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  1. Article ; Online: Anticoagulation for Atrial Fibrillation in Advanced CKD: Can Observational Studies Provide the Answer?

    Weiner, Daniel E / Sarnak, Mark J

    American journal of kidney diseases : the official journal of the National Kidney Foundation

    2024  Volume 83, Issue 3, Page(s) 288–290

    MeSH term(s) Humans ; Atrial Fibrillation/complications ; Atrial Fibrillation/drug therapy ; Blood Coagulation ; Anticoagulants/therapeutic use ; Anticoagulants/pharmacology ; Renal Insufficiency, Chronic/complications ; Renal Insufficiency, Chronic/drug therapy ; Stroke/etiology ; Stroke/prevention & control ; Administration, Oral
    Chemical Substances Anticoagulants
    Language English
    Publishing date 2024-01-17
    Publishing country United States
    Document type Editorial
    ZDB-ID 604539-x
    ISSN 1523-6838 ; 0272-6386
    ISSN (online) 1523-6838
    ISSN 0272-6386
    DOI 10.1053/j.ajkd.2023.12.002
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    Zs.A 1669: Show issues Location:
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  2. Article ; Online: Home Dialysis in Patients with Cardiovascular Diseases.

    Reaves, Allison C / Weiner, Daniel E / Sarnak, Mark J

    Clinical journal of the American Society of Nephrology : CJASN

    2024  

    Abstract: Kidney failure with replacement therapy and cardiovascular disease are frequently comorbid. In patients with kidney failure with replacement therapy, cardiovascular disease is a major contributor to morbidity and mortality. Conventional thrice-weekly in- ... ...

    Abstract Kidney failure with replacement therapy and cardiovascular disease are frequently comorbid. In patients with kidney failure with replacement therapy, cardiovascular disease is a major contributor to morbidity and mortality. Conventional thrice-weekly in-center dialysis confers risk factors for cardiovascular disease, including acute hemodynamic fluctuations and rapid shifts in volume and solute concentration. Home hemodialysis and peritoneal dialysis (PD) may offer benefits in attenuation of cardiovascular disease risk factors primarily through improved volume and BP control, reduction (or slowing progression) of left ventricular mass, decreased myocardial stunning, and improved bone and mineral metabolism. Importantly, although trial data are available for several of these risk factors for home hemodialysis, evidence for PD is limited. Among patients with prevalent cardiovascular disease, home hemodialysis and PD may also have potential benefits. PD may offer particular advantages in heart failure given it removes volume directly from the splanchnic circulation, thus offering an efficient method of relieving intravascular congestion. PD also avoids the risk of blood stream infections in patients with cardiac devices or venous wires. We recognize that both home hemodialysis and PD are also associated with potential risks, and these are described in more detail. We conclude with a discussion of barriers to home dialysis and the critical importance of interdisciplinary care models as one component of advancing health equity with respect to home dialysis.
    Language English
    Publishing date 2024-02-06
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2226665-3
    ISSN 1555-905X ; 1555-9041
    ISSN (online) 1555-905X
    ISSN 1555-9041
    DOI 10.2215/CJN.0000000000000410
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Authors' Reply: A Specific Target BP in Chronic Kidney Disease Remains Unclear.

    Ku, Elaine / McCulloch, Charles E / Sarnak, Mark J

    Journal of the American Society of Nephrology : JASN

    2023  Volume 34, Issue 6, Page(s) 1122

    MeSH term(s) Humans ; Renal Insufficiency, Chronic ; Blood Pressure
    Language English
    Publishing date 2023-04-27
    Publishing country United States
    Document type Letter ; Research Support, N.I.H., Extramural ; Comment
    ZDB-ID 1085942-1
    ISSN 1533-3450 ; 1046-6673
    ISSN (online) 1533-3450
    ISSN 1046-6673
    DOI 10.1681/ASN.0000000000000136
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  4. Article ; Online: Cardiorenal Syndrome in the Hospital.

    McCallum, Wendy / Sarnak, Mark J

    Clinical journal of the American Society of Nephrology : CJASN

    2023  

    Abstract: ... the urine sediment and kidney imaging. The hallmark of the cardiorenal syndrome is intense sodium avidity ...

    Abstract The cardiorenal syndrome refers to a group of complex, bidirectional pathophysiological pathways involving dysfunction in both the heart and kidney. Upward of 60% of patients admitted for acute decompensated heart failure have CKD, as defined by an eGFR of <60 ml/min per 1.73 m2. CKD, in turn, is one of the strongest risk factors for mortality and cardiovascular events in acute decompensated heart failure. Although not well understood, the mechanisms in the cardiorenal syndrome include venous congestion, arterial underfilling, neurohormonal activation, inflammation, and endothelial dysfunction. Arterial underfilling may lead to activation of the renin-angiotensin-aldosterone system and sympathetic nervous system, leading to sodium reabsorption and vasoconstriction. Venous congestion likely also mediates and perpetuates these maladaptive pathways. To rule out intrinsic kidney disease that is distinct from the cardiorenal syndrome, one should obtain a careful history, review longitudinal eGFR trends, assess albuminuria and proteinuria, and review the urine sediment and kidney imaging. The hallmark of the cardiorenal syndrome is intense sodium avidity and diuretic resistance, often requiring a combination of diuretics with varying pharmacological targets, and monitoring of urinary response to guide escalations in therapy. Invasive means of decongestion may be required including ultrafiltration or kidney RRT such as peritoneal dialysis, which is often better tolerated from a hemodynamic perspective than intermittent hemodialysis. Strategies for increasing forward perfusion in states of low cardiac output and cardiogenic shock may include afterload reduction and inotropes and, in the most severe cases, mechanical circulatory support devices, many of which have kidney-specific considerations.
    Language English
    Publishing date 2023-01-13
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2226665-3
    ISSN 1555-905X ; 1555-9041
    ISSN (online) 1555-905X
    ISSN 1555-9041
    DOI 10.2215/CJN.0000000000000064
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  5. Article ; Online: The Reply.

    McCallum, Wendy / Testani, Jeffrey M / Sarnak, Mark J

    The American journal of medicine

    2022  Volume 135, Issue 10, Page(s) e400

    Language English
    Publishing date 2022-10-05
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 80015-6
    ISSN 1555-7162 ; 1873-2178 ; 0002-9343 ; 1548-2766
    ISSN (online) 1555-7162 ; 1873-2178
    ISSN 0002-9343 ; 1548-2766
    DOI 10.1016/j.amjmed.2022.06.012
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  6. Article ; Online: Screening for Cardiovascular Disease in CKD: COMMENTARY.

    McCallum, Wendy / Sarnak, Mark J

    Kidney360

    2022  Volume 3, Issue 11, Page(s) 1839–1841

    MeSH term(s) Humans ; Cardiovascular Diseases/complications ; Renal Insufficiency, Chronic/complications ; Glomerular Filtration Rate
    Language English
    Publishing date 2022-02-28
    Publishing country United States
    Document type Journal Article ; Comment
    ISSN 2641-7650
    ISSN (online) 2641-7650
    DOI 10.34067/KID.0000742022
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  7. Article ; Online: Transcatheter mitral valve repair in patients with CKD.

    McCallum, Wendy / Sarnak, Mark J

    Nature reviews. Nephrology

    2022  Volume 18, Issue 8, Page(s) 483–484

    MeSH term(s) Cardiac Surgical Procedures ; Humans ; Mitral Valve/surgery ; Renal Insufficiency, Chronic/surgery ; Risk Assessment ; Treatment Outcome
    Language English
    Publishing date 2022-05-04
    Publishing country England
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Comment
    ZDB-ID 2490366-8
    ISSN 1759-507X ; 1759-5061
    ISSN (online) 1759-507X
    ISSN 1759-5061
    DOI 10.1038/s41581-022-00583-y
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    Zs.MG 107: Show issues

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  8. Article ; Online: The challenge of cardiovascular risk assessment in Chronic Kidney Disease; is there a role for CTA and FFR

    Weir-McCall, Jonathan R / Sarnak, Mark J / Nørgaard, Bjarne L

    Journal of cardiovascular computed tomography

    2022  Volume 16, Issue 5, Page(s) 452–453

    MeSH term(s) Cardiovascular Diseases/diagnostic imaging ; Computed Tomography Angiography ; Coronary Angiography ; Coronary Artery Disease ; Coronary Stenosis ; Coronary Vessels ; Fractional Flow Reserve, Myocardial ; Heart Disease Risk Factors ; Humans ; Predictive Value of Tests ; Renal Insufficiency, Chronic/complications ; Renal Insufficiency, Chronic/diagnosis ; Risk Factors
    Language English
    Publishing date 2022-06-08
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 2394360-9
    ISSN 1876-861X ; 1934-5925
    ISSN (online) 1876-861X
    ISSN 1934-5925
    DOI 10.1016/j.jcct.2022.05.007
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    Zs.A 6761: Show issues Location:
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  9. Article ; Online: Pulmonary Hypertension in Chronic Kidney Disease.

    Travers, Alison / Farber, Harrison W / Sarnak, Mark J

    Cardiology clinics

    2021  Volume 39, Issue 3, Page(s) 427–434

    Abstract: There is a high prevalence of pulmonary hypertension in chronic kidney disease (CKD), with rates increasing as glomerular filtration rate declines. Pulmonary hypertension is associated with a higher risk of cardiovascular events and mortality in non- ... ...

    Abstract There is a high prevalence of pulmonary hypertension in chronic kidney disease (CKD), with rates increasing as glomerular filtration rate declines. Pulmonary hypertension is associated with a higher risk of cardiovascular events and mortality in non-dialysis-dependent CKD stages 3 to 5, dialysis-dependent CKD, as well as kidney transplant recipients. The pathophysiology of pulmonary hypertension in CKD is multifactorial and includes higher pulmonary capillary wedge pressure caused by ischemic heart disease and cardiomyopathy, higher cardiac output caused by anemia and arteriovenous access used for hemodialysis, as well as potentially higher pulmonary vascular resistance. Treatment should focus on the underlying cause.
    MeSH term(s) Glomerular Filtration Rate ; Humans ; Hypertension ; Hypertension, Pulmonary/epidemiology ; Hypertension, Pulmonary/etiology ; Hypertension, Pulmonary/therapy ; Prevalence ; Renal Dialysis ; Renal Insufficiency, Chronic/complications ; Renal Insufficiency, Chronic/epidemiology
    Language English
    Publishing date 2021-07-12
    Publishing country Netherlands
    Document type Journal Article ; Review
    ZDB-ID 1196385-2
    ISSN 1558-2264 ; 0733-8651
    ISSN (online) 1558-2264
    ISSN 0733-8651
    DOI 10.1016/j.ccl.2021.04.004
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  10. Article ; Online: Intensive Blood Pressure Targets and Kidney Disease.

    Chang, Tara I / Sarnak, Mark J

    Clinical journal of the American Society of Nephrology : CJASN

    2018  Volume 13, Issue 10, Page(s) 1575–1577

    MeSH term(s) Clinical Trials as Topic ; Humans ; Hypertension/complications ; Hypertension/therapy ; Renal Insufficiency, Chronic/complications
    Language English
    Publishing date 2018-05-24
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2226665-3
    ISSN 1555-905X ; 1555-9041
    ISSN (online) 1555-905X
    ISSN 1555-9041
    DOI 10.2215/CJN.02010218
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