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Book: Cardiology and nephrology

Kalra, Philip A.

time for a more integrated approach

(Journal of renal care ; 36, Suppl. 1)

2010

Author's details	guest ed.: P. A. Kalra
Series title	Journal of renal care ; 36, Suppl. 1
Collection
Language	English
Size	171 S. : Ill., graph. Darst.
Publisher	Wiley-Blackwell
Publishing place	Malden, MA
Publishing country	United States
Document type	Book
HBZ-ID	HT016382755
Database	Catalogue ZB MED Medicine, Health

In stock of ZB MED Cologne/Königswinter

Shelf mark	Loan status	Location
Zs A 6308 -36,Suppl.1-	verfügbar in Königswinter	Königswinter

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Article ; Online: Mechanistic Links between Central Obesity and Cardiorenal Metabolic Diseases.

Al-Chalabi, Saif / Syed, Akheel A / Kalra, Philip A / Sinha, Smeeta

Cardiorenal medicine

2024 Volume 14, Issue 1, Page(s) 12–22

Abstract: Background: There is a marked increase in the global prevalence of obesity over the last decades with an estimated 1.9 billion adults living with overweight or obesity. This is associated with a sharp rise in prevalence of cardiorenal metabolic diseases ...

Abstract	Background: There is a marked increase in the global prevalence of obesity over the last decades with an estimated 1.9 billion adults living with overweight or obesity. This is associated with a sharp rise in prevalence of cardiorenal metabolic diseases such as type 2 diabetes mellitus, chronic kidney disease, and heart failure. With recent evidence of the efficacy of sodium glucose cotransporter-2 inhibitors and glucagon-like peptide-1 receptor agonists on cardiorenal protection and weight reduction, it is reasonable to investigate common causative pathways for cardiorenal metabolic diseases. Summary: Central obesity is a common condition with 41.5% prevalence worldwide. It is associated with adverse outcomes even in people with a normal body mass index. Central obesity develops when the personal fat threshold for expansion in the subcutaneous adipose tissue exceeds a certain level. Multiple factors such as age, gender, genetics, and hormones may play a role in determining personal susceptibility to central obesity. Cardiorenal metabolic diseases usually cluster in certain populations - commonly in people with central obesity - and cause a substantial burden on health services and increase the risk of all-cause mortality. In this review, we investigate the pathophysiological pathways between central obesity and cardiorenal metabolic diseases. These pathways include activation of the renin-angiotensin-aldosterone system and the sympathetic nervous system, inflammation and oxidative stress, haemodynamic impairment, insulin resistance, and endothelial dysfunction. Key message: Central obesity has a pivotal role in the development of cardiorenal metabolic diseases and should be targeted with population-based approaches, such as dietary and lifestyle interventions, as well as the development of pharmacotherapy to reduce the burden of cardiorenal metabolic diseases.
MeSH term(s)	Adult ; Humans ; Obesity, Abdominal/complications ; Obesity, Abdominal/epidemiology ; Diabetes Mellitus, Type 2/complications ; Diabetes Mellitus, Type 2/epidemiology ; Obesity/complications ; Obesity/epidemiology ; Obesity/metabolism ; Renin-Angiotensin System ; Renal Insufficiency, Chronic/complications ; Renal Insufficiency, Chronic/epidemiology
Language	English
Publishing date	2024-01-03
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2595659-0
ISSN	1664-5502 ; 1664-3828
ISSN (online)	1664-5502
ISSN	1664-3828
DOI	10.1159/000535772
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Article ; Online: Experience of a Bespoke Hyperkalaemia Clinic to Facilitate Prescribing of Renin-Angiotensin-Aldosterone System Inhibitors in Patients with Heart Failure with Reduced Ejection Fraction.

Ali, Ibrahim / Green, Darren / Kalra, Paul / Kalra, Philip A

Cardiorenal medicine

2022 Volume 12, Issue 5-6, Page(s) 196–204

Abstract: Background: Renin-angiotensin-aldosterone system inhibitors (RAASi) improve prognosis in patients with heart failure with reduced ejection fraction (HFrEF), but suboptimal dosing or discontinuation of these medications often occurs due to RAASi- ... ...

Abstract	Background: Renin-angiotensin-aldosterone system inhibitors (RAASi) improve prognosis in patients with heart failure with reduced ejection fraction (HFrEF), but suboptimal dosing or discontinuation of these medications often occurs due to RAASi-associated hyperkalaemia. We established a nephrology-led hyperkalaemia clinic to oversee prescribing of patiromer, an oral potassium binder, to facilitate RAASi optimization. Methods: The clinic was established in July 2019 at a nephrology tertiary centre in the UK. Patients with HFrEF who were unable to increase RAASi dosage due to hyperkalaemia were referred to the clinic, where all patients commenced patiromer 8.4 g daily. RAASi adjustments were deferred to the referring teams. Study outcomes included the percentage of patients who achieved a RAASi dose increase and the proportion of patients with normokalaemia at follow-up. Outcomes were evaluated until 1 May 2021. Results: A total of 34 patients were reviewed in the clinic between July 2019 and December 2020. Mean age was 71.6 years (±10.6 years), 56% had diabetes, and 71% had chronic kidney disease stages 3a-5; mean estimated glomerular filtration rate was 56 mL/min/1.73 m2 (±21 mL/min/1.73 m2). During follow-up, 13 patients discontinued patiromer (6 of whom did so due to gastrointestinal side effects) and were discharged; 2 patients died from non-hyperkalaemia-related illness; one switched to an alternative potassium binder. Over a mean follow-up of 13.4 months (±5.8 months), 17 of the 20 patients (85%) who continued with a potassium binder achieved a RAASi dose increase, with 4 patients (20%) receiving maximal dosages. This was attained by achieving normokalaemia during follow-up. No patients required magnesium supplementation. Of the 19 patients on patiromer, 12 continued this therapy for more than 12 months and 4 received it safely for 20 months. Discussion/conclusion: Patiromer prescribing in a nephrology-led hyperkalaemia clinic facilitated RAASi up-titration in patients with HFrEF by controlling potassium levels.
MeSH term(s)	Humans ; Aged ; Renin-Angiotensin System ; Heart Failure/complications ; Heart Failure/drug therapy ; Potassium ; Stroke Volume ; Hyperkalemia/chemically induced ; Hyperkalemia/drug therapy
Chemical Substances	Potassium (RWP5GA015D)
Language	English
Publishing date	2022-08-31
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2595659-0
ISSN	1664-5502 ; 1664-3828
ISSN (online)	1664-5502
ISSN	1664-3828
DOI	10.1159/000526106
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Article ; Online: A Systematic Review, Meta-Analysis, and Indirect Comparison of Blindly Adjudicated Cardiovascular Event Incidence with Ferric Derisomaltose, Ferric Carboxymaltose, and Iron Sucrose.

Pollock, Richard F / Kalra, Philip A / Kalra, Paul R / Ahmed, Fozia Z

Advances in therapy

2022 Volume 39, Issue 10, Page(s) 4678–4691

Abstract: Introduction: Intravenous (IV) iron is the preferred treatment for patients with iron deficiency anemia (IDA) who require rapid replenishment of iron stores or in whom oral iron is not tolerated or effective. Data from two large-scale randomized ... ...

Abstract	Introduction: Intravenous (IV) iron is the preferred treatment for patients with iron deficiency anemia (IDA) who require rapid replenishment of iron stores or in whom oral iron is not tolerated or effective. Data from two large-scale randomized controlled trials (RCTs) have recently been published reporting the incidence of adjudicated cardiovascular events after ferric derisomaltose (FDI) and iron sucrose (IS). The objective was to calculate the relative incidence of cardiovascular events with FDI and IS, and to conduct an indirect comparison with ferric carboxymaltose (FCM) based on previously published studies of cardiovascular risk. Methods: RCTs reporting the incidence of blindly adjudicated cardiovascular events in IDA patients treated with IV iron were identified by systematic literature review (SLR). Pairwise random effects meta-analyses of FDI versus IS, and FCM versus IS were conducted for the pre-specified adjudicated composite cardiovascular endpoint of: death due to any cause, nonfatal myocardial infarction, nonfatal stroke, unstable angina requiring hospitalization, congestive heart failure, arrhythmia, and protocol-defined hypertensive and hypotensive events. Analyses were also conducted for the composite endpoint excluding blood pressure events. Meta-analysis results were combined in an adjusted indirect comparison to provide an indirect estimate of cardiovascular risk with FDI versus FCM. Results: The SLR retrieved 694 unique articles, of which four were RCTs reporting the incidence of the composite cardiovascular endpoint; two studies comparing FCM (N = 1529) with IS (N = 1505), and two studies comparing FDI (N = 2008) with IS (N = 1000). The odds ratios of the composite CV endpoint were 0.59 (95% confidence interval: 0.39-0.90) for FDI versus IS, 1.12 (95% CI 0.90-1.40) for FCM versus IS, and the indirect OR for FDI versus FCM was 0.53 (95% CI 0.33-0.85). Conclusions: Pooling data from four large-scale RCTs suggested that FDI was associated with significantly lower incidence of cardiovascular adverse events compared to both FCM and IS.
MeSH term(s)	Anemia, Iron-Deficiency/drug therapy ; Cardiovascular Diseases/epidemiology ; Disaccharides ; Ferric Compounds/adverse effects ; Ferric Oxide, Saccharated/adverse effects ; Heart Failure ; Humans ; Incidence ; Iron ; Maltose/analogs & derivatives ; Randomized Controlled Trials as Topic
Chemical Substances	Disaccharides ; Ferric Compounds ; ferric carboxymaltose (6897GXD6OE) ; Maltose (69-79-4) ; ferric derisomaltose (AHU547PI9H) ; Iron (E1UOL152H7) ; Ferric Oxide, Saccharated (FZ7NYF5N8L)
Language	English
Publishing date	2022-08-10
Publishing country	United States
Document type	Journal Article ; Meta-Analysis ; Systematic Review ; Research Support, Non-U.S. Gov't
ZDB-ID	632651-1
ISSN	1865-8652 ; 0741-238X
ISSN (online)	1865-8652
ISSN	0741-238X
DOI	10.1007/s12325-022-02242-x
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Article ; Online: A validation study of the 4-variable and 8-variable kidney failure risk equation in transplant recipients in the United Kingdom.

Ali, Ibrahim / Kalra, Philip A

BMC nephrology

2021 Volume 22, Issue 1, Page(s) 57

Abstract: Background: There is emerging evidence that the 4-variable Kidney Failure Risk Equation (KFRE) can be used for risk prediction of graft failure in transplant recipients. However, geographical validation of the 4-variable KFRE in transplant patients is ... ...

Abstract	Background: There is emerging evidence that the 4-variable Kidney Failure Risk Equation (KFRE) can be used for risk prediction of graft failure in transplant recipients. However, geographical validation of the 4-variable KFRE in transplant patients is lacking, as is whether the more extensive 8-variable KFRE improves predictive accuracy. This study aimed to validate the 4- and 8-variable KFRE predictions of the 5-year death-censored risk of graft failure in patients in the United Kingdom. Methods: A retrospective cohort study involved 415 transplant recipients who had their first renal transplant between 2003 and 2015 and were under follow-up at Salford Royal NHS Foundation Trust. The KFRE risk scores were calculated on variables taken 1-year post-transplant. The area under the receiver operating characteristic curves (AUC) and calibration plots were evaluated to determine discrimination and calibration of the 4- and 8-variable KFREs in the whole cohort as well as in a subgroup analysis of living and deceased donor recipients and in patients with an eGFR< 45 ml/min/1.73m Results: There were 16 graft failure events (4%) in the whole cohort. The 4- and 8-variable KFREs showed good discrimination with AUC of 0.743 (95% confidence interval [CI] 0.610-0.876) and 0.751 (95% CI 0.629-0.872) respectively. In patients with an eGFR< 45 ml/min/1.73m Conclusions: Despite adequate discrimination, the 4- and 8-variable KFREs are imprecise in predicting graft failure in transplant recipients using data 1-year post-transplant. Larger, international studies involving diverse patient populations should be considered to corroborate these findings.
MeSH term(s)	Adult ; Cohort Studies ; Female ; Humans ; Kidney Transplantation ; Male ; Mathematical Concepts ; Middle Aged ; Postoperative Complications/epidemiology ; Renal Insufficiency/epidemiology ; Retrospective Studies ; Risk Assessment/methods ; Risk Factors ; United Kingdom/epidemiology
Language	English
Publishing date	2021-02-09
Publishing country	England
Document type	Journal Article ; Validation Study
ZDB-ID	2041348-8
ISSN	1471-2369 ; 1471-2369
ISSN (online)	1471-2369
ISSN	1471-2369
DOI	10.1186/s12882-021-02259-4
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Article ; Online: The effect of primary renal disease upon outcomes after renal transplant.

Garland, Shona / Pullerits, Kairi / Chukwu, Chukwuma A / Chinnadurai, Rajkumar / Middleton, Rachel / Kalra, Philip A

Clinical transplantation

2024 Volume 38, Issue 3, Page(s) e15216

Abstract: Background: This study investigated whether nature of primary renal disease affects clinical outcomes after renal transplantation at a single center in the United Kingdom.: Methods: This was a retrospective cohort study of 961 renal transplant ... ...

Abstract	Background: This study investigated whether nature of primary renal disease affects clinical outcomes after renal transplantation at a single center in the United Kingdom. Methods: This was a retrospective cohort study of 961 renal transplant recipients followed up at a large renal center from 2000 to 2020. Separation of diseases responsible for end-stage kidney disease included glomerulonephritis, diabetic kidney disease, hypertensive nephropathy, autosomal dominant polycystic kidney disease, unknown cause, other causes and chronic pyelonephritis. Outcome data included graft loss, cardiovascular events, malignancy, post-transplant diabetes mellitus and death, analyzed according to primary disease type. Results: The mean age at transplantation was 47.3 years. During a mean follow-up of 7.6 years, 18% of the overall cohort died corresponding to an annualised mortality rate of 2.3%. Death with a functioning graft occurred at a rate of 2.1% per annum, with the highest incidence observed in in patients with diabetic kidney disease (4.1%/year). Post-transplant cardiovascular events occurred in 21% of recipients (2.8% per year), again highest in recipients with diabetic kidney disease (5.1%/year) and hypertensive nephropathy (4.5%/year). Post-transplant diabetes mellitus manifested in 19% of the cohort at an annualized rate of2.1% while cancer incidence stood at 9% with an annualized rate of 1.1% . Graft loss occurred in 6.8% of recipients at the rate of1.2% per year with chronic allograft injury, acute rejection and recurrent glomerulonephritis being the predominant causative factors. Median + IQR dialysis-free survival of the whole cohort was 16.2 (9.9 - > 20) years, being shortest for diabetic kidney disease (11.0 years) and greatest for autosomal dominant polycystic kidney disease (18.2 years) .The collective mean decline in eGFR over time was -1.14ml/min/year. Recipients with Pre-transplant diabetic kidney disease exhibited the fastest rate of decline(-2.1ml/min/year) a statistically significant difference in comparison to the other native kidney diseases with Autosomal dominant polycystic kidney disease exhibiting the lowest rate of decline(-0.05ml/min/year) CONCLUSION: Primary renal disease can influence the outcome after renal transplantation, with patients with prior diabetic kidney disease having the poorest outcome in terms of dialysis-free survival and loss of transplant function. Autosomal polycystic kidney disease, other cause and unknown cause had the best outcomes compared to other primary renal disease groups.
MeSH term(s)	Humans ; Middle Aged ; Kidney Transplantation/adverse effects ; Diabetic Nephropathies ; Polycystic Kidney, Autosomal Dominant ; Retrospective Studies ; Hypertension, Renal ; Glomerulonephritis ; Nephritis
Language	English
Publishing date	2024-03-07
Publishing country	Denmark
Document type	Journal Article
ZDB-ID	639001-8
ISSN	1399-0012 ; 0902-0063
ISSN (online)	1399-0012
ISSN	0902-0063
DOI	10.1111/ctr.15216
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Article ; Online: Improving outcomes in atherosclerotic renovascular disease: importance of clinical presentation and multi-disciplinary review.

de Bhailis, Áine M / Lake, Edward / Chrysochou, Constantina / Green, Darren / Chinnadurai, Rajkumar / Kalra, Philip A

Journal of nephrology

2024

Abstract: Background and objectives: Atherosclerotic renal artery stenosis may cause hypertension, chronic kidney disease and heart failure, but large randomized control trials to date have shown no major additional benefit of renal revascularization over optimal ...

Abstract	Background and objectives: Atherosclerotic renal artery stenosis may cause hypertension, chronic kidney disease and heart failure, but large randomized control trials to date have shown no major additional benefit of renal revascularization over optimal medical management. However, these trials did not consider outcomes specifically in relation to clinical presentations. Given that atherosclerotic renal artery stenosis is a heterogenous condition, measures of success likely differ according to the clinical presentation. Our retrospective study objectives were to determine the effects of revascularization when applied to specific clinical presentations and after careful multi-disciplinary team review. Methods: All patients presenting to our centre and its referring hospitals with radiological findings of at least one renal artery stenosis > 50% between January 2015 and January 2020 were reviewed at the renovascular multi-disciplinary team meeting with revascularization considered in accordance with international guidelines, notably for patients with anatomically significant renal artery stenosis, adequately sized kidney and presentations with any of; deteriorating kidney function, heart failure syndrome, or uncontrollable hypertension. Optimal medical management was recommended for all patients which included lipid lowering agents, anti-platelets and anti-hypertensives targeting blood pressure ≤ 130/80 mmHg. The effect of revascularization was assessed according to the clinical presentation; blood pressure and number of agents in those with renovascular hypertension, delta glomerular filtration rate in those with ischaemic nephropathy and heart failure re-admissions in those with heart failure syndromes. Results: During this 5-year period, 127 patients with stenosis ≥ 50% were considered by the multidisciplinary team, with 57 undergoing revascularization (17 primarily for severe hypertension, 25 deteriorating kidney function, 6 heart failure syndrome and 9 for very severe anatomical stenosis). Seventy-nine percent of all revascularized patients had a positive outcome specific to their clinical presentation, with 82% of those with severe hypertension improving blood pressure control, 72% with progressive ischaemic nephropathy having attenuated GFR decline, and no further heart failure admissions in those with heart failure. Seventy-eight percent of patients revascularized for high grade stenosis alone had better blood pressure control with 55% also manifesting renal functional benefits. Conclusions: Multi-disciplinary team discussion successfully identified a group of patients more likely to benefit from revascularization based on 3 key factors: clinical presentation, severity of the renal artery lesion and the state of the kidney beyond the stenotic lesion. In this way, a large proportion of patients can clinically improve after revascularization if their outcomes are considered according to the nature of their clinical presentation.
Language	English
Publishing date	2024-04-09
Publishing country	Italy
Document type	Journal Article
ZDB-ID	1093991-x
ISSN	1724-6059 ; 1120-3625 ; 1121-8428
ISSN (online)	1724-6059
ISSN	1120-3625 ; 1121-8428
DOI	10.1007/s40620-024-01902-1
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Article: Revolutionising outpatient clinic experience (RevOCE): the future of chronic kidney disease care and associated multimorbidity.

Al-Chalabi, Saif / Santhirasekaran, Schanhave / Kalra, Philip A / Ritchie, James / Poulikakos, Dimitrios / Sinha, Smeeta

Future healthcare journal

2024 Volume 10, Issue Suppl 3, Page(s) 13–14

Language	English
Publishing date	2024-04-22
Publishing country	England
Document type	Journal Article
ZDB-ID	3016427-8
ISSN	2514-6653 ; 2514-6645
ISSN (online)	2514-6653
ISSN	2514-6645
DOI	10.7861/fhj.10-3-s13
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Article: Risk factors for infective endocarditis in patients receiving hemodialysis: A propensity score matched cohort study.

Al-Chalabi, Saif / Tay, Tricia / Chinnadurai, Rajkumar / Kalra, Philip A

Clinical nephrology

2023 Volume 100, Issue 2, Page(s) 51–59

Abstract: In patients receiving hemodialysis, infective endocarditis (IE) may present in a similar way to other causes of bacteremia, which may delay early diagnosis and can lead to worse outcomes. In this study, we aimed to identify the risk factors for IE in ... ...

Abstract	In patients receiving hemodialysis, infective endocarditis (IE) may present in a similar way to other causes of bacteremia, which may delay early diagnosis and can lead to worse outcomes. In this study, we aimed to identify the risk factors for IE in hemodialysis patients with bacteremia. This study was conducted on all patients diagnosed with IE and receiving hemodialysis between 2005 and 2018 in Salford Royal Hospital. Patients with IE were propensity score matched with similar hemodialysis patients with episodes of bacteremia between 2011 and 2015 (non-IE bacteremic (NIEB)). Logistic regression analysis was used to predict the risk factors associated with infective endocarditis. There were 35 cases of IE, and these were propensity matched with 70 NIEB cases. The median age of the patients was 65 years with a predominance of males (60%). The IE group had higher peak C-reactive protein compared to the NIEB group (median, 253 mg/L vs. 152, p = 0.001). Patients with IE had a longer duration of prior dialysis catheter use than NIEB patients (150 vs. 28.5 days: p = 0.004). IE patients had a much higher 30-day mortality rate (37.1% vs. 17.1%, p = 0.023). Logistic regression analysis showed previous valvular heart disease (OR: 29.7; p < 0.001), and a higher baseline C-reactive protein (OR: 1.01; p = 0.001) as significant predictors for infective endocarditis. Bacteremia in patients receiving hemodialysis through a catheter access should be actively investigated with a high index of suspicion for infective endocarditis, particularly in those with known valvular heart disease and a higher baseline C-reactive protein.
MeSH term(s)	Male ; Humans ; Aged ; Female ; Renal Dialysis/adverse effects ; Cohort Studies ; Propensity Score ; C-Reactive Protein ; Endocarditis, Bacterial/diagnosis ; Endocarditis, Bacterial/epidemiology ; Endocarditis, Bacterial/etiology ; Endocarditis/diagnosis ; Endocarditis/epidemiology ; Endocarditis/etiology ; Risk Factors ; Heart Valve Diseases/etiology ; Bacteremia/etiology ; Bacteremia/complications ; Retrospective Studies
Chemical Substances	C-Reactive Protein (9007-41-4)
Language	English
Publishing date	2023-06-08
Publishing country	Germany
Document type	Journal Article
ZDB-ID	185101-9
ISSN	0301-0430
ISSN	0301-0430
DOI	10.5414/CN111117
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Article ; Online: Mortality and Renal Outcomes Are Impacted by Obesity in Cardiorenal Metabolic Disease but Not in People with Concomitant Diabetes Mellitus.

Al-Chalabi, Saif / Chinnadurai, Rajkumar / Kalra, Philip A / Sinha, Smeeta

Cardiorenal medicine

2023 Volume 14, Issue 1, Page(s) 23–33

Abstract: Introduction: Mounting evidence in the literature describes a reverse association, whereby obesity may have a protective effect on mortality - the "obesity paradox." Due to the significant overlap between elements of cardiorenal metabolic disease, we ... ...

Abstract	Introduction: Mounting evidence in the literature describes a reverse association, whereby obesity may have a protective effect on mortality - the "obesity paradox." Due to the significant overlap between elements of cardiorenal metabolic disease, we examined the effects of obesity on outcomes in a cohort of patients with non-dialysis chronic kidney disease (ND-CKD) by grouping patients according to their level of cardiometabolic co-morbidity to reduce the risk of bias. Methods: This study was undertaken on all patients with a documented body mass index (BMI) in the Salford Kidney Study database from October 2002 until December 2016. Patients were grouped according to their BMI into normal weight, overweight, and obese, and also according to their level of co-morbidity into 4 groups: group 1 had CKD only; group 2 had CKD and heart failure (HF); group 3 had CKD and diabetes mellitus (DM); and group 4 had CKD, DM, and HF. Univariate and multivariate Cox regression analyses were performed. Results: A total of 2,416 patients were included in the analysis. The median age was 67.3 years, 61.8% were male, and 96.4% were Caucasian. Obesity was associated with a lower incidence of combined outcomes in patients with ND-CKD who did not have DM (hazard ratio [HR] 0.74; p = <0.001 and HR 0.48; p = 0.008 for CKD alone and CKD + HF groups, respectively). This protective effect remained significant after correcting for major factors. In patients with ND-CKD and DM, there was no difference in all-cause mortality between the normal weight group and the obesity groups. Conclusion: Obesity may be protective against adverse outcomes only in groups 1 (CKD alone) and 2 (CKD + HF). This "protective" effect was not seen in patients who had concomitant diabetes. These data suggest that diabetes is a potent predictor of adverse outcomes, irrespective of BMI; however, in patients without diabetes, obesity may play a protective role.
MeSH term(s)	Humans ; Male ; Aged ; Female ; Obesity/complications ; Obesity/epidemiology ; Diabetes Mellitus/epidemiology ; Renal Insufficiency, Chronic/complications ; Heart Failure/complications ; Heart Failure/epidemiology ; Kidney
Language	English
Publishing date	2023-12-29
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2595659-0
ISSN	1664-5502 ; 1664-3828
ISSN (online)	1664-5502
ISSN	1664-3828
DOI	10.1159/000536038
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