Cardiorenal MedicinePub Date : 2025-01-01Epub Date: 2025-02-20DOI: 10.1159/000544817
Amir Kazory, Claudio Ronco
{"title":"Advances in Cardiorenal Medicine: The Year 2024 in Review.","authors":"Amir Kazory, Claudio Ronco","doi":"10.1159/000544817","DOIUrl":"10.1159/000544817","url":null,"abstract":"","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"229-237"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143466647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Health Implications Associated with Fat-Free Mass: A Phenome-Wide Mendelian Randomization Study.","authors":"Yuchen Ying, Chunxia Zhang, Shanshan Wu, Shudan Wang, Jiangfang Lian, Yupin Lin, Haiwang Guan, Dihui Cai","doi":"10.1159/000545641","DOIUrl":"10.1159/000545641","url":null,"abstract":"<p><strong>Introduction: </strong>Fat-free mass (FFM) is a critical component of the human body, with implications for various diseases.</p><p><strong>Methods: </strong>We conducted a comprehensive analysis integrating a phenome-wide association study (PheWAS), a two-sample Mendelian randomization (MR) analysis, and a systematic review to investigate the associations between FFM and health outcomes.</p><p><strong>Results: </strong>PheWAS identified 183 phenotypes enriched for FFM associations, including diseases, body composition, and lifestyle factors. A two-sample MR analysis using the FinnGen and UK Biobank dataset revealed significant associations between genetically determined FFM and 36 disease outcomes, including cardiovascular diseases, metabolic disorders, and musculoskeletal conditions. The mediation MR analysis indicates that FFM indirectly influences the levels of five biomarkers in visceral adipose tissue. A systematic review identified consistent associations between FFM and several diseases, including type 2 diabetes and cervical disc disorders. Moreover, new associations such as low back pain and ovarian cancer were discovered.</p><p><strong>Conclusion: </strong>These findings challenge the conventional notion of FFM as a protective factor in health, suggesting that higher FFM levels may be linked to an increased risk of various diseases. Further clinical studies are warranted to validate these findings and elucidate the underlying mechanisms.</p>","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"295-308"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cardiorenal MedicinePub Date : 2025-01-01Epub Date: 2025-04-14DOI: 10.1159/000545821
Song Wen, Xueting Qiu, Xingjie Huang, Zehan Huang, Feng Wang, Dunliang Ma, Zhonghua Xia, Feihuang Han, Jiquan Xiao, Qiheng Wan, Bin Zhang, Nan Chen, Yuqing Huang
{"title":"The Association of Cumulative Chinese Visceral Adiposity Index and New-Onset Hypertension in Middle-Aged and Elderly Chinese Populations: A Cohort Study.","authors":"Song Wen, Xueting Qiu, Xingjie Huang, Zehan Huang, Feng Wang, Dunliang Ma, Zhonghua Xia, Feihuang Han, Jiquan Xiao, Qiheng Wan, Bin Zhang, Nan Chen, Yuqing Huang","doi":"10.1159/000545821","DOIUrl":"10.1159/000545821","url":null,"abstract":"<p><strong>Introduction: </strong>Previous studies have reported a significant relationship between the baseline Chinese visceral adipose index (CVAI) and the risk of new-onset hypertension (NOH). However, the long-term effect of the CVAI and the risk of NOH remains uncertain. This study aimed to investigate the association between the cumulative CVAI and the risk of NOH.</p><p><strong>Methods: </strong>Data were obtained from the China Health and Retirement Longitudinal Study from 2011 to 2020. In total, 2,836 Chinese participants ≥45 years were included. Multivariable logistic regression analysis as well as restricted cubic spline regression analysis were performed to assess the association of the cumulative CVAI, visceral adiposity index (VAI), and lipid accumulation product (LAP) with the risk of NOH. Furthermore, receiver operating characteristic (ROC) curve analysis was used to determine the area under the ROC curves between the risk of NOH and the adiposity indices to compare the predictive powers of the cumulative CVAI, VAI, and LAP for NOH.</p><p><strong>Results: </strong>During the 5-year follow-up period, 433 cases of NOH were recorded. The cumulative CVAI, VAI, and LAP were positively associated with the risk of NOH. After adjusting for potential confounders, as compared to the lowest quartile of the cumulative CVAI, VAI, and LAP, the participants in the highest quartile had a significantly higher risk for NOH (odds ratio = 1.74, 1.46, and 1.95; 95% confidence interval = 1.25-2.42, 1.05-2.03, and 1.39-2.75, respectively). ROC analysis revealed that the cumulative CVAI had the highest relationship with the risk of NOH.</p><p><strong>Conclusion: </strong>The cumulative CVAI was positively associated with an increased risk of NOH in middle-aged and elderly Chinese populations. In addition, the performance of the cumulative CVAI to predict NOH was superior to other visceral obesity indices. Monitoring long-term changes to the CVAI may assist with early identification of individuals at high risk of NOH.</p>","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"309-322"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143980286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cardiorenal MedicinePub Date : 2025-01-01Epub Date: 2025-05-19DOI: 10.1159/000546387
Lijuan Xu, Zhen Wang, Lei Sun, Bin Liu, Hongxiao Li
{"title":"Ultrafiltration in Elderly Patients with Type 1 Cardiorenal Syndrome: Efficacy and Safety Outcomes.","authors":"Lijuan Xu, Zhen Wang, Lei Sun, Bin Liu, Hongxiao Li","doi":"10.1159/000546387","DOIUrl":"10.1159/000546387","url":null,"abstract":"<p><strong>Introduction: </strong>Due to the typical exclusion of very elderly patients from clinical trials, the applicability of trial results to this population with heart failure remains uncertain. Limited data exist regarding the efficacy and safety of ultrafiltration in elderly patients with type 1 cardiorenal syndrome (CRS). Consequently, our study aimed to compare the efficacy and safety of ultrafiltration versus diuretics, providing evidence-based insights into the optimal management strategy for elderly patients with type 1 CRS.</p><p><strong>Methods: </strong>In this prospective pilot trial, patients aged over 70 years old with type I CRS were treated with either diuretics or ultrafiltration. All patients were followed for up to 180 days post-discharge. Efficacy outcomes encompassed both immediate measures (changes in weight and dyspnea score from baseline to 48 h posttreatment) and long-term stability indicators (length of hospital stay and heart failure-related medical visits within 180 days post-discharge). Safety outcomes were assessed in both groups, focusing on changes in systolic blood pressure, heart rate, serum creatinine, blood urea nitrogen, blood potassium, and sodium ion concentrations, bleeding or thromboembolic events, and major adverse cardiovascular events.</p><p><strong>Results: </strong>A total of 159 patients with type I CRS were enrolled, with 80 receiving diuretics and 79 undergoing ultrafiltration. The mean age was 82.1 ± 5.8 years. At 48 h, patients in the ultrafiltration group demonstrated significantly greater weight loss and improvements in dyspnea score compared to those in the diuretic group (p < 0.05). Furthermore, the ultrafiltration group had shorter hospital stays and fewer medical visits for heart failure within 180 days post-discharge (p < 0.05). Notably, there were no statistically significant differences in safety outcomes between the two groups, indicating comparable safety profiles.</p><p><strong>Conclusion: </strong>Ultrafiltration demonstrated superior efficacy with comparable safety profiles compared to diuretics. Therefore, ultrafiltration may be considered a preferred treatment option for elderly patients with type I CRS.</p>","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"430-438"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12180765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cardiorenal MedicinePub Date : 2025-01-01Epub Date: 2025-04-14DOI: 10.1159/000545017
Marco Montomoli, Miguel Gonzalez Ricoa, José Luis Górriz Terue, Maria Jesus Puchades Montesa, Gonzalo Nuñez Marín, Maria Soledad Lecueder
{"title":"Addressing Renal Sodium Avidity in Chronic Heart Failure: There Is Always More than One Way to Skin a Cat.","authors":"Marco Montomoli, Miguel Gonzalez Ricoa, José Luis Górriz Terue, Maria Jesus Puchades Montesa, Gonzalo Nuñez Marín, Maria Soledad Lecueder","doi":"10.1159/000545017","DOIUrl":"10.1159/000545017","url":null,"abstract":"<p><strong>Background: </strong>Renal sodium avidity is a defining characteristic of chronic cardiorenal syndrome (CRS), leading to persistent sodium retention despite significant fluid overload. This phenomenon exacerbates volume overload, contributes to hemodynamic instability, and accelerates the decline of cardiac and renal function. Conventional diuretic therapies, though effective in acute settings, often fail chronically due to neurohormonal activation, renal tubular adaptations, and diuretic resistance.</p><p><strong>Summary: </strong>This review explores innovative approaches to overcoming natriuresis and diuresis resistance in CRS patients. Emerging pharmacological treatments, including sodium-glucose cotransporter 2 (SGLT2) inhibitors and glucagon-like peptide-1 receptor (GLP-1R) agonists, show potential in enhancing sodium excretion. Additionally, extracorporeal techniques such as ultrafiltration (UF) via hemodialysis and peritoneal dialysis (PD) provide precise sodium and fluid removal, bypassing many of the limitations of traditional pharmacotherapy. PD, in particular, has demonstrated efficacy in refractory cases by preserving residual renal function and improving diuretic responsiveness. As the saying goes, \"there's always more than one way to skin a cat.\"</p><p><strong>Key messages: </strong>(1) Renal sodium avidity plays a crucial role in CRS progression, necessitating targeted interventions. (2) Standard diuretic therapies often fail to provide sustained relief due to compensatory mechanisms. (3) Novel pharmacological agents (SGLT2 inhibitors, GLP-1R agonists) and extracorporeal techniques (UF, PD) offer promising alternatives for managing sodium retention and fluid overload. (4) A multidisciplinary and personalized treatment strategy is essential for optimizing patient outcomes and improving quality of life.</p>","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"399-412"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cardiorenal MedicinePub Date : 2025-01-01Epub Date: 2024-11-14DOI: 10.1159/000542628
Carmine Zoccali
{"title":"A New Clinical Entity Bridging the Cardiovascular System and the Kidney: The Chronic Cardiovascular-Kidney Disorder.","authors":"Carmine Zoccali","doi":"10.1159/000542628","DOIUrl":"10.1159/000542628","url":null,"abstract":"<p><strong>Background: </strong>The complex relationship between heart and kidney dysfunction has been a subject of medical inquiry since the 19th century. The term \"cardio-renal syndrome\" (CRS) was introduced in the early 2000s and has since become a focal point of research. CRS is typically categorized into five subtypes based on the sequence of cardiovascular and kidney disease events.</p><p><strong>Summary: </strong>The cardiovascular-kidney-metabolic (CKM) syndrome, as defined by the American Heart Association, describes a set of interrelated metabolic risk factors and their effects on the kidneys and cardiovascular system. This syndrome emphasizes the complexity of managing patients with combined conditions and identifies several knowledge gaps, including disease mechanisms, clinical phenotype variability, and the impact of social determinants of health. The chronic cardiovascular-kidney disorder (CCKD) framework proposes a shift from the term \"syndrome\" to \"disorder,\" focusing on concurrent cardiovascular and kidney problems regardless of their sequence.</p><p><strong>Key messages: </strong>(i) The CCKD concept calls for simplification and conceptual clarity, arguing that understanding the bidirectional acceleration of disease progression between heart and kidney dysfunction can lead to more effective treatment strategies. (ii) Both CKM and CCKD share common pathophysiological mechanisms and risk factors, including hypertension, diabetes, obesity, and dyslipidemia. Managing these conditions requires a comprehensive approach that addresses the underlying risk factors and pathophysiological mechanisms. (iii) Future directions include embracing precision medicine, public health strategies, interdisciplinary care models, and ongoing research and innovation. Both frameworks underscore the need for comprehensive, interdisciplinary care models and innovative treatment strategies to address the complex interplay between cardiovascular and kidney diseases.</p>","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"21-28"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11844677/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142615367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cardiorenal MedicinePub Date : 2025-01-01Epub Date: 2024-12-03DOI: 10.1159/000542964
Saif Al-Chalabi, Sally Alezergawi, Darren Green, Smeeta Sinha, Philip A Kalra
{"title":"Global Longitudinal Strain Correlates Poorly with Mortality in People with Diabetes Mellitus and Receiving Haemodialysis.","authors":"Saif Al-Chalabi, Sally Alezergawi, Darren Green, Smeeta Sinha, Philip A Kalra","doi":"10.1159/000542964","DOIUrl":"10.1159/000542964","url":null,"abstract":"<p><strong>Introduction: </strong>Haemodialysis (HD) is a life-sustaining treatment for individuals with end-stage kidney disease. However, the risk of mortality remains significantly higher compared to the general population, even when matched for age and sex. Global longitudinal strain (GLS), derived from speckle tracking echocardiography, has shown promise as a predictor of mortality in HD patients. However, its prognostic utility in patients with multiple cardiovascular risk factors such as diabetes mellitus (DM) and receiving HD remains unclear. This study aimed to evaluate the prognostic value of GLS in HD patients, with and without DM.</p><p><strong>Methods: </strong>This prospective study was a long-term follow-up extension study of an earlier published study that investigated a cohort of HD patients from a single centre with a comprehensive cardiovascular imaging protocol. All patients had an echocardiography with the use of speckle tracking software to determine GLS. Patients were divided into group A (with DM) and group B (without DM). Patients were followed up until death, major adverse cardiovascular events, transplantation, or the censoring date (29 February 2024). Statistical analyses were performed using univariate and multivariate Cox proportional hazards models.</p><p><strong>Results: </strong>A total of 184 patients receiving HD were included in the analysis. Patients with DM (group A) had significantly higher all-cause mortality (ACM) (47.1% vs. 20.7%, p < 0.001) and a lower chance of receiving a kidney transplant (13.2% vs. 43.1%, p < 0.001). In group A, GLS did not predict ACM, whereas in group B, a GLS cut-off of -15.76% correlated with higher 5-year ACM (p = 0.036). Left ventricular ejection fraction (LVEF) was a significant predictor of ACM in group A (HR 0.98; p = 0.036).</p><p><strong>Conclusion: </strong>GLS is a poor predictor of adverse outcomes in HD patients with DM, likely due to their high cardiovascular risk. In contrast, GLS was a significant predictor of mortality in non-diabetic HD patients. LVEF may be a more reliable prognostic indicator in high-risk diabetic patients.</p>","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"61-71"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11844706/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cardiorenal MedicinePub Date : 2025-01-01Epub Date: 2024-12-04DOI: 10.1159/000542965
Lorenzo Lo Cicero, Paolo Lentini, Concetto Sessa, Niccolò Castellino, Ambra D'Anca, Irene Torrisi, Carmelita Marcantoni, Pietro Castellino, Domenico Santoro, Luca Zanoli
{"title":"Inflammation and Arterial Stiffness as Drivers of Cardiovascular Risk in Kidney Disease.","authors":"Lorenzo Lo Cicero, Paolo Lentini, Concetto Sessa, Niccolò Castellino, Ambra D'Anca, Irene Torrisi, Carmelita Marcantoni, Pietro Castellino, Domenico Santoro, Luca Zanoli","doi":"10.1159/000542965","DOIUrl":"10.1159/000542965","url":null,"abstract":"<p><strong>Background: </strong>Patients with chronic kidney disease (CKD) have an increased cardiovascular (CV) risk. The lower the glomerular filtration rate, the higher the CV risk.</p><p><strong>Summary: </strong>Current data suggest that several uremic toxins lead to vascular inflammation and oxidative stress that, in turn, lead to endothelial dysfunction, changes in smooth muscle cells' phenotype, and increased degradation of elastin and collagen fibers. These processes lead to both functional and structural arterial stiffening and explain part of the increased risk of acute myocardial infarction and stroke reported in patients with CKD. Considering that, at least in patients with end-stage kidney disease, the reduction of arterial stiffness is associated with a parallel decrease of the CV risk; vascular function is a potential target for therapy to reduce the CV risk.</p><p><strong>Key messages: </strong>In this review, we explore mechanisms of vascular dysfunction in CKD, paying particular attention to inflammation, reporting current data in other models of mild and severe inflammation, and discussing the vascular effect of several drugs currently used in nephrology.</p>","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"29-40"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11844711/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142779401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cardiorenal MedicinePub Date : 2025-01-01Epub Date: 2025-04-10DOI: 10.1159/000545822
Li Wang, Fangfang Xiang, Jun Ji, Lin Zhang, Xiaotian Jiang, Yi Fang, Xiaoqiang Ding, Wuhua Jiang
{"title":"Association of Uric Acid to High-Density Lipoprotein Cholesterol Ratio with Left Ventricular Hypertrophy in Chronic Kidney Disease.","authors":"Li Wang, Fangfang Xiang, Jun Ji, Lin Zhang, Xiaotian Jiang, Yi Fang, Xiaoqiang Ding, Wuhua Jiang","doi":"10.1159/000545822","DOIUrl":"10.1159/000545822","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic kidney disease (CKD) is associated with a high prevalence of cardiovascular complications, including left ventricular hypertrophy (LVH), which significantly increases morbidity and mortality. LVH in CKD results from a complex interplay of hemodynamic, neurohormonal, and metabolic factors. The uric acid-to-high density lipoprotein cholesterol ratio (UHR) has recently been proposed as a potential marker for cardiovascular outcomes, combining the effects of uric acid and HDL-C on inflammation and cardiovascular risk. However, the relationship between UHR and LVH in CKD patients remains unexplored. This study aimed to investigate the association between UHR and LVH in patients with CKD.</p><p><strong>Methods: </strong>This cross-sectional study included CKD patients admitted to the Division of Nephrology between April 2019 and October 2019. CKD was staged according to the Kidney Disease: Improving Global Outcomes (KDIGO) guidelines. LVH was assessed using transthoracic echocardiography, and left ventricular mass index (LVMI) was calculated. LVH was defined as an LVMI >115 g/m2 for men and >95 g/m2 for women. UHR was calculated by dividing serum uric acid levels (µmol/L) by HDL-C levels (mmol/L). Multivariable logistic regression models were used to assess the association between UHR and LVH, adjusting for covariates including age, gender, BMI, and other relevant clinical factors.</p><p><strong>Results: </strong>A total of 466 patients were included, of whom 56 had LVH. Patients with LVH had significantly higher UHR levels compared to those without LVH. In multivariable regression analysis, the natural logarithm of UHR (LnUHR) was significantly associated with an increased risk of LVH (OR: 2.04, 95% CI: 1.05-4.12, p = 0.035) after full adjustment for confounders. Further analysis using restricted cubic splines revealed a non-linear relationship between UHR and LVH, with an inflection point at UHR = 0.60. Below this threshold, each increase of one standard deviation in UHR was associated with a 2.11-fold increase in LVH risk (OR: 2.11, 95% CI: 1.51-3.03, p < 0.001), while above this threshold, the association was not significant (OR: 0.82, 95% CI: 0.39-1.47, p = 0.54).</p><p><strong>Conclusion: </strong>This study provides the first evidence of an association between UHR and LVH in CKD patients, particularly at lower UHR levels. The findings suggest that UHR could serve as a novel marker for cardiovascular risk stratification in CKD, reflecting the balance between pro-inflammatory and protective cardiovascular factors. These results highlight the potential of UHR as a cost-effective tool for identifying CKD patients at increased risk of LVH, warranting further investigation in longitudinal studies to establish causality and explore targeted interventions.</p>","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"323-332"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143974938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cardiorenal MedicinePub Date : 2025-01-01Epub Date: 2025-04-16DOI: 10.1159/000545403
Davi Wei Ming Wang, Bruna Cristine D Rodrigues, Maria Eugenia Canziani, Gabriel Merli, Helena Souza, Julia de Toledo Martins, Wilson Jacob-Filho, Roberto Zatz, Rosa M A Moysés, Fernanda Marciano Consolim-Colombo, Rosilene M Elias
{"title":"Blood Pressure Variability in Older Patients with Chronic Kidney Disease.","authors":"Davi Wei Ming Wang, Bruna Cristine D Rodrigues, Maria Eugenia Canziani, Gabriel Merli, Helena Souza, Julia de Toledo Martins, Wilson Jacob-Filho, Roberto Zatz, Rosa M A Moysés, Fernanda Marciano Consolim-Colombo, Rosilene M Elias","doi":"10.1159/000545403","DOIUrl":"10.1159/000545403","url":null,"abstract":"<p><strong>Background: </strong>An increased blood pressure variability (BPV) is associated with a high risk of cardiovascular events in the general population. This concept was scarcely tested in patients with chronic kidney disease (CKD). We investigated the behavior of BPV parameters in a large cohort of older patients with CKD.</p><p><strong>Methods: </strong>This retrospective cohort study included patients ≥75 years old with eGFR ≤60 mL/min. Three systolic and diastolic consecutive blood pressure (BP) measurements were obtained automatically per visit (short term - 3 consecutive measurements) and across visits (long term - across visits). We calculated (1) standard deviation (SD); (2) coefficient of variation (SD divided by the BP average); and (3) variability independent of the mean (VIM). For each BPV parameter, patients were divided into quartiles.</p><p><strong>Results: </strong>We included 1,063 patients (17,363 measurements). For short BPV, the higher systolic BPV (SD and VIM) was associated with older age, a lower proportion of males, and a higher proportion of patients with pulse pressure (PP) >40 mm Hg. Higher diastolic BPV (SD and VIM) was associated with lower body mass index, lower eGFR, and a higher proportion of PP >40 mm Hg (for SD). Bland-Altman plots revealed comparable results between short- and long-term BPV.</p><p><strong>Conclusion: </strong>A higher BPV was associated with reduced renal function in older patients with CKD. Our study also suggests that short- and long-term BPV can be used with similar results. Further studies are needed to confirm the association between BPV and outcomes and understand the physiological mechanisms underlying this correlation.</p>","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"347-357"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143973921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}