Background The association between the administration of sodium–glucose cotransporter 2 inhibitors (SGLT2is) during acute kidney injury (AKI) and the incidence of major adverse kidney events (MAKEs) ...is not known. Methods This retrospective cohort study included patients with AKI and compared the outcomes for those who were treated with SGLT2is during hospitalization and those without SGLT2i treatment. The associations of SGLT2i use with MAKEs at 10 and 30–90 days, each individual MAKE component, and the pre-specified patient subgroups were analyzed. Results From 2021 to 2023, 374 patients were included in the study—316 without SGLT2i use and 58 with SGLT2i use. Patients who were treated with SGLT2is were older; had a greater prevalence of diabetes, hypertension, chronic heart failure, and chronic kidney disease; required hemodialysis less often; and presented stage 3 AKI less frequently than those who were not treated with SGLT2is. Logistic regression analysis with nearest-neighbor matching revealed that SGLT2i use was not associated with the risk of MAKE10 (OR 1.08 0.45–2.56) or with MAKE30–90 (OR 0.76 0.42–1.36). For death, the stepwise approach demonstrated that SGLT2i use was associated with a reduced risk (OR 0.08; 0.01–0.64), and no effect was found for kidney replacement therapy (KRT). The subgroups of patients who experienced a reduction in the risk of MAKEs in patients with AKI treated with SGLT2is were those older than 61 years, those with an eGFR >81, and those without a history of hypertension or DM ( p ≤ 0.05 for all). Conclusion The use of SGLT2is during AKI had no effect on short- or medium-term MAKEs, but some subgroups of patients may have experienced benefits from SGLT2i treatment.
Introduction: Urea is a toxin present in acute kidney injury (AKI). We hypothesize that reduction in serum urea levels might improve clinical outcomes. We examined the association between the ...reduction in urea and mortality. Methods: Patients with AKI admitted to the Hospital Civil de Guadalajara were enrolled in this retrospective cohort study. We create 4 groups of urea reduction ratio (UXR) stratified by their decrease in urea from the highest index value in comparison to the value on day 10 (0%, 1–25%, 26–50%, and >50%), or at the time of death or discharge if prior to 10 days. Our primary endpoint was to observe the association between UXR and mortality. Secondary observations included determination of which types of patients achieved a UXR >50%, whether the modality of kidney replacement therapy (KRT) effected changes in UXR, and if serum creatinine (sCr) value changes were similarly associated with patient mortality. Results: A total of 651 AKI patients were enrolled. The mean age was 54.1 years, and 58.6% were male. AKI 3 was present in 58.5%; the mean admission urea was 154 mg/dL. KRT was started in 32.4%, and 18.9% died. A trend toward decreased risk of death was observed in association with the magnitude of UXR. The best survival (94.3%) was observed in patients with a UXR >50%, and the highest mortality (72.1%) was observed in patients achieving a UXR of 0%. After adjusting for age, sex, diabetes mellitus, CKD, antibiotics, sepsis, hypovolemia, cardio-renal syndrome, shock, and AKI stage, the 10-day mortality was higher in groups that did not achieve a UXR of at least 25% (OR: 1.20). Patients achieving a UXR >50% were most likely initiated on dialysis due to a diagnosis of the uremic syndrome or had a diagnosis of obstructive nephropathy. Percentage change in sCr was also associated with increased mortality risk. Conclusions: In our retrospective cohort of AKI patients, the percent decrease in UXR from admission was associated with a stratified risk of death. Patients with a UXR >25% had the best associated outcomes. Overall, a greater magnitude in UXR was associated with improved patient survival.
Background A correct blood pressure (BP) measurement is essential for the diagnosis and control of high BP.
To evaluate the agreement and repeatability of BP measurements with the OMRON HEM-7320-LA ...device compared to a mercury sphygmomanometer.
A cross-sectional study comparing BP measurements made by two randomly selected trained nurses and an automatic oscillometric device. The mercurial sphygmomanometer was connected to the automated device via a "T" type connector and a dual-head stethoscope was used, allowing simultaneous measurements. The results were analyzed with one-factor analysis of variance, Bland-Altman's test, repeatability coefficient (RC), and intra-class correlation coefficient (ICC).
Forty-nine participants aged 56 ± 19 years were included. Nineteen had hypertension (38%). We did not observe a significant difference in either systolic (SBP) or diastolic blood pressure (DBP) pressure measurements between the observers and the device. The mean difference was -0.09 mmHg (95% confidence intervals (CI)-0.9 to 0.7) for SBP and -0.9 mmHg (95% CI -1.7 to -0.13) for DBP. The RC for SBP (6.2, 5.2 and 5.8 mmHg) and DBP (4.7, 4.2 y 5.2 mmHg) was similar between the observers and the device. The ICC for SBP was 0.990 (95% CI 0.983 to 0.995, p < 0.01) and 0.986 (95% CI 0.977 to 0.991, p < 0.01) for DBP.
There was a high level of agreement and similar measurement repeatability in the measurements performed by the automatic device and the mercurial sphygmomanometer. No differences in BP measurements were observed.
Introduction
Ankylosing spondylitis (AS) is an inflammatory rheumatic disease associated with accelerated atherosclerosis and increased cardiovascular morbidity and mortality.
Objectives
To assess ...the local arterial stiffness in carotid artery in subjects with AS compared with controls evaluated by carotid artery pulse wave velocity (carPWV).
Methods
Ultrasound examinations were conducted with a Mylab One color Doppler ultrasound diagnostic system (Esaote, Firenze, Italy), the right common carotid artery (RCCA) was scanned, using a 5–12 MHz vascular probe with built-in quality arterial stiffness (QAS) which calculate carPWV.
Results
Forty-seven male subjects (20 with Ankylosing Spondylitis and 27 controls) aged between 20 and 75 (mean age 41.17 ± 11) were evaluated. AS patients have not Hypertension, history of cardiovascular risk factors or smoking). Higher carPWV was observed in patients with AS (6.27 ± 0.72 vs 5.56 ± 1.02 m/s; p = 0.0123) compared with controls, respectively.
Conclusions
AS subjects showed higher carPWV compared with controls, this novel assessment for local arterial stiffness could be useful in the future to calculate cardiovascular risk, more studies should be developed with this method in this pathology in our population.
Figure 1
AS, ankylosing Spondylitis: cPWY, carotid artery pulse wave velocity; SD: standard deviation. Continuous variables are shown as median with analysis by t-rest.
Background: Ankylosing spondylitis (AS) is a chronic, inflammatory disease of the axial spine that can manifest with various clinical signs and symptoms1.Cardio-ankle vascular index (CAVI), which is ...calculated based on the stiffness parameter thus obtained, is theoretically independent of changes in blood pressure. With this distinct advantage, CAVI has been widely applied clinically to assess arterial stiffness in subjects with or without known cardiovascular diseases2. Objectives: The aim of this study was to evaluate the Cardio Ankle Vascular Index (CAVI) in subjects with ankylosing spondylitis pared with controls free of morbidities. Methods: We enrolled 41 participants in this study. Eighteen patients with diagnosed AS and 23 controls free of comorbidities. CAVI was measured by VaSera VS-1000 (Fukuda- Denshi Company, Ltd, Tokyo, Japan). Results: The results are expressed as mean ± standard deviation for continuous variables. The data were analyzed using SPSS v. 24 (SPSS Inc., Chicago, IL). The normality of the data was evaluated with Shapiro-Wilk test. A two-tailed p < 0.05 was considered statistically significant. Individuals with AS exhibited greater pSBP (p < 0.01), DBP (p < 0.05), and MBP (p < 0.01) compared to controls. Moreover, in the AS group we observed a higher CAVI with a mean difference of 1.14 (p < 0.01, 95% CI of .41 to 1.8) (Figure 1). Conclusion: AS is a chronic inflammatory disease that primarily affects the articular joints of the spine. Individuals with ankylosing spondylitis showed increased CAVI, this contributes to explain the higher risk of cardiovascular disease in this pathological condition.
Urea Reduction in AKI and Mortality Chavez, Jonathan; Blackaller, Guillermo Navarro; Maggiani, Pablo ...
Journal of the American Society of Nephrology,
11/2022, Letnik:
33, Številka:
11S
Journal Article
Background
Ankylosing spondylitis (AS) is a chronic, inflammatory disease of the axial spine that can manifest with various clinical signs and symptoms
1
.Cardio-ankle vascular index (CAVI), which is ...calculated based on the stiffness parameter thus obtained, is theoretically independent of changes in blood pressure. With this distinct advantage, CAVI has been widely applied clinically to assess arterial stiffness in subjects with or without known cardiovascular diseases
2
.
Objectives
The aim of this study was to evaluate the Cardio Ankle Vascular Index (CAVI) in subjects with ankylosing spondylitis pared with controls free of morbidities.
Methods
We enrolled 41 participants in this study. Eighteen patients with diagnosed AS and 23 controls free of comorbidities. CAVI was measured by VaSera VS-1000 (Fukuda- Denshi Company, Ltd, Tokyo, Japan).
Results
The results are expressed as mean ± standard deviation for continuous variables. The data were analyzed using SPSS v. 24 (SPSS Inc., Chicago, IL). The normality of the data was evaluated with Shapiro-Wilk test. A two-tailed p < 0.05 was considered statistically significant. Individuals with AS exhibited greater pSBP (p < 0.01), DBP (p < 0.05), and MBP (p < 0.01) compared to controls. Moreover, in the AS group we observed a higher CAVI with a mean difference of 1.14 (p < 0.01, 95% CI of .41 to 1.8) (Figure 1).
Conclusion
AS is a chronic inflammatory disease that primarily affects the articular joints of the spine. Individuals with ankylosing spondylitis showed increased CAVI, this contributes to explain the higher risk of cardiovascular disease in this pathological condition.
Figure 1
Cardio-anlde vascular index: (CAVI) in patients with ankylosing spondylitis (AS) compared to Controls
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