Exploring the Link between Cardiorenal and Metabolic Diseases

A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "Chronic Care".

Deadline for manuscript submissions: closed (31 March 2023) | Viewed by 9723

Special Issue Editors


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Guest Editor
1. Department of Medicine & Surgery, Universidad Cardenal Herrera-CEU, CEU Universities, Carrer Lluis Vives, 1, 46115 Valencia, Spain
2. Department of Nephrology, Hospital General Universitario de Valencia, Valencia, Spain
Interests: chronic kidney disease; cardiovascular disease; diabetes; adiposopathy; inflammation
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Guest Editor
1. Department of Medicine & Surgery, Universidad Cardenal Herrera-CEU, CEU Universities, 46115 Valencia, Spain
2. Aston Institute of Health & Neurodevelopment (IHN), School of Life & Health Sciences, Aston University, Birmingham B4 7ET, UK
Interests: melatonin; circadian rhythms; inflammation; neurology; children

Special Issue Information

Dear Colleagues,

Metabolic diseases, such as obesity and diabetes mellitus, are well-known risk factors for both cardiovascular and chronic kidney diseases. This influence takes place not only through direct factors such as hypertension, but also through indirect pro-inflammatory/pro-atherogenic effects mediated by adipokines and other hormones secreted by adipose tissue. In turn, chronic kidney disease is a systemic inflammatory syndrome that predisposes to cardiovascular disease and impacts metabolism through pathways favoring inflammation, oxidative stress, and insulin resistance. Therefore, a better understanding of the link between the kidney–heart axis and metabolic alterations will spur the search for metabolic markers to identify the preclinical stages of the cardiorenal disease. Additionally, this will lead to the more accurate management of the complications derived from chronic kidney disease and metabolic disorders in the clinical setting.

This Special Issue seeks articles (original research and reviews) exploring the biological and environmental (diet, lifestyle) risk factors for the metabolic events predisposing to cardiorenal disease, as well as the metabolic effects derived from pharmacological/non-pharmacological interventions for cardiorenal disease and vice versa.

This invitation is addressed to all clinicians involved in the care of patients with cardiorenal/metabolic disorders and to biomedical researchers conducting either preclinical or clinical studies in these fields.

Prof. Dr. Luis D’Marco
Prof. Dr. Ana Checa Ros
Guest Editors

Manuscript Submission Information

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Keywords

  • chronic kidney disease
  • cardiovascular disease
  • inflammation
  • oxidative stress
  • insulin resistance
  • CRP
  • adipokines
  • adipose tissue
  • aging

Published Papers (6 papers)

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Editorial

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6 pages, 610 KiB  
Editorial
Exploring the Link between Cardiorenal and Metabolic Diseases
by Luis D’Marco and Ana Checa-Ros
Healthcare 2023, 11(21), 2831; https://doi.org/10.3390/healthcare11212831 - 26 Oct 2023
Viewed by 840
Abstract
The close link between metabolic diseases, such as obesity and diabetes mellitus, and cardiorenal disease can be attributed not only to direct risk factors, such as hypertension, but also to the intricate interplay of various pathophysiological processes [...] Full article
(This article belongs to the Special Issue Exploring the Link between Cardiorenal and Metabolic Diseases)
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Research

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14 pages, 2044 KiB  
Article
Role of the Nephrologist in Non-Kidney Solid Organ Transplant (NKSOT)
by Iris Viejo-Boyano, Luis Carlos López-Romero, Luis D’Marco, Ana Checa-Ros, María Peris-Fernández, Enrique Garrigós-Almerich, María Carmen Ramos-Tomás, Ana Peris-Domingo and Julio Hernández-Jaras
Healthcare 2023, 11(12), 1760; https://doi.org/10.3390/healthcare11121760 - 15 Jun 2023
Cited by 1 | Viewed by 841
Abstract
Background: Chronic kidney disease (CKD) is a common complication of a non-kidney solid organ transplant (NKSOT). Identifying predisposing factors is crucial for an early approach and correct referral to nephrology. Methods: This is a single-center retrospective observational study of a cohort of CKD [...] Read more.
Background: Chronic kidney disease (CKD) is a common complication of a non-kidney solid organ transplant (NKSOT). Identifying predisposing factors is crucial for an early approach and correct referral to nephrology. Methods: This is a single-center retrospective observational study of a cohort of CKD patients under follow-up in the Nephrology Department between 2010 to 2020. Statistical analysis was performed between all the risk factors and four dependent variables: end-stage renal disease (ESKD); increased serum creatinine ≥50%; renal replacement therapy (RRT); and death in the pre-transplant, peri-transplant, and post-transplant periods. Results: 74 patients were studied (7 heart transplants, 34 liver transplants, and 33 lung transplants). Patients who were not followed-up by a nephrologist in the pre-transplant (p < 0.027) or peri-transplant (p < 0.046) periods and those who had the longest time until an outpatient clinic follow-up (HR 1.032) were associated with a higher risk of creatinine increase ≥50%. Receiving a lung transplant conferred a higher risk than a liver or heart transplant for developing a creatinine increase ≥50% and ESKD. Peri-transplant mechanical ventilation, peri-transplant and post-transplant anticalcineurin overdose, nephrotoxicity, and the number of hospital admissions were significantly associated with a creatinine increase ≥50% and developing ESKD. Conclusions: Early and close follow-up by a nephrologist was associated with a decrease in the worsening of renal function. Full article
(This article belongs to the Special Issue Exploring the Link between Cardiorenal and Metabolic Diseases)
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14 pages, 986 KiB  
Article
Prevalence of Cardio-Embolic Brain Complications in Permanent and Paroxysmal Atrial Fibrillation Patients
by Ciprian Ilie Rosca, Abhinav Sharma, Daniel-Dumitru Nisulescu, Gabriela Otiman, Daniel-Marius Duda-Seiman, Stelian Ioan Morariu, Daniel Florin Lighezan and Nilima Rajpal Kundnani
Healthcare 2023, 11(2), 175; https://doi.org/10.3390/healthcare11020175 - 6 Jan 2023
Cited by 4 | Viewed by 1321
Abstract
Background: Atrial fibrillation (AF) is the most frequent of all cardiac arrhythmias, with an increasing prevalence in the last 20 years. Cardio-embolic brain complications (CEBC) related to AF often occur or recur, even following appropriate treatment. Method: We conducted a retrospective study and [...] Read more.
Background: Atrial fibrillation (AF) is the most frequent of all cardiac arrhythmias, with an increasing prevalence in the last 20 years. Cardio-embolic brain complications (CEBC) related to AF often occur or recur, even following appropriate treatment. Method: We conducted a retrospective study and analyzed the presence of stroke, dementia, and Parkinson’s disease (PD) in both paroxysmal and permanent AF patients. The records of 1111 consecutive admitted patients with primary diagnosis of AF at the Municipal Emergency University Hospital, Timisoara, between 2015 and 2016 were examined. Statistical analysis was performed on the patients included in the study based on the inclusion and exclusion criteria. Results: A significant statistical difference was noted among the permanent AF group for stroke (48.75% vs. 26.74%, p < 0.001) and dementia (10.25% vs. 3.86%, p < 0.001) compared to paroxysmal AF patients. Permanent AF patients presented a higher risk of developing stroke, dementia, and PD compared to patients with paroxysmal AF. Meanwhile, male gender and an increase in age showed an increase in the odds of having cardio-embolic brain complications in patients with paroxysmal AF. Conclusion: Based on the results obtained, it can be concluded that the risk of cardio-cerebral embolic complications is greater in permanent AF patients compared to paroxysmal AF cases. Ischemic stroke and dementia are more frequent in the permanent AF group, but analyzing the data regarding the age of onset paroxysmal AF is critical due to the fact that it involves a younger population. Prompt diagnosis and treatment can help significantly in saving stroke patients. Full article
(This article belongs to the Special Issue Exploring the Link between Cardiorenal and Metabolic Diseases)
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8 pages, 878 KiB  
Article
Etelcalcetide and Paricalcitol in Chronic Kidney Disease: When the Target Is Inflammation
by Luis D’Marco, Ana Checa-Ros, Dionilux Gamero, Carlos Soto, Juan Salazar, Manuel Nava, Valmore Bermúdez and Fabiola Dapena
Healthcare 2023, 11(1), 72; https://doi.org/10.3390/healthcare11010072 - 26 Dec 2022
Cited by 1 | Viewed by 1842
Abstract
Introduction: secondary hyperparathyroidism (SHP) is frequent in patients with chronic kidney disease (CKD), particularly in those in dialysis. To treat this complication, the current options available include phosphorus restriction, phosphate binders, the inhibition of parathyroid hormone (PTH) synthesis and secretion by the supplementation [...] Read more.
Introduction: secondary hyperparathyroidism (SHP) is frequent in patients with chronic kidney disease (CKD), particularly in those in dialysis. To treat this complication, the current options available include phosphorus restriction, phosphate binders, the inhibition of parathyroid hormone (PTH) synthesis and secretion by the supplementation of vitamin D or VDR activators, or the use of calcimimetics. Beyond the control of PTH, the effects of the treatment of SHP on other biomarkers of risk may represent an additional benefit for this population. In this study, we explore the benefits of current SHP treatment options, mainly paricalcitol and/or etelcalcetide in the inflammatory state of hemodialysis (HD) patients. Results: the study finally included 142 maintenance HD patients (5 patients were excluded) followed for 6 months (dialysis vintage 26 ± 30 months, mean age 70 years old, 73% women, 81% Spanish white, 47% diabetic). In this case, 52 patients were on regular treatment with paricalcitol for SHP and 25 patients were eligible to initiate etelcalcetide. The baseline serum levels of Ca, P, PTH, Ferritin, albumin, C-reactive protein (CRP), and other variables were measured. We found serum PTH levels showed an improvement after the treatment with etelcalcetide again paricalcitol and no treatment (p < 0.04). Of note, serum levels of CRP were significantly lower in a small group of patients (n = 11) receiving paricalcitol + etelcalcetide compared to paricalcitol or etelcalcetide alone. The proportion of patients with CRP within target ranges (≤1.0 mg/dL) increased significantly after combined treatment (p < 0.001). Conclusions: etelcalcetide proved to safely reduce the PTH levels without significant adverse events and the possibility of a synergic anti-inflammatory effect with the simultaneous use of Paricalcitol in HD patients. Full article
(This article belongs to the Special Issue Exploring the Link between Cardiorenal and Metabolic Diseases)
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10 pages, 646 KiB  
Article
Oral Anticoagulation in Patients with Chronic Kidney Disease and Non-Valvular Atrial Fibrillation: The FAERC Study
by Marco Montomoli, Lourdes Roca, Mariana Rivera, Raul Fernandez-Prado, Beatriz Redondo, Rosa Camacho, Cayetana Moyano, Saul Pampa, Angela Gonzalez, Juan Casas, Maria Kislikova, Ana Sanchez Horrillo, Alicia Cabrera Cárdena, Borja Quiroga, Cristina Rabasco, Sara Piqueras, Andrea Suso, Javier Reque, Juan Villa, Raquel Ojeda and David Arroyoadd Show full author list remove Hide full author list
Healthcare 2022, 10(12), 2566; https://doi.org/10.3390/healthcare10122566 - 17 Dec 2022
Cited by 2 | Viewed by 1839
Abstract
Atrial fibrillation (AF) is the most common arrhythmia in patients with chronic kidney disease (CKD), and its presence is associated with a higher risk of stroke and mortality. Material and Methods: The FAERC study performed a retrospective multicentre analysis of historical cohorts in [...] Read more.
Atrial fibrillation (AF) is the most common arrhythmia in patients with chronic kidney disease (CKD), and its presence is associated with a higher risk of stroke and mortality. Material and Methods: The FAERC study performed a retrospective multicentre analysis of historical cohorts in which data were collected from arrhythmia diagnosis onwards. Results: We analysed a Spanish cohort of 4749 patients with CKD (mean eGFR 33.9 mL/min) followed up in the nephrology clinic, observing a 12.2% prevalence of non-valvular AF. In total, 98.6% of these patients were receiving anticoagulant treatment, mainly with coumarins (79.7%). Using direct-acting oral anticoagulants (DOACs) was associated with fewer cerebrovascular events than using acenocoumarol, but in contrast with other studies, we could not corroborate the association of risk of bleeding, coronary events, or death with a type of anticoagulant prescribed. Conclusions: Atrial fibrillation is highly prevalent in renal patients. Direct-acting anticoagulants seem to be associated with fewer ischemic-embolic complications, with no differences in bleeding, coronary events, or mortality rates. Full article
(This article belongs to the Special Issue Exploring the Link between Cardiorenal and Metabolic Diseases)
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Other

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8 pages, 266 KiB  
Perspective
Fabry Disease: Switch from Enzyme Replacement Therapy to Oral Chaperone Migalastat: What Do We Know Today?
by Fernando Perretta and Sebastián Jaurretche
Healthcare 2023, 11(4), 449; https://doi.org/10.3390/healthcare11040449 - 4 Feb 2023
Cited by 6 | Viewed by 2420
Abstract
Fabry disease is a lysosomal storage disorder caused by the deficiency of the α-galactosidase-A enzyme. The result is the progressive accumulation of complex glycosphingolipids and cellular dysfunction. Cardiac, renal, and neurological involvement significantly reduces life expectancy. Currently, there is increasing evidence that clinical [...] Read more.
Fabry disease is a lysosomal storage disorder caused by the deficiency of the α-galactosidase-A enzyme. The result is the progressive accumulation of complex glycosphingolipids and cellular dysfunction. Cardiac, renal, and neurological involvement significantly reduces life expectancy. Currently, there is increasing evidence that clinical response to treatment improves with early and timely initiation. Until a few years ago, treatment options for Fabry disease were limited to enzyme replacement therapy with agalsidase alfa or beta administered by intravenous infusion every 2 weeks. Migalastat (Galafold®) is an oral pharmacological chaperone that increases the enzyme activity of “amenable” mutations. The safety and efficacy of migalastat were supported in the phase III FACETS and ATTRACT studies, compared to available enzyme replacement therapies, showing a reduction in left ventricular mass, and stabilization of kidney function and plasma Lyso-Gb3. Similar results were confirmed in subsequent extension publications, both in patients who started migalastat as their first treatment and in patients who were previously on enzyme replacement therapy and switched to migalastat. In this review we describe the safety and efficacy of switching from enzyme replacement therapy to migalastat in patients with Fabry disease and “amenable” mutations, referring to publications available to date. Full article
(This article belongs to the Special Issue Exploring the Link between Cardiorenal and Metabolic Diseases)
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