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Recent Advances in Kidney and Cardiovascular Diseases
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Recent Advances in Kidney and Cardiovascular Diseases

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

Deadline for manuscript submissions: closed (31 December 2020) | Viewed by 17937

Special Issue Editors

Dr. Biagio Raffaele Di Iorio

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Guest Editor
Chief of Nephrology, Department of Medicine, AORN “Antonio Cardarelli”, Naeples, Italy
Interests: nutritional therapy of CKD; anemia; CKD-MBD; metabolic acidosis; microbiome
Special Issues, Collections and Topics in MDPI journals
Dr. Antonio Bellasi

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Guest Editor
Department of Research, Innovation, Brand Reputation, Ospedale di Bergamo, ASST Papa Giovanni XXIII, Bergamo, Italy
Interests: CKD-related cardiovascular diseases; acute kidney injury; diabetic nephropathy; direct oral anticoagulants and CKD; CKD-MBD; metabolic acidosis
Special Issues, Collections and Topics in MDPI journals
Dr. Luca Di Lullo

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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. Roberto Ciarcia

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Guest Editor
Department of Veterinary Medicine and Animal Productions, University of Naples “Federico II”, Naples, Via Delpino 1, 80137 Naples, Italy
Interests: hematological cancers; leukemia; oxidative stress
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

We would like to direct to your attention to a Special Issue focused on Cardionephrology. Cardiovascular and renal disease are closely linked through different mechanisms, such as chronic inflammation, dyslipidemia, calcium–phosphorus metabolism abnormalities, or comorbid conditions such as arterial hypertension, coronary artery disease, and diabetes, which may affect the heart and the kidneys at the same or in different times. This Special Issue will review comorbidities and metabolic abnormalities from the cardiorenal syndrome to the metabolic consequences of chronic kidney and heart disease that occur as the glomerular filtration rate decreases and create a direct link between kidney and cardiovascular diseases. The key areas of the Special Issue are related to the cardiovascular aspects of kidney diseases and vice versa:

  • Heart failure and CKD;
  • Atrial fibrillation and anticoagulation strategies in CKD patients;
  • Diabetic nephropathy and its cardiovascular involvement;
  • Cardiorenal aspects of new antidiabetic drugs;
  • Calcium–phosphorus imbalance and valvular diseases;
  • Arterial hypertension;
  • Lung and liver involvement in cardiorenal disease;
  • Electrolytic disorders and their management;
  • Nutritional aspects of cardiorenal patients;
  • Cardiovascular aspects of the new SARS–Cov 2 infection;
  • Doctors, new technologies, and patient care.
Dr. Biagio Raffaele Di Iorio
Dr. Antonio Bellasi
Dr. Luca Di Lullo
Dr. Roberto Ciarcia
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

  • cardionephrology
  • heart failure
  • CKD and heart
  • renal disease
  • atrial fibrillation and new oral anticoagulants
  • diabetic nephropathy
  • Kidney transplant
  • nutritional aspects
  • Covid 19 and kidney
  • information and medicine

Published Papers (6 papers)

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Research

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17 pages, 2499 KiB  
Article
Ketoanalogs’ Effects on Intestinal Microbiota Modulation and Uremic Toxins Serum Levels in Chronic Kidney Disease (Medika2 Study)
by Maria Teresa Rocchetti, Biagio Raffaele Di Iorio, Mirco Vacca, Carmela Cosola, Stefania Marzocco, Ighli di Bari, Francesco Maria Calabrese, Roberto Ciarcia, Maria De Angelis and Loreto Gesualdo
J. Clin. Med. 2021, 10(4), 840; https://doi.org/10.3390/jcm10040840 - 18 Feb 2021
Cited by 21 | Viewed by 2650
Abstract
Nutritional therapy (NT) is a therapeutic option in the conservative treatment of chronic kidney disease (CKD) patients to delay the start of dialysis. The aim of this study was to evaluate the specific effect of ketoanalogs (KA)-supplemented diets for gut microbiota modulation. In [...] Read more.
Nutritional therapy (NT) is a therapeutic option in the conservative treatment of chronic kidney disease (CKD) patients to delay the start of dialysis. The aim of this study was to evaluate the specific effect of ketoanalogs (KA)-supplemented diets for gut microbiota modulation. In a previous study we observed that the Mediterranean diet (MD) and a KA-supplemented very-low-protein diet (VLPD) modulated beneficially gut microbiota, reducing indoxyl- and p-cresyl-sulfate (IS, PCS) serum levels, and ameliorating the intestinal permeability in CKD patients. In the current study, we added a third diet regimen consisting of KA-supplemented MD. Forty-three patients with CKD grades 3B–4 continuing the crossover clinical trial were assigned to six months of KA-supplemented MD (MD + KA). Compared to MD, KA-supplementation in MD + KA determined (i) a decrease of Clostridiaceae, Methanobacteriaceae, Prevotellaceae, and Lactobacillaceae while Bacteroidaceae and Lachnospiraceae increased; (ii) a reduction of total and free IS and PCS compared to a free diet (FD)—more than the MD, but not as effectively as the VLPD. These results further clarify the driving role of urea levels in regulating gut integrity status and demonstrating that the reduction of azotemia produced by KA-supplemented VLPD was more effective than KA-supplemented MD in gut microbiota modulation mainly due to the effect of the drastic reduction of protein intake rather than the effect of KA. Full article
(This article belongs to the Special Issue Recent Advances in Kidney and Cardiovascular Diseases)
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14 pages, 1075 KiB  
Article
Predictive Value of Measures of Vascular Calcification Burden and Progression for Risk of Death in Incident to Dialysis Patients
by Antonio Bellasi, Luca Di Lullo, Domenico Russo, Roberto Ciarcia, Michele Magnocavallo, Carlo Lavalle, Carlo Ratti, Maria Fusaro, Mario Cozzolino and Biagio Raffaele Di Iorio
J. Clin. Med. 2021, 10(3), 376; https://doi.org/10.3390/jcm10030376 - 20 Jan 2021
Cited by 11 | Viewed by 2020
Abstract
Background: Vascular calcification (VC) is a marker of cardiovascular (CV) disease and various methods allow for presence and extension assessment in different arterial districts. Nevertheless, it is currently unclear which one of these methods for VC evaluation best predict outcome and if this [...] Read more.
Background: Vascular calcification (VC) is a marker of cardiovascular (CV) disease and various methods allow for presence and extension assessment in different arterial districts. Nevertheless, it is currently unclear which one of these methods for VC evaluation best predict outcome and if this piece of information adds to the predictive value of traditional CV risk factors in patients receiving hemodialysis (HD). Methods: data of 184 of the 466 patients followed in the Independent study (NCT00710788) were post hoc examined to assess the association three concurrent measures of vascular calcification and all-cause survival. Specifically, coronary artery calcification (CAC) was determined by the Agatston and the volume score while abdominal aorta calcification was determined by plain X-ray of the lumbar spine (Kauppila score (KS)). Survival and regression models as well as metrics of risk recalculation were used to test the association of VC and outcome beyond the Framingham risk score. Results: Middle-age (62.6(15.8) years) men (51%) and women (49%) starting HD were analyzed. Over 36 (median 36; interquartile range: 8–36) months of follow-up 69 patients expired. Each measure of VC (CAC or KS) predicted all-cause mortality independently factors commonly associated with all-cause survival (p < 0.001). Far more importantly, each measurement of VC significantly improved risk prediction and patient reclassification (p < 0.001) beyond traditional cardiovascular risk factors. Conclusions: Overall, presence and extension of VC, irrespective of the arterial site, predict risk of all-cause of death in patients starting hemodialysis. Of note, both CAC and KS increase risk stratification beyond traditional CV risk factors. However, future efforts are needed to assess whether a risk-based approach encompassing VC screening to guide HD patient management improves survival. Full article
(This article belongs to the Special Issue Recent Advances in Kidney and Cardiovascular Diseases)
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9 pages, 455 KiB  
Article
Short- and Long-Term Evaluation of Renal Function after Radical Cystectomy and Cutaneous Ureterostomy in High-Risk Patients
by Massimiliano Creta, Ferdinando Fusco, Roberto La Rocca, Marco Capece, Giuseppe Celentano, Ciro Imbimbo, Vittorio Imperatore, Luigi Russo, Francesco Mangiapia, Vincenzo Mirone, Domenico Russo and Nicola Longo
J. Clin. Med. 2020, 9(7), 2191; https://doi.org/10.3390/jcm9072191 - 11 Jul 2020
Cited by 7 | Viewed by 1691
Abstract
Deterioration of renal function has been reported after radical cystectomy (RC) with urinary diversion. We investigated renal function changes in elderly bladder cancer (BCa) patients who underwent RC with cutaneous ureterostomy (CU) urinary diversion. We performed a retrospective, observational study. BCa patients aged [...] Read more.
Deterioration of renal function has been reported after radical cystectomy (RC) with urinary diversion. We investigated renal function changes in elderly bladder cancer (BCa) patients who underwent RC with cutaneous ureterostomy (CU) urinary diversion. We performed a retrospective, observational study. BCa patients aged ≥75 with an American Society of Anesthesiologists (ASA) class greater than II were included. Glomerular filtration rate (GFR) was the main outcome measure. GFR values were recorded preoperatively, at discharge, at 6-month follow-up, and yearly up to 60 months. A total of 70 patients with a median age of 78.0 years were identified. Median preoperative GFR was 74.3 mL/min/1.73 m2 and declined significantly to 54.6 mL/min/1.73 m2 after 6 months (p < 0.001). A gradual GFR decline was observed thereafter, reaching a median value of 46.2 after 60 months. Preoperative GFR and acute kidney injury were significant predictors of fast deterioration of GFR and of 25% deterioration of GFR after 12 months. Elderly BCa patients with high comorbidity rates undergoing RC with CU should be carefully informed about the risk of GFR deterioration and the need for adequate monitoring. Full article
(This article belongs to the Special Issue Recent Advances in Kidney and Cardiovascular Diseases)
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15 pages, 2533 KiB  
Article
Effects of a Red Orange and Lemon Extract in Obese Diabetic Zucker Rats: Role of Nicotinamide Adenine Dinucleotide Phosphate Oxidase
by Sara Damiano, Chiara Lauritano, Consiglia Longobardi, Emanuela Andretta, Ali Murat Elagoz, Paolo Rapisarda, Mattia Di Iorio, Salvatore Florio and Roberto Ciarcia
J. Clin. Med. 2020, 9(5), 1600; https://doi.org/10.3390/jcm9051600 - 25 May 2020
Cited by 6 | Viewed by 3333
Abstract
Diabetic nephropathy (DN) is the primary cause of end-stage renal disease, worldwide, and oxidative stress has been recognized as a key factor in the pathogenesis and progression of DN. Nicotinamide adenine dinucleotide phosphate (NADPH) oxidase has the most important contribution to reactive oxygen [...] Read more.
Diabetic nephropathy (DN) is the primary cause of end-stage renal disease, worldwide, and oxidative stress has been recognized as a key factor in the pathogenesis and progression of DN. Nicotinamide adenine dinucleotide phosphate (NADPH) oxidase has the most important contribution to reactive oxygen species generation during the development of DN. Bioactive compound use has emerged as a potential approach to reduce chronic renal failure. Therefore, a red orange and lemon extract (RLE) rich in anthocyanins was chosen in our study, to reduce the toxic renal effects during the development of DN in Zucker diabetic fatty rat (ZDF). RLE effects were examined daily for 24 weeks, through gavage, in ZDF rats treated with RLE (90 mg/kg). At the end of the experiment, ZDF rats treated with RLE showed a reduction of the diabetes-associated up-regulation of both NOX4 and the p47-phox and p22-phox subunits, and restored the BAX/BCL-2 ratio respect to ZDF rats. Furthermore, RLE was able to reduce the oxidative DNA damage measured in urine samples in ZDF rats. This study showed that RLE could prevent the renal damage induced by DN through its capacity to inhibit NOX4 and apoptosis mechanisms. Full article
(This article belongs to the Special Issue Recent Advances in Kidney and Cardiovascular Diseases)
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Review

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14 pages, 322 KiB  
Review
Mid-Regional Proadrenomedullin as a New Biomarker of Kidney and Cardiovascular Diseases—Is It the Future?
by Katarzyna Czajkowska, Edyta Zbroch, Angelika Bielach-Bazyluk, Katarzyna Mitrosz, Elzbieta Bujno, Katarzyna Kakareko, Alicja Rydzewska-Rosolowska and Tomasz Hryszko
J. Clin. Med. 2021, 10(3), 524; https://doi.org/10.3390/jcm10030524 - 02 Feb 2021
Cited by 7 | Viewed by 2732
Abstract
The increasing prevalence of cardiovascular disease and concomitant chronic kidney disease among the aging populations is responsible for considerable growth of mortality. Additionally, frequent, prolonged hospitalizations and long-term treatment generates progressive decline in bodily functions as well as substantial public health and economic [...] Read more.
The increasing prevalence of cardiovascular disease and concomitant chronic kidney disease among the aging populations is responsible for considerable growth of mortality. Additionally, frequent, prolonged hospitalizations and long-term treatment generates progressive decline in bodily functions as well as substantial public health and economic burden. Accessibility to easy, non-invasive prognostic markers able to detect patients at risk of cardiovascular events may improve effective therapy and mitigate disease progression. Moreover, an early diagnosis allows time for implementation of prophylactic and educational programs that may result in decreased morbidity, improved quality of life and reduced public health expenditure. One of the promising candidates for a novel cardiovascular biomarker is mid-regional proadrenomedullin, a derivative of adrenomedullin. Adrenomedullin is a peptide hormone known for its vasodilatory, antioxidant, antiapoptotic and antifibrotic effects. A remarkable advantage of mid-regional proadrenomedullin is its longer half-life which is a prerequisite for plasma measurements. These review aims to discuss the importance of mid-regional proadrenomedullin with reference to its usefulness as a biomarker of increased cardiovascular risk and kidney disease progression. Full article
(This article belongs to the Special Issue Recent Advances in Kidney and Cardiovascular Diseases)
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17 pages, 4224 KiB  
Review
Thromboembolic and Bleeding Risk in Atrial Fibrillation Patients with Chronic Kidney Disease: Role of Anticoagulation Therapy
by Michele Magnocavallo, Antonio Bellasi, Marco Valerio Mariani, Maria Fusaro, Maura Ravera, Ernesto Paoletti, Biagio Di Iorio, Vincenzo Barbera, Domenico Giovanni Della Rocca, Roberto Palumbo, Paolo Severino, Carlo Lavalle and Luca Di Lullo
J. Clin. Med. 2021, 10(1), 83; https://doi.org/10.3390/jcm10010083 - 28 Dec 2020
Cited by 26 | Viewed by 4588
Abstract
Atrial fibrillation (AF) and chronic kidney disease (CKD) are strictly related; several independent risk factors of AF are often frequent in CKD patients. AF prevalence is very common among these patients, ranging between 15% and 20% in advanced stages of CKD. Moreover, the [...] Read more.
Atrial fibrillation (AF) and chronic kidney disease (CKD) are strictly related; several independent risk factors of AF are often frequent in CKD patients. AF prevalence is very common among these patients, ranging between 15% and 20% in advanced stages of CKD. Moreover, the results of several studies showed that AF patients with end stage renal disease (ESRD) have a higher mortality rate than patients with preserved renal function due to an increased incidence of stroke and an unpredicted elevated hemorrhagic risk. Direct oral anticoagulants (DOACs) are currently contraindicated in patients with ESRD and vitamin K antagonists (VKAs), remaining the only drugs allowed, although they show numerous critical issues such as a narrow therapeutic window, increased tissue calcification and an unfavorable risk/benefit ratio with low stroke prevention effect and augmented risk of major bleeding. The purpose of this review is to shed light on the applications of DOAC therapy in CKD patients, especially in ESRD patients. Full article
(This article belongs to the Special Issue Recent Advances in Kidney and Cardiovascular Diseases)
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