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Abstract Background and aims Chronic kidney disease (CKD) is a public health concern worldwide and has been recognized as a significant risk factor for cardiovascular disease. The elevated level of uric acid (hyperuricemia) has been suggested to be associated with obesity, hypertension, cardiovascular disease and diabetes. However, there is limited information on the relationship between hyperuricemia and CKD. Therefore, this study aimed to estimate the prevalence of CKD and assess its relationship with hyperuricemia in Bangladeshi adults. Methods In this study, blood samples were collected from 545 participants (398 males and 147 females) aged ≥ 18 years. Biochemical parameters such as serum uric acid (SUA), lipid profile markers, glucose, creatinine and urea were measured by colorimetric methods. The estimated glomerular filtration rate (eGFR) and CKD were determined based on serum creatinine levels with existed formula. Multivariate logistic regression analysis was performed to evaluate the association between SUA and CKD. Results The overall prevalence of CKD was 5.9% with 6.1% in males and 5.2% in females. Hyperuricemia was prevalent in 18.7% of participants with 23.2% in males and 14.6% in females. An increasing trend of CKD prevalence was observed with increasing age in the groups. The mean eGFR level was significantly lower in male (95.1 ± 31.8 ml/min/1.73m2) than in female (109.3 ± 77.4 ml/min/1.73m2) subjects (p

Background: Data are scant on use of finerenone in diabetic kidney disease (DKD). We undertook this meta-analysis to address this knowledge gap. Methods: Electronic databases were searched for randomized controlled trials (RCTs) involving diabetes patients receiving finerenone compared to controls. The primary outcome was changes in urine albumin-creatinine ratio (UACR). Secondary outcomes were time to kidney failure (decline in GFR by >40% from baseline over 4 weeks), time to end-stage kidney disease, hospitalization for any cause, death and adverse events reported. Results: From initially screened 79 articles, data from 7 RCTs involving 13,783 patients were analyzed (3 in active control group [ACG] defined as having eplerenone/spironolactone as active comparator; 4 in passive control group [PCG] defined as having placebo as controls). Patients receiving finerenone had greater percentage lowering of UACR from baseline as compared to PCG [MD23.82% (95%CI: –24.87 to –22.77); P < 0.01; I2 = 96%] at 90 days, after 2 years [MD 37.9% (95%CI: –38.09 to –37.71); P < 0.01] and 4 years [MD 25.20%(95%CI: –25.63 to –24.77);P < 0.01] of treatment. Patients receiving finerenone has lower chance of >40% decline in GFR (OR 0.83 [95%CI: 0.75 to 0.92];P < 0.01; I2 = 0%). Patients receiving finerenone had lower occurrence of cardiovascular death, non-fatal myocardial infarction, non-fatal stroke or hospitalization for heart failure, as compared to placebo/eplerenone (OR0.86 [95%CI: 0.78 to 0.95]; P = 0.003; I2 = 0%). TAEs was similar (RR0.97 [95%CI: 0.88–1.07]; P = 0.56; I2 = 0%), but SAEs significantly lower (RR0.91 [95%CI: 0.84 to 0.97]; P < 0.01; I2 = 0%) in finerenone-group compared to controls. Conclusion: This meta-analysis provides reassuring data on beneficial impact of finerenone in reducing UACR and GFR decline as compared to placebo. We still lack head-to-head comparison of renal outcomes of finerenone vs eplerenone/spironolactone in DKD.

Background: The presence of calcified lesions in chronic kidney disease (CKD) patients adversely affects the outcomes of percutaneous coronary interventions (PCIs). Lesion modification using rotational atherectomy (RA) followed by drug-eluting stent (DES) implantation may, therefore, be a suitable strategy to treat heavily calcified coronary lesions in CKD patients. Aim: The aim of the study was to compare the effectiveness and safety of PCI using RA and new-generation DES for treating calcified coronary lesions in patients with mild versus moderate-to-severe CKD. Methods: This was a single-center, retrospective study. Data were collected from the medical records of all CKD patients with calcified coronary artery lesions who underwent RA + DES implantation from November 2014 to October 2019. The primary outcomes were the rates of in-stent restenosis (ISR), repeat revascularization (RR), and major adverse cardiovascular and cerebrovascular events. Secondary outcomes included procedural success, death after intervention, and procedural/in-hospital complications. Results: A total of 77 and 126 patients with mild and moderate-to-severe CKD were treated with RA + DES. Patients with moderate-to-severe CKD were significantly older when compared to patients with mild CKD (mean age: 66.6 ± 8.2 vs. 59.5 ± 7.7 years, respectively, P < 0.0001). Body mass index was significantly lower in moderate-to-severe CKD group compared to the mild CKD group. The number of patients in whom postdilatation was performed after stent implantation was significantly higher in the moderate-to-severe CKD group compared to the mild CKD group (100% vs. 96%, P = 0.025). Overall procedural success was 97.5% with minimal periprocedural complications. The rates of ISR and RR were not significantly different between patients with mild and moderate-to-severe CKD. The two groups did not differ significantly in terms of procedural success, postprocedural complications, and procedural mortality. Conclusion: RA followed by DES implantation is an effective and safe strategy to treat calcified coronary artery lesions in patients with CKD, regardless of the degree of renal dysfunction.

Background: Chronic kidney disease (CKD) is a public health problem that increases the risk of cardiovascular morbidity and mortality. Heart failure with preserved ejection fraction characterized by left ventricular hypertrophy (LVH) and diastolic dysfunction is a common cardiovascular complication of CKD. Anaemia is present in both dialysis & non dialysis CKD patients. Anaemia causes left ventricular hypertrophy (LVH) which in turn leads to increases morbidity and mortality in CKD, even before progression of chronic kidney disease (CKD) to end stage renal disease (ESRD). Our study is aimed at to evaluate the prevalence of left ventricular hypertrophy (LVH) and its correlation with anaemia in hospitalized CKD patients. Materials and Methods: A cross-sectional study was done on 50 patients of different stages of CKD admitted in the chittagong medical college hospital (CMCH). All the clinical data were reviewed and recorded. Data was analyzed by SPSS-18 and p value <0.05 was considered statistically significant. Journal of Bangladesh College of Physicians and Surgeons Vol. 42, No. 1, January 2024 Results: Majority of study population 64% was male, 36% was female. Most of the male patient (40%) of the study population were having abnormal left ventricular mass index (>130 gm/m²). More patients with severe left ventricular hypertrophy were found in stage 5 of CKD in female and male which was 8 and 23 respectively. Regarding correlation of Hb% with LVMI there was a significant negative correlation was found (r= -0.420, p = 0.003) between them means if Hb% decreases LVMI level increases. It was also found in male and female patients separately (for male r = -0.778, p = 0.001 and for female r = -0.746, p = 0.001). Conclusion: Anemia is widely prevalent in our CKD patients. Severity of anemia is correlated to left ventricular hypertrophy in these patients. Hence correction of anemia early in these group of patients can halt or prevent cardiovascular morbidity and mortality. [ABSTRACT FROM AUTHOR]

Background: The presence of calcified lesions in chronic kidney disease (CKD) patients adversely affects the outcomes of percutaneous coronary interventions (PCIs). Lesion modification using rotational atherectomy (RA) followed by drug-eluting stent (DES) implantation may, therefore, be a suitable strategy to treat heavily calcified coronary lesions in CKD patients. Aim: The aim of the study was to compare the effectiveness and safety of PCI using RA and new-generation DES for treating calcified coronary lesions in patients with mild versus moderate-to-severe CKD. Methods: This was a single-center, retrospective study. Data were collected from the medical records of all CKD patients with calcified coronary artery lesions who underwent RA + DES implantation from November 2014 to October 2019. The primary outcomes were the rates of in-stent restenosis (ISR), repeat revascularization (RR), and major adverse cardiovascular and cerebrovascular events. Secondary outcomes included procedural success, death after intervention, and procedural/in-hospital complications. Results: A total of 77 and 126 patients with mild and moderate-to-severe CKD were treated with RA + DES. Patients with moderate-to-severe CKD were significantly older when compared to patients with mild CKD (mean age: 66.6 ± 8.2 vs. 59.5 ± 7.7 years, respectively, P < 0.0001). Body mass index was significantly lower in moderate-to-severe CKD group compared to the mild CKD group. The number of patients in whom postdilatation was performed after stent implantation was significantly higher in the moderate-to-severe CKD group compared to the mild CKD group (100% vs. 96%, P = 0.025). Overall procedural success was 97.5% with minimal periprocedural complications. The rates of ISR and RR were not significantly different between patients with mild and moderate-to-severe CKD. The two groups did not differ significantly in terms of procedural success, postprocedural complications, and procedural mortality. Conclusion: RA followed by DES implantation is an effective and safe strategy to treat calcified coronary artery lesions in patients with CKD, regardless of the degree of renal dysfunction. [ABSTRACT FROM AUTHOR]

Aim: Coronary artery calcification is an important factor influencing revascularisation outcomes in patients with chronic kidney disease (CKD). Lesion preparation using rotational atherectomy (RA) may help adequately modify calcified plaques and facilitate the achievement of optimal clinical outcomes in these patients. In this study, we assessed the safety and effectiveness of percutaneous coronary intervention (PCI) using RA followed by new-generation drug-eluting stent (DES) implantation in patients with CKD and calcified coronary artery disease (CAD). Methods and results: From November 2014 to October 2019, a total of 203 patients with calcified CAD who underwent RA followed by second- or third-generation DES implantation at our centre were included in the study. Mild, moderate, and severe CKD was present in 38%, 55.5%, and 6.5% of the patients, respectively. Diffused coronary calcifications were present in 85%. Procedural success was 97.5% with minimal periprocedural complications. In-stent restenosis occurred in one patient (0.5%); major adverse cardiovascular and cerebrovascular events were reported in 22 patients (10.8%); cardiac death occurred in eight patients during follow-up. Conclusion: Percutaneous coronary intervention using RA followed by second- or third-generation DES implantation is feasible and safe with high procedural success and low in-stent restenosis in CKD patients with calcified coronary lesions.