symptom management related to the manifestations of AIDS-specific opportunistic infections and malignancies, it now addresses the needs of a growing number of HIV-infected patients living for years with the disease and an expanding range of comorbidities, as well as a process that has been described as ‘accelerated ageing’. Comorbid chronic diseases which commonly occur in HIV-infected patients may affect cardiovascular, pulmonary, renal, hepatic, metabolic, and neurocognitive function. Attention to the symptoms that result, and to quality of life issues and psychosocial problems in long-surviving patients, will be increasingly important to support engagement with care and effective adherence with antiretroviral therapy over time. End of life care also remains important, as patients may still die from AIDS, or even more commonly, from end-organ failure, non-AIDS defining malignancies, and/or other complications of ageing and chronic comorbid disease. All these converging factors have now resulted in a new need for the reintegration of HIV care and palliative care, both to help HIV-infected patients live better and longer, as well as to manage late-stage and end of life issues when they emerge.

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Chrysant, George, and Suzanne Oparil. "Treatment of Hypertension in the Patient with Cardiovascular Disease * *Abbreviations: ACEI, angiotensin converting enzyme inhibitor; ACS, acute coronary syndromes; AF, atrial fibrillation; MI, myocardial infarction; ARB, angiotensin II type 1 receptor blocker; BB, beta-adrenergic receptor blocker; BP, blood pressure; CCB, calcium channel blocker; CVD, cardiovascular disease; CHD, coronary heart disease; DM, diabetes mellitus; DBP, diastolic blood pressure; ESRD, end-stage renal disease; HF, heart failure; HTN, hypertension; ISH, isolated systolic hypertension; LVEF, left ventricular ejection fraction; LVMI, left ventricular mass index; LVH, left ventricular hypertrophy; PP, pulse pressure; PAD, peripheral arterial disease; PWV, pressure wave velocity; RAAS, renin-angiotensin-aldosterone system; RWT, relative wall thickness; SBP, systolic blood pressure; U.S., United States." In Cardiovascular Therapeutics, 625–46. Elsevier, 2007. http://dx.doi.org/10.1016/b978-1-4160-3358-5.50040-1.

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