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Hot Cardiovascular Topics in Chronic and End-Stage Renal Disease
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Hot Cardiovascular Topics in Chronic and End-Stage Renal Disease

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiovascular Medicine".

Deadline for manuscript submissions: closed (20 September 2023) | Viewed by 6867

Special Issue Editors

Dr. Luca Di Lullo

E-Mail Website
Guest Editor
Department of Nephrology and Dialysis, “L. Parodi – Delfino” Hospital, Colleferro, Italy
Interests: cardiorenal disease; diabetes mellitus; anticoagulant therapy; acute kidney disease
Special Issues, Collections and Topics in MDPI journals
Dr. Antonio Bellasi

E-Mail Website
Guest Editor
Department of Medicine, Division of Nephrology, Ente Ospedaliero Cantonale, 6900 Lugano, Switzerland
Interests: CKD–MBD; cardiorenal disease; chronic kidney disease; vascular disease
Special Issues, Collections and Topics in MDPI journals
Dr. Biagio Raffaele Di Iorio

E-Mail Website
Guest Editor
Nephrology and Dialysis, AORN "San Giuseppe Moscati", 83100 Avellino, Italy
Interests: CKD–MBD; cardiorenal disease; chronic kidney disease; vascular disease

Special Issue Information

Dear Colleagues,

Cardiovascular disease represents the main cause of morbidity in patients with chronic kidney disease (CKD), as well as the main cause of death in patients with end-stage chronic kidney disease (ESRD).

In light of this, the early identification of cardiovascular risk factors, as well as the correct treatment of all diseases with cardio-renal involvement, is essential in a population, such as that of patients with CKD, which is particularly at risk.

The term cardio–renal syndrome, almost universally recognized, identifies precisely those clinical situations in which heart and kidney are involved, simultaneously or in more or less rapid progression.

Cardiorenal syndromes do not represent, however, the only manifestations of cardiovascular involvement during chronic kidney disease, regardless of the stage of kidney disease itself.

In fact, in the patient with chronic kidney disease coexist both the classic cardiovascular risk factors (age, sex, abnormalities of lipid metabolism, hypertension) and those more closely related to a condition of chronic kidney disease: this is the case, for example, for cardiovascular involvement during secondary hyperparathyroidism but also of cardiovascular disease due to an accelerated atherosclerotic process.

We solicit papers on traditional and CKD-related cardiovascular risk factors as far as on new therpaies in the fields of diabetes and cardiorenal diseases such as new hypoglycemic agents and the new oral anticoagulant drugs focused on delay the progression of renal disease.

Dr. Luca Di Lullo
Dr. Antonio Bellasi
Dr. Biagio Raffaele Di Iorio
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • cardiorenale syndromes
  • cardiovascular risk factors
  • chronic kidney disease
  • end-stage renal disease
  • arterial hypertension
  • anticoagulant therapy
  • new hypoglicemic agents

Published Papers (4 papers)

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Research

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11 pages, 612 KiB  
Article
Clinical Factors Associated with Arterial Stiffness in Chronic Kidney Disease
by Jin Yao, Zheyi Dong, Qian Wang, Zhe Li, Weiguang Zhang, Wenwen Lin, Yayong Luo, Hangtian Li, Xinru Guo, Li Zhang, Guangyan Cai, Wanjun Shen, Shuwei Duan and Xiangmei Chen
J. Clin. Med. 2023, 12(3), 1077; https://doi.org/10.3390/jcm12031077 - 30 Jan 2023
Cited by 2 | Viewed by 1531
Abstract
Background: Arterial stiffness influences the prognosis of patients with end-stage kidney disease; however, the factors that promote arterial stiffness in chronic kidney disease (CKD) patients remain unknown. We aimed to explore the clinical factors associated with arterial stiffness in CKD. Methods: Between September [...] Read more.
Background: Arterial stiffness influences the prognosis of patients with end-stage kidney disease; however, the factors that promote arterial stiffness in chronic kidney disease (CKD) patients remain unknown. We aimed to explore the clinical factors associated with arterial stiffness in CKD. Methods: Between September 2017 and September 2022, all CKD patients treated at the Department of Nephrology, General Hospital of the Chinese People’s Liberation Army, excluding dialysis patients, were screened and their medical records within the last month were collected. Arterial stiffness was measured by the augmentation index (AIx). The correlative clinical factors with arterial stiffness were explored in different linear regression models. Results: 559 patients were included in the study. AIx@75 increased as the deterioration of CKDG1–CKDG5, with values of 1 (−9, 11), 5.5 (−4, 13.25), 9 (0, 16), 12 (1.5, 23.5), and 22 (13, 28), respectively (Z = 63.03, p < 0.001). Multivariate linear regression analysis showed that AIx@75 was positively associated with female sex (β = 8.926, 95% confidence interval (CI) 6.291, 11.562, p < 0.001), age (β = 0. 485, 95% CI 0.39, 0.58, p < 0.001), mean arterial pressure (MAP) (β = 0.255, 95% CI 0.159, 0.35, p < 0.001), and was negatively associated with ACEI/ARB (β = −4.466, 95% CI −6.963, −1.969, p < 0.001) and glucocorticoid (β = −3.163, 95% CI −6.143, −0.183, p = 0.038). Smoking, eGFR, hemoglobin, and cause of disease were associated with AIx@75 in multivariate linear regression models when considering factors partly. Conclusions: Female, age, smoking, MAP, eGFR, cause of disease, ACEI/ARB, and glucocorticoid were found to be associated with atherosclerosis in CKD patients. Full article
(This article belongs to the Special Issue Hot Cardiovascular Topics in Chronic and End-Stage Renal Disease)
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14 pages, 1520 KiB  
Article
High Inferior Vena Cava Diameter with High Left Ventricular End Systolic Diameter as a Risk Factor for Major Adverse Cardiovascular Events, Cardiovascular and Overall Mortality among Chronic Hemodialysis Patients
by Chung-Kuan Wu, Noi Yar, Zih-Kai Kao, Ming-Tsang Chuang and Tzu-Hao Chang
J. Clin. Med. 2022, 11(18), 5485; https://doi.org/10.3390/jcm11185485 - 19 Sep 2022
Cited by 2 | Viewed by 1371
Abstract
Background: Little is known about the association of inferior vena cava diameter (IVCD) and left ventricular end-systolic diameter (LVESD) with mortality in patients undergoing hemodialysis (HD). Methods: The single medical center observational cohort study enrolled 241 adult chronic HD patients from 1 October [...] Read more.
Background: Little is known about the association of inferior vena cava diameter (IVCD) and left ventricular end-systolic diameter (LVESD) with mortality in patients undergoing hemodialysis (HD). Methods: The single medical center observational cohort study enrolled 241 adult chronic HD patients from 1 October 2018 to 31 December 2018. Echocardiography results of IVCD and LVESD prior to dialysis were retrieved and patients were divided into high IVCD and low IVCD groups. Patients who received HD via a tunneled cuffed catheter were excluded. Study outcomes included all-cause mortality, cardiovascular mortality, and major adverse cardiovascular events (MACE). Subgroup analyses of HD patients with high and low LVESD were also performed. Results: The incidence of all-cause mortality, cardiovascular mortality, and MACE were higher in chronic HD patients with high IVCD (p < 0.01). High IVCD patients had significantly greater all-cause mortality, cardiovascular mortality, and MACE (log-rank test; p < 0.05). High IVCD patients are also associated with an increased risk of all-cause mortality and MACE relative to low IVCD patients (aHRs, 2.88 and 3.42; 95% CIs, 1.06–7.86 and 1.73–6.77, respectively; all p < 0.05). In the subgroup analysis of patients with high or low LVESD, the high IVCD remained a significant risk factor for all-cause mortality and MACE, and the HR is especially high in the high LVESD group. Conclusions: Dilated IVCD is a risk factor for all-cause mortality and MACE in chronic HD patients. In addition, these patients with high LVESD also have a significantly higher HR of all-cause mortality and MACE. Full article
(This article belongs to the Special Issue Hot Cardiovascular Topics in Chronic and End-Stage Renal Disease)
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7 pages, 600 KiB  
Article
Associations between Serum Saturated Fatty Acids Content and Mortality in Dialysis Patients
by Malgorzata Sikorska-Wisniewska, Adriana Mika, Tomasz Sledzinski and Michal Chmielewski
J. Clin. Med. 2022, 11(17), 5051; https://doi.org/10.3390/jcm11175051 - 28 Aug 2022
Cited by 2 | Viewed by 1125
Abstract
Background: Cardiovascular mortality in dialysis population remains very high. Saturated fatty acids (SFA) contribute to atherosclerosis and to cardiovascular risk. Aim: The aim of this study was to evaluate the relationship between mortality in dialysis patients and the serum SFA content. Methods: Survival [...] Read more.
Background: Cardiovascular mortality in dialysis population remains very high. Saturated fatty acids (SFA) contribute to atherosclerosis and to cardiovascular risk. Aim: The aim of this study was to evaluate the relationship between mortality in dialysis patients and the serum SFA content. Methods: Survival of 54 patients on dialysis was assessed. A total of 21 SFA from patients’ sera were measured by gas chromatography-mass spectrometry (GC-MS). Diet was assessed by food frequency questionnaire FFQ-6. The SFA content is presented as fatty acid proportion (%). Results: During the observation time (median 66 months) 22 patients died. There was a significant relationship between elevated SFA (above SFA mean) and mortality (log-rank 3.13; p = 0.0017). Moreover, patients who ingested foods rich in SFA, according to FFQ-6, had a higher mortality risk (log-rank 2.24; p = 0.03). The hazard ratio for mortality associated with increased SFA content equalled 4.47 (1.63–12.26). Addition of age and inflammation (hsCRP > 5 mg/L) into the Cox model did not modify this relationship. However, SFA content turned out to be significantly higher in patients with diabetes mellitus and cardiovascular disease, as compared to patients free from these co-morbidities. Their addition to the model attenuated the relationship between SFA and mortality, making it statistically insignificant. Conclusion: The serum content of SFA turned out to be a strong predictor of mortality in dialysis patients. However, given the significant associations between SFA, DM, and CVD, interventional studies with controlled SFA intake are needed to evaluate the causal links between SFA, co-morbidities and survival. Full article
(This article belongs to the Special Issue Hot Cardiovascular Topics in Chronic and End-Stage Renal Disease)
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Review

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14 pages, 918 KiB  
Review
New Challenges in Heart Failure with Reduced Ejection Fraction: Managing Worsening Events
by Carlo Lavalle, Luca Di Lullo, Jean Pierre Jabbour, Marta Palombi, Sara Trivigno, Marco Valerio Mariani, Francesco Summaria, Paolo Severino, Roberto Badagliacca, Fabio Miraldi, Antonio Bellasi and Carmine Dario Vizza
J. Clin. Med. 2023, 12(22), 6956; https://doi.org/10.3390/jcm12226956 - 07 Nov 2023
Cited by 1 | Viewed by 2021
Abstract
Patients with an established diagnosis of heart failure (HF) with reduced ejection fraction (HFrEF) are prone to experience episodes of worsening symptoms and signs despite continued therapy, termed “worsening heart failure” (WHF). Despite guideline-directed medical therapy, worsening of chronic heart failure accounts for [...] Read more.
Patients with an established diagnosis of heart failure (HF) with reduced ejection fraction (HFrEF) are prone to experience episodes of worsening symptoms and signs despite continued therapy, termed “worsening heart failure” (WHF). Despite guideline-directed medical therapy, worsening of chronic heart failure accounts for almost 50% of all hospital admissions for HF, and patients experiencing WHF carry a substantially higher risk of death and hospitalization than patients with “stable” HF. New drugs are emerging as arrows in the quiver for clinicians to address the residual risk of HF hospitalization and cardiovascular deaths in patients with WHF. This question-and-answer-based review will discuss the emerging definition of WHF in light of the recent clinical consensus released by the Heart Failure Association (HFA) of the European Society of Cardiology (ESC), the new therapeutic approaches to treat WHF and then move on to their timing and safety concerns (i.e., renal profile). Full article
(This article belongs to the Special Issue Hot Cardiovascular Topics in Chronic and End-Stage Renal Disease)
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