1,720,995 research outputs found
Association between 25-hydroxyvitamin D deficiency and cardiovascular disease in type 2 diabetic patients with mild kidney dysfunction.
No full textRisk of cardiovascular disease and chronic kidney disease in diabetic patients with non-alcoholic fatty liver disease: just a coincidence? [Review]
No full textNon-alcoholic fatty liver disease (NAFLD) is estimated to afflict ∼20-30% of the general population, and over 70% of the patients with Type 2 diabetes. Given the expected rise in the prevalence of obesity and diabetes, NAFLD will be, if not already there, an epidemic. The consequences of NAFLD are numerous, and range from progression to chronic liver disease with its associated morbidity and mortality, to worsening insulin resistance and Type 2 diabetes, to being a contributor to both cardiovascular disease (CVD) and chronic kidney disease (CKD). NAFLD is, therefore, a complex problem with implications far beyond the liver. This review focuses on the rapidly expanding body of clinical evidence suggesting that NAFLD is associated with an increased prevalence and incidence of both CVD and CKD in patients with diabetes. This association appears to be independent of obesity, hypertension, and other potential confounding factors. However, given the heterogeneity and small number of observational studies, further research is urgently required to corroborate the prognostic role of NAFLD in the development and progression of CVD and CKD among patients with diabetes, and to further elucidate the complex and intertwined mechanisms that link NAFLD with these adverse outcomes
25-hydroxyvitamin D deficiency and inflammation and their association with hemoglobin levels in chronic kidney disease.
No full textUric acid as a target of therapy in chronic kidney disease. [Review]
No full textThe prevalence of chronic kidney disease (CKD) has increased and will continue to increase in the United States and worldwide. This is alarming considering that CKD is an irreversible condition and patients who progress to chronic kidney failure have reduced quality of life and high mortality rates. As such, it is imperative to identify modifiable risk factors to develop strategies to slow CKD progression. One such factor is hyperuricemia. Recent observational studies have associated hyperuricemia with kidney disease. In addition, hyperuricemia is largely prevalent in patients with CKD. Data from experimental studies have shown several potential mechanisms by which hyperuricemia may contribute to the development and progression of CKD. In this article, we offer a critical review of the experimental evidence linking hyperuricemia to CKD, highlight gaps in our knowledge on the topic as it stands today, and review the observational and interventional studies that have examined the potential nephroprotective effect of decreasing uric acid levels in patients with CKD. Although uric acid also may be linked to cardiovascular disease and mortality in patients with CKD, this review focuses only on uric acid as a potential therapeutic target to prevent kidney disease onset and progression
Relationship between serum gamma-glutamyltransferase concentrations and chronic kidney disease in the United States population. Findings from the National Health and Nutrition Examination Survey 2001-2006.
No full textBACKGROUND AND AIMS: Elevated serum levels of gamma-glutamyltransferase (GGT) are a marker of liver injury, but may also be associated with other diseases and death. Currently, the association of serum GGT concentrations with chronic kidney disease has not been established in the U.S. general population.
METHODS AND RESULTS: We performed a cross-sectional analysis of data from the National Health and Nutrition Examination Survey 2001 through 2006 and examined the association between serum GGT concentrations and chronic kidney disease in a nationally representative sample of 13,188 adults aged 20 years or older. Glomerular filtration rate (eGFR) was estimated using the Modification of Diet in Renal Disease formula. The prevalence of chronic kidney disease defined as eGFR <60 ml/min/1.73 m(2) or abnormal albuminuria in those with eGFR ≥60 ml/min/1.73 m(2) was 13.9% (n = 1842). Serum GGT elevation was associated with an increased odds of chronic kidney disease (odds ratio 2.38, 95% confidence intervals 2.02-2.80, p<0.0001). After adjustment for demographics, comorbidities, daily alcohol consumption, lipid-lowering medications, viral hepatitis status and laboratory measures, the odds ratio of chronic kidney disease per log serum GGT increase was 1.79 (1.41, 2.27; p<0.0001).
CONCLUSIONS: These results show a strong, independent, relationship of increased serum GGT concentrations with chronic kidney disease in the US adult population
Hemostatic and fibrinolytic abnormalities in endocrine diseases: a narrative review. [Review]
No full textThis review summarizes current knowledge of the effects of polycystic ovary syndrome, Cushing’s syndrome, thyrotoxicosis, hypothyroidism, primary hyperparathyroidism, acromegaly, hypopituitarism, and growth hormone deficiency on coagulation and fibrinolysis. Several abnormalities of the coagulation-fibrinolytic system have been described among patients affected by these endocrine disorders. Although further larger studies are needed to provide more definitive information, clinically overt hypothyroidism appears to be associated with a bleeding tendency, whereas all other endocrine diseases appear to be associated with a thrombotic tendency. The disorders of coagulation and fibrinolysis observed in these endocrine pathologies usually range from mild to moderate and, rarely, to potentially severe laboratory abnormalities (e.g., bleeding diathesis in overt hypothyroidism mainly due to an acquired von Willebrand’s syndrome type 1), are reversible after pharmacologic treatment of the hormonal dysfunction, and are usually of limited consequence in clinical practice. Nevertheless, the prompt recognition of potentially severe disorders of blood coagulation is mandatory for the correct management ofthese patients
25-hydroxyvitamin D deficiency is independently associated with cardiovascular disease in the Third National Health and Nutrition Examination Survey.
No full textObjective: Serum 25-hydroxyvitamin D [25(OH)D] levels are inversely associated with important cardiovascular
disease (CVD) risk factors. However, the association between 25(OH)D levels and prevalent CVD
has not been extensively examined in the general population.
Methods: We performed a cross-sectional analysis of data from the Third National Health and Nutrition
Examination Survey (1988–1994) and examinedthe association between serum25(OH)Dlevels and prevalence
of CVD in a representative population-based sample of 16,603 men and women aged 18 years or
older. Prevalence of CVDwas defined as a composite measure inclusive of self-reported angina,myocardial
infarction or stroke.
Results: In the whole population, there were 1308 (8%) subjects with self-reported CVD. Participants with
CVD had a greater frequency of 25(OH)D deficiency [defined as serum 25(OH)D levels <20 ng/mL] than
those without (29.3% vs. 21.4%; p < 0.0001). After adjustment for age, gender, race/ethnicity, season of
measurement, physical activity, body mass index, smoking status, hypertension, diabetes, elevated lowdensity
lipoprotein cholesterol, hypertriglyceridemia, low high-density lipoprotein cholesterol, chronic
kidney disease and vitamin D use, participants with 25(OH)D deficiency had an increased risk of prevalent
CVD (odds ratio 1.20 [95% confidence interval (CI) 1.01–1.36; p = 0.03]).
Conclusions: These results indicate a strong and independent relationship of 25(OH)D deficiency with
prevalent CVD in a large sample representative of the US adult population
Association between non-alcoholic fatty liver disease and chronic kidney disease: an ultrasound analysis from the NHANES 1988-1994.
No full textBackground/ Aims: Nonalcoholic fatty liver disease (NAFLD) has been proposed to contribute to chronic kidney disease (CKD) independently of traditional cardiometabolic risk factors. We hypothesized that NAFLD is associated with CKD and that greater severity of NAFLD is associated with higher odds of CKD. Methods: A cross-sectional analysis of 11,469 adults who participated in the National Health and Nutrition Examination Survey (NHANES) 1988-1994. NAFLD was defined by ultrasonographic detection of steatosis in the absence of other liver diseases. CKD was defined as an estimated glomerular filtration rate of ≤60 ml/min/1.73 m(2) or the presence of albuminuria in subjects with an estimated glomerular filtration rate of >60 ml/min/1.73 m(2). Results: 2,891 (25.4%) patients in the cohort had CKD. The prevalence of NAFLD was higher in individuals with CKD compared to those without CKD (42.2 vs. 34.5%, p < 0.0001). NAFLD was associated with CKD in unadjusted logistic regression analysis (OR = 1.47, 95% CI: 1.29-1.67, p < 0.0001). Adjustment for demographics and components of metabolic syndrome attenuated this relationship (OR = 1.04, 95% CI: 0.88-1.23, p = 0.64). Moderate and severe NAFLD on ultrasound were increasingly associated with prevalent CKD in unadjusted analysis, but not after adjustment for metabolic syndrome components. Conclusion: After adjusting for features of metabolic syndrome, ultrasound-diagnosed NAFLD is not associated with prevalent CKD among US adults. Aggressive public health efforts are needed to prevent and treat metabolic syndrome
Extra-skeletal effects of vitamin D deficiency in chronic kidney disease. [Review]
No full textCardiovascular diseases (CVD) and infectious diseases represent the two most important causes of death in patients with chronic kidney disease (CKD). The traditional risk factors of CVD do not appear to account sufficiently for the increased risk of CVD in patients with CKD, and vitamin D deficiency appears to be an important non-traditional, and potentially modifiable, CVD risk factor in this patient population. 25-Hydroxyvitamin D (25(OH)D) is converted to its biologically active form, 1,25-dihydroxyvitamin D (1,25(OH)(2)D), by the enzyme 1 alpha alpha-hydroxylase in the kidneys. The recent discovery that many extrarenal tissues also possess both the 1 alpha alpha-hydroxylase enzyme and the vitamin D receptors has provided new insights into the important physiologic autocrine and paracrine roles of vitamin D in various tissues and organs that are mainly dependent on the availability of 25(OH)D from the circulating plasma. Accordingly, the present review focuses on the rapidly expanding body of clinical and experimental evidence that supports a strong association between 25(OH)D deficiency/insufficiency and the risk of adverse CVD outcomes and infectious diseases as well as on the non-calcemic autocrine and paracrine actions of vitamin D both in the general population and in patients with CKD
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