Increased targeting of cardiovascular risk factors in patients with chronic kidney disease does not improve atheroma burden or cardiovascular function

American Heart Journal
N M IsbelT H Marwick

Abstract

Although multiple risk factor intervention (MRFI) is recommended to reduce the increased morbidity and mortality of cardiovascular disease (CVD) in chronic kidney disease (CKD), its efficacy is unknown. We studied the efficacy of a MRFI program in CKD. This randomized controlled study of 200 patients with stage 4 or 5 CKD compared a physician-supervised, nurse-driven MRFI clinic (focused on dyslipidemia, hyperhomocysteinemia, blood pressure [BP], anemia, and hyperphosphatemia) with conventional care in CKD. One hundred eleven subjects completed 2 years of follow-up (median follow-up 674 days [interquartile range {IQR} 348-719 days]). Outcome measures were atheroma burden (carotid intimamedia thickness [IMT]) and endothelial function (brachial artery reactivity [BAR]). The MRFI group showed significant improvements, compared with usual care, in serum low-density lipoprotein cholesterol (-30.9 mg/dL vs -12.7 mg/dL, P = .001), homocysteine (-6.95 vs -0.67 micromol/L, P < .001), systolic BP (-6.9 vs -0.2 mm Hg, P = .049), and diastolic BP (-4.8 vs -1.0 mm of Hg, P = .043). No significant changes were seen in serum phosphate or hemoglobin level. Despite observed improvements in risk factors, no differences from baseline were demonst...Continue Reading

References

Jan 1, 1976·Nephron·D W Cockcroft, M H Gault
May 1, 1990·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·E G Lowrie, N L Lew
Mar 3, 1998·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·C van GuldenerC D Stehouwer
Nov 20, 1998·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·R N FoleyM J Sarnak
Feb 13, 1999·Kidney International·J ZimmermannC Wanner
Feb 22, 2001·The American Journal of Medicine·R KennedyT H Marwick
Apr 23, 2002·Kidney International·Kunitoshi IsekiShuichi Takishita
Mar 4, 2003·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Yoshiki NishizawaMasaaki Inaba
Mar 13, 2003·Kidney International·Kamyar Kalantar-ZadehJoel D Kopple
Apr 16, 2003·The American Journal of the Medical Sciences·Allan J Collins
Dec 20, 2003·Journal of the American Society of Nephrology : JASN·Giovanna LeonciniRoberto Pontremoli
Jan 9, 2004·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Robert FathiThomas H Marwick
Jan 30, 2004·Journal of the American Society of Nephrology : JASN·Elizabeth M WroneStephen P Fortmann
Jan 30, 2004·JAMA : the Journal of the American Medical Association·Yongmei LiuMichael J Klag
Aug 19, 2004·Kidney & Blood Pressure Research·Christoph WannerUNKNOWN Deutsche Diabetes-Dialyse-Studie (4D) Study Group
Sep 24, 2004·The New England Journal of Medicine·Alan S GoChi-yuan Hsu
Mar 9, 2005·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Colin BaigentDavid C Wheeler

❮ Previous
Next ❯

Citations

Mar 29, 2007·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Jeffrey M Saland, Henry N Ginsberg
Aug 27, 2013·American Journal of Cardiovascular Drugs : Drugs, Devices, and Other Interventions·A OlyaeiE Lerma
Mar 18, 2008·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Mieczyslaw LitwinFranz Schaefer
Sep 5, 2009·Clinical Journal of the American Society of Nephrology : CJASN·David W JohnsonKathryn J Wiggins
Jan 23, 2009·Clinical Journal of the American Society of Nephrology : CJASN·Teresa AdragaoHartmut H Malluche
Jun 4, 2011·Cardiology Research and Practice·Christopher R Martens, David G Edwards
Oct 28, 2010·Expert Opinion on Pharmacotherapy·Anna GlubaMaciej Banach
Jan 17, 2016·Clinical Journal of the American Society of Nephrology : CJASN·Megan RossiKatrina L Campbell
Jul 21, 2015·Journal of the Formosan Medical Association = Taiwan Yi Zhi·Yen-Wen LiuJunne-Ming Sung
Nov 13, 2013·Archives of Medical Research·Héctor R Martínez-RamírezAlfonso M Cueto-Manzano
May 1, 2013·Kidney International Supplements·Alfonso M Cueto-ManzanoLaura Cortés-Sanabria
Aug 21, 2012·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Rathika KrishnasamyDavid W Johnson
Nov 22, 2011·Advances in Chronic Kidney Disease·Garland Adam Campbell, Warren Kline Bolton
Feb 27, 2016·Advanced Biomedical Research·Mohammad Reza SabriAlaleh Gheissari
Sep 21, 2010·Endocrinología y nutrición : órgano de la Sociedad Española de Endocrinología y Nutrición·Joana MesquitaJosé Luís Medina
Dec 2, 2008·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·Nicola C EdwardsRichard P Steeds
May 30, 2007·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Gursharan DograGerald Watts
Dec 13, 2006·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Gursharan DograGerald Watts
Jan 30, 2007·Hemodialysis International·David W JohnsonNicole Maree Isbel
Jul 4, 2008·Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research·Astrid Fahrleitner-PammerHartmut H Malluche
Jun 2, 2014·Nutrition, Metabolism, and Cardiovascular Diseases : NMCD·M RossiN Isbel
Jan 22, 2015·Electrolyte & Blood Pressure : E & BP·Hoon Young ChoiSung Kyu Ha
Jun 30, 2011·Nature Reviews. Nephrology·Adeera Levin, Paul E Stevens
Feb 3, 2007·Journal of the American Society of Nephrology : JASN·Brenda R HemmelgarnBruce F Culleton
Mar 29, 2008·Clinical Journal of the American Society of Nephrology : CJASN·Eberhard Ritz, Christoph Wanner
May 25, 2013·Clinical Journal of the American Society of Nephrology : CJASN·Yen-Wen LiuWei-Chuan Tsai
May 23, 2019·American Journal of Physiology. Renal Physiology·Isabel Amador-MartínezJonatan Barrera-Chimal
Jun 27, 2014·American Journal of Physiology. Renal Physiology·Christopher R MartensDavid G Edwards
Jul 24, 2014·American Journal of Physiology. Endocrinology and Metabolism·Neerupma SilswalMichael J Wacker
Dec 3, 2013·Peritoneal Dialysis International : Journal of the International Society for Peritoneal Dialysis·Yueqiang WenXueqing Yu
Jun 1, 2016·The Cochrane Database of Systematic Reviews·Sagar U NigwekarMeg J Jardine
Aug 1, 2008·NDT Plus·Philip Kam-Tao LiGary Tin-Choi Ko
Apr 25, 2019·Physiological Reports·Elissa K KatulkaMelissa A H Witman
Feb 10, 2021·Archives of Medical Research·Miguel A Villasís-KeeverLuis Antonio Arenas-Aguayo
Apr 5, 2021·The Journal of Thoracic and Cardiovascular Surgery·Takuya OgamiHiroo Takayama

❮ Previous
Next ❯

Related Concepts

Related Feeds

Cardiovascular Disease Pathophysiology

Cardiovascular disease involves several different processes that contribute to the pathological mechanism, including hyperglycemia, inflammation, atherosclerosis, hypertension and more. Vasculature stability plays a critical role in the development of the disease. Discover the latest research on cardiovascular disease pathophysiology here.

Anemia

Anemia develops when your blood lacks enough healthy red blood cells. Anemia of inflammation (AI, also called anemia of chronic disease) is a common, typically normocytic, normochromic anemia that is caused by an underlying inflammatory disease. Here is the latest research on anemia.

Related Papers

Clinical Journal of the American Society of Nephrology : CJASN
Elizabeth A BaylissDiane M Lanese
Journal of the American Society of Nephrology : JASN
Brenda R HemmelgarnBruce F Culleton
The New England Journal of Medicine
B FellströmAURORA Study Group
© 2021 Meta ULC. All rights reserved