Brain, Stroke and Kidney , livre ebook

S. Karger AG

Découvre YouScribe en t'inscrivant gratuitement

Je m'inscris

Obtenez un accès à la bibliothèque pour le consulter en ligne
En savoir plus

118 pages

English

Vous pourrez modifier la taille du texte de cet ouvrage

Obtenez un accès à la bibliothèque pour le consulter en ligne
En savoir plus

A propos
Informations
Extrait

Description

Chronic kidney disease (CKD) is an established risk factor for cardiovascular diseases. Stroke, on the other hand, is not only a major player in cardiovascular disease, but it also has strong two-way relationships with CKD. Moreover, subclinical cerebral abnormalities are also associated with CKD. But despite all these connections, the cerebro-renal interaction has so far not received much attention. This book includes easily understandable reviews on brain, stroke and kidney by both experts in nephrology and neurology. Examined are underlying concepts for cerebro-renal interaction, risk of clinical and subclinical brain damage in CKD patients, primary prevention and acute/chronic management for stroke patients with CKD and end-stage kidney disease.This book promotes not only further understanding and a multidisciplinary collaboration between nephrologists and neurologists, but it is also of interest for neurosurgeons and cardiologists.

Informations

Publié par	S. Karger AG
Date de parution	02 mai 2013
Nombre de lectures	0
EAN13	9783318023527
Langue	English
Poids de l'ouvrage	1 Mo

Informations légales : prix de location à la page 0,0582€. Cette information est donnée uniquement à titre indicatif conformément à la législation en vigueur.

Extrait

Brain, Stroke and Kidney
Contributions to Nephrology
Vol. 179
Series Editor
Claudio Ronco Vicenza
Brain, Stroke and Kidney
Volume Editor
Kazunori Toyoda Osaka
21 figures and 20 tables, 2013
Contributions to Nephrology
(Founded 1975 by Geoffrey M. Berlyne)
___________________________
Kazunori Toyoda Department of Cerebrovascular Medicine National Cerebral and Cardiovascular Center 5-7-1 Fujishirodai, Suita Osaka, 565-8565 Japan
Library of Congress Cataloging-in-Publication Data
Brain, stroke, and kidney / volume editor, Kazunori Toyoda.
p.; cm. –– (Contributions to nephrology, ISSN 0302-5144; v. 179)
Includes bibliographical references and indexes.
ISBN 978-3-318-02351-0 (alk. paper) –– ISBN 978-3-318-02352-7 (e-ISBN)
I. Toyoda, Kazunori (Physician) II. Series: Contributions to nephrology; v. 179.0302-5144
[DNLM: 1. Stroke-physiopathology. 2. Kidney Diseases-complications. 3. Stroke-prevention & control. 4. Stroke-therapy. W1 C0778UN v.179 2013/ WL 356] RC388.5 616.8'1-dc23
2013008815
Bibliographic Indices. This publication is listed in bibliographic services, including Current Contents ® and Index Medicus.
Disclaimer. The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publisher and the editor(s). The appearance of advertisements in the book is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
Drug Dosage. The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any change in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
© Copyright 2013 by S. Karger AG, P.O. Box, CH-40009 Basel (Switzerland)
www.karger.com
Printed in Germany on acid-free and non-aging paper (ISO 9706) by Bosch Druck, Ergolding
ISSN 0302-5144
e-ISSN 1662-2782
ISBN 978-3-318-02351-0
e-ISBN 978-3-318-02352-7
Contents
Introduction
Cerebrorenal Interaction and Stroke
Toyoda, K. (Suita, Osaka)
Underlying Concepts for Cerebrorenal Interaction
Inhibition of the Renin-Angiotensin-Aldosterone System for Cerebrorenal Protection
Lambers Heerspink, H.J. (Groningen)
Obesity and Heart Failure as a Mediator of the Cerebrorenal Interaction
Jindal, A.; Whaley-Connell, A.; Sowers, J.R. (Columbia, Mo.)
Risk of Clinical and Subclinical Brain Damage in Kidney Disease
Subclinical Cerebral Abnormalities in Chronic Kidney Disease
Yao, H.; Takashima, Y.; Hashimoto, M. (Saga); Uchino, A. (Saitama); Yuzuriha, T. (Saga)
Carotid Atherosclerosis in Kidney Disease
Kokubo, Y. (Suita)
Kidney Disease and Cognitive Function
Elias, M.F.; Dore, G.A. (Orono, Me.); Davey, A. (Philadelphia, Pa.)
Risk of Stroke in Kidney Disease
Ninomiya, T. (Fukuoka)
Primary Prevention of Stroke in Kidney Disease
Role of 24-Hour Blood Pressure Management in Preventing Kidney Disease and Stroke
Nagai, M.; Hoshide, S.; Kario, K. (Tochigi)
Preventing Stroke and Systemic Embolism in Renal Patients with Atrial Fibrillation: Focus on Anticoagulation
Ahmad, Y.; Lip, G.Y.H. (Birmingham)
Management for Stroke in Kidney Disease
Stroke Features and Management in Patients with Chronic Kidney Disease
Kamouchi, M. (Fukuoka)
Stroke Feature and Management in Dialysis Patients
Iseki, K. (Okinawa)
Thrombolysis and Hyperacute Reperfusion Therapy for Stroke in Renal Patients
Hirano, J. (Yufu)
Antiplatelet Therapy for Preventing Stroke in Patients with Chronic Kidney Disease
Kim, S.J.; Bang, O.Y. (Seoul)
Author Index
Subject Index
Introduction
Toyoda K (ed): Brain, Stroke and Kidney. Contrib Nephrol. Basel, Karger, 2013, vol 179, pp 1-6 (DOI: 10.1159/000346944 )
______________________
Cerebrorenal Interaction and Stroke
Kazunori Toyoda
Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
______________________
Abstract
Beyond the original meaning of chronic kidney disease (CKD) as high-risk state for future dialysis, CKD is now known as an established risk factor for cardiovas cular diseases. Stroke is a major player of cardiovascular disease and has deep two-way relationships with CKD. CKD is an evident risk factor for stroke. Meta-analyses of cohort studies and trials indicate that proteinuria/albuminuria increases the risk of stroke by 71-92%, and reduced glomerular filtration rate increases the risk by 43%. In addition, CKD has a strong relationship with subclinical brain damage including white matter changes, microbleeds, cognitive impairment, and carotid atherosclerosis. CKD is prevalent in acute stroke patients; patients with estimated glomerular filtration rate <60 ml/min/1.73 m 2 or proteinuria amounted to 46% of total ischemic stroke patients and 39% of total intracerebral hemorrhage patients in our institute. Acute and chronic management of stroke are influenced by CKD. Therapeutic effects of several antithrombotic and thrombolytic agents, including recently-developed novel oral anticoagulants, are affected by renal function. Moreover, reduced glomerular filtration rate is independently associated with increased 1-and 10-year mortalities in the end. Stroke also has deep relationships with end-stage kidney disease. Stroke occurs much more commonly in dialysis patients than general population or CKD patients without need for dialysis. The triggers of ischemic and hemorrhagic stroke in patients with end-stage kidney disease include special characteristics unique to dialysis, such as drastic hemodynamic change, dialysate and anticoagulants, and vascular calcification. As cohorts of dialysis patients become older, more hypertensive, and more diabetic than before, stroke become more prevalent and more serious events in dialysis clinics. Now, clinicians should have much interest in the association between CKD and cerebrovascular diseases, so-called the cerebro-renal interaction.
Copyright © 2013 S. Karger AG, Basel
More than ten years have passed since the National Kidney Foundation in the United States first advocated the concept of chronic kidney disease (CKD) [ 1 ], and it is now seen as a major public health problem. According to the 2002 version of the guideline, the prevalence estimates of CKD in the United States (1999-2004) were as follows [ 1 ]: 1.8% (95% CI 1.4-2.3%) for stage 1 (estimated glomerular filtration rate (eGFR) >90 ml/min/1.73 m 2 and albuminuria); 3.2% (95% CI 2.6-3.9%) for stage 2 (GFR 60-89 ml/min/1.73 m 2 and albuminuria); 7.7% (95% CI 7.0-8.4%) for stage 3 (GFR 30-59 ml/min/1.73 m 2 ), and 0.35% (0.25-0.45%) for stage 4 (GFR 15-29 ml/min/1.73 m 2 ) [ 2 ]. Estimates were 2.7 ± 0.3, 3.2 ± 0.4, 4.2 ±0.1, and 0.2 ± 0.01%, respectively, in Norway (1995-1997) [ 3 ]; 7.4% (95% CI 6.9-7.8%), 4.7% (4.4-5.1%), 1.8% (1.5-2.0%), and none, respectively, in Beijing [ 4 ], and 0.6, 1.7, 10.4, and 0.2% (including CKD stage 5 without dialysis), respectively, in Japan (2005) [ 5 ] ( fig. 1 ). Thus, more than one tenth of the general population worldwide is estimated to have CKD, and its prevalence increases dramatically with age.

Fig. 1. The prevalence of eGFR <60 ml/min/1.73 m 2 or proteinuria in both the general population and stroke patients. Cited from refs. 2-5 and 12-14. Note that both eGFR and proteinuria in stroke patients were measured during the acute stage of stroke, and thereby might have been affected by stroke damage.
Beyond the original meaning of CKD as a high-risk state for future dialysis, CKD is now known to be an established risk factor for cardiovascular diseases. This message was clarified by the Kaiser Permanente Renal Registry involving more than one million adults [ 6 ]. An independent, graded association was observed between a reduced eGFR and the risk of death and cardiovascular events including stroke. Since then, many studies have proven the positive association of CKD with risk and outcomes of cardiovascular disease. The reason for the positive association is partly the high prevalence of traditional cardiovascular risk factors in CKD patients. In addition, nontraditional risk factors, including endothelial dysfunction, maladaptive arterial remodeling, homocysteinemia, coagulation disorders, impaired endothelial release of tissue plasminogen activator (t-PA), extravascular coagulation, anemia, and higher levels of inflammatory cytokines and oxidative stress, seem to increase the risk of cardiovascular disease. In 2008, a consensus conference on cardio-renal syndromes was held to identify and classify dysfunction of the heart and kidneys whereby