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Deleting death and dialysis : conservative care of cardio-vascular risk and kidney function loss in chronic kidney disease (CKD)

(2018) TOXINS. 10(6).
Author
Organization
Abstract
The uremic syndrome, which is the clinical expression of chronic kidney disease (CKD), is a complex amalgam of accelerated aging and organ dysfunctions, whereby cardio-vascular disease plays a capital role. In this narrative review, we offer a summary of the current conservative (medical) treatment options for cardio-vascular and overall morbidity and mortality risk in CKD. Since the progression of CKD is also associated with a higher cardio-vascular risk, we summarize the interventions that may prevent the progression of CKD as well. We pay attention to established therapies, as well as to novel promising options. Approaches that have been considered are not limited to pharmacological approaches but take into account lifestyle measures and diet as well. We took as many randomized controlled hard endpoint outcome trials as possible into account, although observational studies and post hoc analyses were included where appropriate. We also considered health economic aspects. Based on this information, we constructed comprehensive tables summarizing the available therapeutic options and the number and kind of studies (controlled or not, contradictory outcomes or not) with regard to each approach. Our review underscores the scarcity of well-designed large controlled trials in CKD. Nevertheless, based on the controlled and observational data, a therapeutic algorithm can be developed for this complex and multifactorial condition. It is likely that interventions should be aimed at targeting several modifiable factors simultaneously.
Keywords
RANDOMIZED CONTROLLED-TRIAL, STAGE RENAL-DISEASE, ARYL-HYDROCARBON, RECEPTOR, BLOOD-PRESSURE CONTROL, TYPE-2 DIABETES-MELLITUS, PLACEBO-CONTROLLED TRIAL, ALL-CAUSE MORTALITY, RENIN-ANGIOTENSIN-SYSTEM, LOW-PROTEIN-DIET, INCIDENT HEMODIALYSIS-PATIENTS, chronic kidney disease, CKD, mortality, outcomes, uremia, medication, lifestyle, diet, prevention, cardiovascular disease

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Citation

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MLA
Vanholder, Raymond, et al. “Deleting Death and Dialysis : Conservative Care of Cardio-Vascular Risk and Kidney Function Loss in Chronic Kidney Disease (CKD).” TOXINS, vol. 10, no. 6, 2018, doi:10.3390/toxins10060237.
APA
Vanholder, R., Van Laecke, S., Glorieux, G., Verbeke, F., Castillo-Rodriguez, E., & Ortiz, A. (2018). Deleting death and dialysis : conservative care of cardio-vascular risk and kidney function loss in chronic kidney disease (CKD). TOXINS, 10(6). https://doi.org/10.3390/toxins10060237
Chicago author-date
Vanholder, Raymond, Steven Van Laecke, Griet Glorieux, Francis Verbeke, Esmeralda Castillo-Rodriguez, and Alberto Ortiz. 2018. “Deleting Death and Dialysis : Conservative Care of Cardio-Vascular Risk and Kidney Function Loss in Chronic Kidney Disease (CKD).” TOXINS 10 (6). https://doi.org/10.3390/toxins10060237.
Chicago author-date (all authors)
Vanholder, Raymond, Steven Van Laecke, Griet Glorieux, Francis Verbeke, Esmeralda Castillo-Rodriguez, and Alberto Ortiz. 2018. “Deleting Death and Dialysis : Conservative Care of Cardio-Vascular Risk and Kidney Function Loss in Chronic Kidney Disease (CKD).” TOXINS 10 (6). doi:10.3390/toxins10060237.
Vancouver
1.
Vanholder R, Van Laecke S, Glorieux G, Verbeke F, Castillo-Rodriguez E, Ortiz A. Deleting death and dialysis : conservative care of cardio-vascular risk and kidney function loss in chronic kidney disease (CKD). TOXINS. 2018;10(6).
IEEE
[1]
R. Vanholder, S. Van Laecke, G. Glorieux, F. Verbeke, E. Castillo-Rodriguez, and A. Ortiz, “Deleting death and dialysis : conservative care of cardio-vascular risk and kidney function loss in chronic kidney disease (CKD),” TOXINS, vol. 10, no. 6, 2018.
@article{8569333,
  abstract     = {{The uremic syndrome, which is the clinical expression of chronic kidney disease (CKD), is a complex amalgam of accelerated aging and organ dysfunctions, whereby cardio-vascular disease plays a capital role. In this narrative review, we offer a summary of the current conservative (medical) treatment options for cardio-vascular and overall morbidity and mortality risk in CKD. Since the progression of CKD is also associated with a higher cardio-vascular risk, we summarize the interventions that may prevent the progression of CKD as well. We pay attention to established therapies, as well as to novel promising options. Approaches that have been considered are not limited to pharmacological approaches but take into account lifestyle measures and diet as well. We took as many randomized controlled hard endpoint outcome trials as possible into account, although observational studies and post hoc analyses were included where appropriate. We also considered health economic aspects. Based on this information, we constructed comprehensive tables summarizing the available therapeutic options and the number and kind of studies (controlled or not, contradictory outcomes or not) with regard to each approach. Our review underscores the scarcity of well-designed large controlled trials in CKD. Nevertheless, based on the controlled and observational data, a therapeutic algorithm can be developed for this complex and multifactorial condition. It is likely that interventions should be aimed at targeting several modifiable factors simultaneously.}},
  articleno    = {{237}},
  author       = {{Vanholder, Raymond and Van Laecke, Steven and Glorieux, Griet and Verbeke, Francis and Castillo-Rodriguez, Esmeralda and Ortiz, Alberto}},
  issn         = {{2072-6651}},
  journal      = {{TOXINS}},
  keywords     = {{RANDOMIZED CONTROLLED-TRIAL,STAGE RENAL-DISEASE,ARYL-HYDROCARBON,RECEPTOR,BLOOD-PRESSURE CONTROL,TYPE-2 DIABETES-MELLITUS,PLACEBO-CONTROLLED TRIAL,ALL-CAUSE MORTALITY,RENIN-ANGIOTENSIN-SYSTEM,LOW-PROTEIN-DIET,INCIDENT HEMODIALYSIS-PATIENTS,chronic kidney disease,CKD,mortality,outcomes,uremia,medication,lifestyle,diet,prevention,cardiovascular disease}},
  language     = {{eng}},
  number       = {{6}},
  pages        = {{71}},
  title        = {{Deleting death and dialysis : conservative care of cardio-vascular risk and kidney function loss in chronic kidney disease (CKD)}},
  url          = {{http://doi.org/10.3390/toxins10060237}},
  volume       = {{10}},
  year         = {{2018}},
}

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