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  1. Article ; Online: Sex Differences in Kidney Transplantation

    Sebastian Hödlmoser / Teresa Gehrig / Marlies Antlanger / Amelie Kurnikowski / Michał Lewandowski / Simon Krenn / Jarcy Zee / Roberto Pecoits-Filho / Reinhard Kramar / Juan Jesus Carrero / Kitty J. Jager / Allison Tong / Friedrich K. Port / Martin Posch / Wolfgang C. Winkelmayer / Eva Schernhammer / Manfred Hecking / Robin Ristl

    Frontiers in Medicine, Vol

    Austria and the United States, 1978–2018

    2022  Volume 8

    Abstract: BackgroundSystematic analyses about sex differences in wait-listing and kidney transplantation after dialysis initiation are scarce. We aimed at identifying sex-specific disparities along the path of kidney disease treatment, comparing two countries with ...

    Abstract BackgroundSystematic analyses about sex differences in wait-listing and kidney transplantation after dialysis initiation are scarce. We aimed at identifying sex-specific disparities along the path of kidney disease treatment, comparing two countries with distinctive health care systems, the US and Austria, over time.MethodsWe analyzed subjects who initiated dialysis from 1979–2018, in observational cohort studies from the US and Austria. We used Cox regression to model male-to-female cause-specific hazard ratios (csHRs, 95% confidence intervals) for transitions along the consecutive states dialysis initiation, wait-listing, kidney transplantation and death, adjusted for age and stratified by country and decade of dialysis initiation.ResultsAmong 3,053,206 US and 36,608 Austrian patients starting dialysis, men had higher chances to enter the wait-list, which however decreased over time [male-to-female csHRs for wait-listing, 1978–1987: US 1.94 (1.71, 2.20), AUT 1.61 (1.20, 2.17); 2008–2018: US 1.35 (1.32, 1.38), AUT 1.11 (0.94, 1.32)]. Once wait-listed, the advantage of the men became smaller, but persisted in the US [male-to-female csHR for transplantation after wait-listing, 2008–2018: 1.08 (1.05, 1.11)]. The greatest disparity between men and women occurred in older age groups in both countries [male-to-female csHR for wait-listing after dialysis, adjusted to 75% age quantile, 2008–2018: US 1.83 (1.74, 1.92), AUT 1.48 (1.02, 2.13)]. Male-to-female csHRs for death were close to one, but higher after transplantation than after dialysis.ConclusionsWe found evidence for sex disparities in both countries. Historically, men in the US and Austria had 90%, respectively, 60% higher chances of being wait-listed for kidney transplantation, although these gaps decreased over time. Efforts should be continued to render kidney transplantation equally accessible for both sexes, especially for older women.
    Keywords chronic kidney disease ; dialysis ; kidney transplantation ; sex ; gender ; USRDS ; Medicine (General) ; R5-920
    Subject code 590
    Language English
    Publishing date 2022-01-01T00:00:00Z
    Publisher Frontiers Media S.A.
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  2. Article ; Online: Titin-Related Dilated Cardiomyopathy

    Przemysław Chmielewski / Grażyna Truszkowska / Ilona Kowalik / Małgorzata Rydzanicz / Ewa Michalak / Małgorzata Sobieszczańska-Małek / Maria Franaszczyk / Piotr Stawiński / Małgorzata Stępień-Wojno / Artur Oręziak / Michał Lewandowski / Przemysław Leszek / Maria Bilińska / Tomasz Zieliński / Rafał Płoski / Zofia T. Bilińska

    Diagnostics, Vol 12, Iss 13, p

    The Clinical Trajectory and the Role of Circulating Biomarkers in the Clinical Assessment

    2022  Volume 13

    Abstract: Titin truncating variants ( TTN tv) are known as the leading cause of inherited dilated cardiomyopathy (DCM). Nevertheless, it is unclear whether circulating cardiac biomarkers are helpful in detection and risk assessment. We sought to assess 1) early ... ...

    Abstract Titin truncating variants ( TTN tv) are known as the leading cause of inherited dilated cardiomyopathy (DCM). Nevertheless, it is unclear whether circulating cardiac biomarkers are helpful in detection and risk assessment. We sought to assess 1) early indicators of cardiotitinopathy including the serum biomarkers high-sensitivity cardiac troponin T (hs-cTnT) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) in clinically stable patients, and 2) predictors of outcome among TTN tv carriers. Our single-center cohort consisted of 108 TTN tv carriers (including 70 DCM patients) from 43 families. Clinical, laboratory and follow-up data were analyzed. The earliest abnormality was left ventricular dysfunction, present in 8, 26 and 47% of patients in the second, third and fourth decade of life, respectively. It was followed by symptoms of heart failure, linked to NT-proBNP elevation and severe left ventricular systolic dysfunction, and later by arrhythmias. Hs-cTnT serum levels were increased in the late stage of the disease only. During the median follow-up of 5.2 years, both malignant ventricular arrhythmia (MVA) and end-stage heart failure (esHF) occurred in 12% of TTN tv carriers. In multivariable analysis, NT-proBNP level ≥650 pg/mL was the best predictor of both composite endpoints (MVA and esHF) and of MVA alone. In conclusion, echocardiographic abnormalities are the first detectable anomalies in the course of cardiotitinopathies. The assessment of circulating cardiac biomarkers is not useful in the detection of the disease onset but may be helpful in risk assessment.
    Keywords cardiotitinopathy ; TTN truncating variants ; troponin T ; NT-proBNP ; malignant ventricular arrhythmia ; end-stage heart failure ; Medicine (General) ; R5-920
    Subject code 610
    Language English
    Publishing date 2022-12-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article ; Online: Can Circulating Cardiac Biomarkers Be Helpful in the Assessment of LMNA Mutation Carriers?

    Przemyslaw Chmielewski / Ewa Michalak / Ilona Kowalik / Maria Franaszczyk / Malgorzata Sobieszczanska-Malek / Grazyna Truszkowska / Malgorzata Stepien-Wojno / Elzbieta Katarzyna Biernacka / Bogna Foss-Nieradko / Michal Lewandowski / Artur Oreziak / Maria Bilinska / Mariusz Kusmierczyk / Frédérique Tesson / Jacek Grzybowski / Tomasz Zielinski / Rafal Ploski / Zofia T. Bilinska

    Journal of Clinical Medicine, Vol 9, Iss 1443, p

    2020  Volume 1443

    Abstract: Mutations in the lamin A/C gene are variably phenotypically expressed; however, it is unclear whether circulating cardiac biomarkers are helpful in the detection and risk assessment of cardiolaminopathies. We sought to assess (1) clinical characteristics ...

    Abstract Mutations in the lamin A/C gene are variably phenotypically expressed; however, it is unclear whether circulating cardiac biomarkers are helpful in the detection and risk assessment of cardiolaminopathies. We sought to assess (1) clinical characteristics including serum biomarkers: high sensitivity troponin T (hsTnT) and N-terminal prohormone brain natriuretic peptide (NT-proBNP) in clinically stable cardiolaminopathy patients, and (2) outcome among pathogenic/likely pathogenic lamin A/C gene ( LMNA ) mutation carriers. Our single-centre cohort included 53 patients from 21 families. Clinical, laboratory, follow-up data were analysed. Median follow-up was 1522 days. The earliest abnormality, emerging in the second and third decades of life, was elevated hsTnT (in 12% and in 27% of patients, respectively), followed by the presence of atrioventricular block, heart failure, and malignant ventricular arrhythmia (MVA). In patients with missense vs. other mutations, we found no difference in MVA occurrence and, surprisingly, worse transplant-free survival. Increased levels of both hsTnT and NT-proBNP were strongly associated with MVA occurrence (HR > 13, p ≤ 0.02 in both) in univariable analysis. In multivariable analysis, NT-proBNP level > 150 pg/mL was the only independent indicator of MVA. We conclude that assessment of circulating cardiac biomarkers may help in the detection and risk assessment of cardiolaminopathies.
    Keywords laminopathy ; LMNA ; biomarkers ; troponin T ; NT-proBNP ; malignant ventricular arrhythmia ; Medicine ; R
    Subject code 610 ; 616
    Language English
    Publishing date 2020-05-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  4. Article ; Online: Sex differences in chronic kidney disease awareness among US adults, 1999 to 2018.

    Sebastian Hödlmoser / Wolfgang C Winkelmayer / Jarcy Zee / Roberto Pecoits-Filho / Ronald L Pisoni / Friedrich K Port / Bruce M Robinson / Robin Ristl / Simon Krenn / Amelie Kurnikowski / Michał Lewandowski / Allison Ton / Juan Jesus Carrero / Eva S Schernhammer / Manfred Hecking

    PLoS ONE, Vol 15, Iss 12, p e

    2020  Volume 0243431

    Abstract: Background Chronic kidney disease (CKD) is less prevalent among men than women, but more men than women initiate kidney replacement therapy. Differences in CKD awareness may contribute to this gender gap, which may further vary by race/ethnicity. We ... ...

    Abstract Background Chronic kidney disease (CKD) is less prevalent among men than women, but more men than women initiate kidney replacement therapy. Differences in CKD awareness may contribute to this gender gap, which may further vary by race/ethnicity. We aimed to investigate trends in CKD awareness and the association between individual characteristics and CKD awareness among US men versus women. Methods and findings We conducted a serial, cross-sectional analysis of 10 cycles (1999-2018) from the National Health and Nutrition Examination Survey (NHANES). Adult participants with CKD stages G3-G5 (estimated glomerular filtration rate [eGFR] <60 mL/min/1.73m2) were included, unless they were on dialysis or medical information was missing. Serum creatinine was measured during NHANES medical exams. CKD stage was classified by eGFR, based on the CKD-EPI formula. CKD awareness was assessed with the question: "Have you ever been told by a health care professional you had weak or failing kidneys", asked in standardized NHANES questionnaires on each survey. Using logistic regression models, we evaluated the association between sex and CKD awareness, adjusting for potential confounders including age, race/ethnicity and comorbidities. We stratified CKD awareness by 5 pre-defined calendar-year periods and conducted all analyses for the complete study population as well as the Caucasian and African American subpopulations. We found that among 101871 US persons participating in NHANES, 4411 (2232 women) had CKD in stages G3-G5. These participants were, on average, 73±10 years old, 25.3% reported diabetes, 78.0% reported hypertension or had elevated blood pressure during medical examinations and 39.8% were obese (percentages were survey-weighted). CKD awareness was more prevalent among those with higher CKD stage, younger age, diabetes, hypertension and higher body mass index. CKD awareness was generally low (<22.5%), though it increased throughout the study period, remaining consistently higher among men compared to women, ...
    Keywords Medicine ; R ; Science ; Q
    Subject code 331
    Language English
    Publishing date 2020-01-01T00:00:00Z
    Publisher Public Library of Science (PLoS)
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  5. Article ; Online: Utilization of Subcutaneous Cardioverter-Defibrillator in Poland and Europe–Comparison of the Results of Multi-Center Registries

    Maciej Kempa / Andrzej Przybylski / Szymon Budrejko / Tomasz Fabiszak / Michał Lewandowski / Krzysztof Kaczmarek / Mateusz Tajstra / Marcin Grabowski / Przemysław Mitkowski / Stanisław Tubek / Ewa Jędrzejczyk-Patej / Radosław Lenarczyk / Dariusz Jagielski / Janusz Romanek / Anna Rydlewska / Zbigniew Orski / Joanna Zakrzewska-Koperska / Artur Filipecki / Marcin Janowski /
    Tatjana Potpara / Serge Boveda

    International Journal of Environmental Research and Public Health, Vol 18, Iss 7178, p

    2021  Volume 7178

    Abstract: The implantation of a subcutaneous cardioverter-defibrillator (S-ICD) may be used instead of a traditional transvenous system to prevent sudden cardiac death. Our aim was to compare the characteristics of S-ICD patients from the multi-center registry of ... ...

    Abstract The implantation of a subcutaneous cardioverter-defibrillator (S-ICD) may be used instead of a traditional transvenous system to prevent sudden cardiac death. Our aim was to compare the characteristics of S-ICD patients from the multi-center registry of S-ICD implantations in Poland with the published results of the European Snapshot Survey on S-ICD Implantation (ESSS-SICDI). We compared data of 137 Polish S-ICD patients with 68 patients from the ESSS-SICDI registry. The groups did not differ significantly in terms of sex, prevalence of ischemic cardiomyopathy, concomitant diseases, and the rate of primary prevention indication. Polish patients had more advanced heart failure (New York Heart Association (NYHA) class III: 11.7% vs. 2.9%, NYHA II: 48.9% vs. 29.4%, NYHA I: 39.4% vs. 67.7%, p < 0.05 each). Young age (75.9% vs. 50%, p < 0.05) and no vascular access (7.3% vs. 0%, p < 0.05) were more often indications for S-ICD. The percentage of patients after transvenous system removal due to infections was significantly higher in the Polish group (11% vs. 1.5%, p < 0.05). In the European population, S-ICD was more frequently chosen because of patients’ active lifestyle and patients’ preference (both 10.3% vs. 0%, p < 0.05). Our analysis shows that in Poland, compared to other European countries, subcutaneous cardioverters-defibrillators are being implanted in patients at a more advanced stage of chronic heart failure. The most frequent reason for choosing a subcutaneous system instead of a transvenous ICD is the young age of a patient.
    Keywords sudden cardiac death ; ventricular arrhythmia ; implantable cardioverter-defibrillator ; subcutaneous implantable cardioverter-defibrillator ; Medicine ; R
    Subject code 610
    Language English
    Publishing date 2021-07-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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