1,720,962 research outputs found
Association between Inflammatory Markers, Left Ventricular Systo – Diastolic Dysfunction and Right Heart Involvement in CKD Patients
No full textBackground: Chronic kidney disease (CKD) is characterized by an increased mortality
and morbidity due to cardiovascular involvement. Both left ventricular systolic and
diastolic function are affected since CKD early stages. Pathophysiology of heart failure in
CKD patients involves left ventricular hyperthophy, dilated cardiomiopathy, arrythmias
and cardiac fi brosis together with widespread infl ammatory status accountable for early
atheroembolic disease.
Methods: We have enrolled 146 patients (96 males and 50 females aged 68 ± 9 years
with mean dialytic age of 18 ± 0.4 months) on hemodialysis treatment and 120 patients (
72 males and 48 females aged 57 ± 8 years) on stage III – V CKD. They underwent trans
– thoracic ecocardiography and screened for infl ammatory markers (CRP, IL-6, TNF-).
Results: Hemodialysis patients showed signifi cant correlations between IL – 6, CRP
and TNF- blood levels and systo - diastolic dysfunction parameters such as E/E’ ratio.
Therefore, they also showed strong and signifi cant correlation between IL-6, CRP levels
and right ventricular dysfunction indexes, such as TAPSE (tricuspid annulus plane systolic
excursion) and systolic pulmonary artery pressure (PAPs). On the other hand, CKD patients
showed no correlations between infl ammatory asset and right heart dysfunction.
Conclusions: Our data confi rm close correlation between systolic dysfunction and
infl ammatory markers in CKD and hemodialysis patients. Therefore, our fi ndings underline
close relationships between infl ammatory markers and right heart dysfunction parameters
in hemodialysis patients such as TAPSE and PAPs refl ecting right heart involvement in
the development of cardio – renal syndrome
FGF-23 but Not Klotho Predicts the Presence of Aortic Valve Calcifi cations in Moderate Chronic Kidney Disease
No full textBackground: Cardiovascular calcifi cation (CVC) is a frequent complication in chronic
kidney disease (CKD) patients. Abnormalities in vitamin D receptor (VDR) activation and
hyperphosphoremia are all supposed to contribute to CVC. Fibroblast Growth Factor 23
(FGF-23) is a phosphaturic glycoprotein, linked to phosphate and vitamin D metabolism
as well as poor outcome in CKD. We investigated association between FGF-23 and cardiac
valvular calcifi cation in moderate CKD.
Methods: In this cross-sectional study, 100 (60 men; mean age of 51 ± 4.6 years) CKD
stage IIIB-IV patients were enrolled and underwent laboratory (25-OH Vitamin D, Klotho,
FGF-23, CRP, serum calcium and phosphorus, iPTH, phosphaturia) and echocardiography
testing to assess mineral metabolism such as mitral and aortic valve calcifi cation.Parametric
and non-parametric tests were used. Finally, Receiving Operating Curve (ROC) was used
to test the model performance.
Results: Overall mean serum calcium (9,2±0,4 mg/dl), phosphorus (4,3±0,2 mg/dl)
25OH vitamin D (34,8±13,5 ng/ml) and iPTH (59,11±8,6 pg/ml) were within the reference
ranges. Serum FGF-23 and Klotho mean values were 10,4±1,7 pg/ml and 887,8±110,3
pg/ml, respectively. Phosphaturia was 1,043±258 g/day. At univariable and multivariable
adjusted analyses, aortic but not mitral valve calcifi cation was associated with FGF-23
levels. Notably, Klotho, iPTH, 25OH Vitamin D, serum phosphorous, phosphaturia and
CRP were not associated with either valvular calcifi cation.
Conclusions: Our data suggests that FGF-23 but not Klotho is strongly and
independently associated with aortic valvular calcifi cation. Future studies should test
whether therapeutic strategies aimed at lowering FGF23 (diet, phosphate binders,
calcimimetics) can affect calcifi cation progression and cardiovascular damage
FIBROBLAST GROWTH FACTOR-23 AND PARATHYROID HORMONE PREDICT THE EXTENT OF AORTIC VALVE CALCIFICATIONS IN PATIENTS WITH CHRONIC KIDNEY DISEASE NOT ON DIALYSIS
No full textINTRODUCTION AND AIMS: Cardiac valve calcification (CVC) are commonly present in patients on dialysis and dependent on deranged mineral metabolism. Few data are available in patients with chronic kidney disease not on dialysis (CKD-ND patients).
In this study association between CVC and levels of PTH, phosphorus, calcium, 25-OH vitamin D, FGF-23, Klotho, C-Reactive protein was contemporaneously evaluated in CKD-ND patients.
METHODS: This is a multicenter study performed in consecutive patients referring to five Nephrology Clinics. Inclusion criteria were: age>18 years, CKD stage 3-4, presence of aortic or mitral valve calcification. Clinical examination, routine biochemistry measurements, extent of mitral (MVC) and aortic valve calcification (AVC) by echocardiography were performed.
RESULTS: One hundred patients met inclusion criteria and underwent final evaluation. AVC was found in n.100 patients; MVC was found in n.96 patients. In univariate analysis, no association was found between MVC and e-GFR, serum phosphorus , PTH, FGF-23, Klotho, 25-OH vitamin D, 24/h phosphaturia, CRP. AVC was positively associated with PTH (r2 = 0.212; p=0.034), FGF-23 (r2 = 0.272; p=0.006), and negatively with Klotho (r2 = - 0.208; p=0.038). In multivariable analysis FGF-23 and PTH were significantly associated with AVC score.
CONCLUSIONS: FGF-23 and PTH were associated to AVC extent of CKD-ND patients. No association was found with other variables of interest. These data indicate that FGF-23 and PTH play a direct action on AVC calcification; the role of FGF-23 and PTH was independent from markers of mineral metabolism and inflammation. These data may come into the still open debate on the usefulness of FGF-23 assay in routine clinical care of CKD-ND as part of cardiovascular risk stratification.
Session: Poster Session: Chronic Kidney Disease. Bone diseas
Chronic kidney disease and cardiovascular complications
No full textAbstract Cardiovascular diseases such as coronary artery
disease, congestive heart failure, arrhythmias and sudden
cardiac death represent main causes of morbidity and
mortality in patients with chronic kidney disease (CKD).
Pathogenesis includes close linkage between heart and
kidneys and involves traditional and non-traditional cardiovascular
risk factors. According to a well-established
classification of cardiorenal syndrome, cardiovascular
involvement in CKD is known as ‘‘type-4 cardiorenal
syndrome’’ (chronic renocardiac). The following review
makes an overview about epidemiology, pathophysiology,
diagnosis and treatment of cardiovascular complications in
CKD patients
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Full text linkWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
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