Glycemic control and dementia risk in patients aged above and below 75 years.

Background: There is a lack of data about the treatment effect of glycemic control on incident dementia in patients with advanced age.

Methods: In a nationwide Korean cohort of 79,076 diabetic patients 75 years or older and a representative cohort of 74,672 diabetics aged 50 to 74 years, multivariable-adjusted incidence of overt dementia was estimated across yearly-averaged on-treatment fasting blood glucose (FBG) levels.

Results: During 9-year follow-up, overt dementia was noted in 24,710 (31.

Blood pressure control in patients aged above and below 75 years.

It remains unclear what the blood pressure target is and at which point in life it is appropriate for antihypertensive treatment. This study aimed to determine age-specific systolic blood pressure (SBP) targets. In a nationwide cohort of 296,470 hypertensive patients aged ≥75 years and a representative cohort of 259,028 hypertensives aged 45-74 years, multivariable-adjusted incidence rates of cardio-kidney composite events, overt dementia, and all-cause deaths were estimated across yearly-averaged on-treatment SBP levels according to age and the presence of 4 additional risk factors (diabetes, dyslipidemia, albuminuria, and smoking).

Albuminuria, estimated glomerular filtration rate, and traditional predictors for composite cardiovascular and kidney outcome: a population-based cohort study in Korea.

Background: Certain pharmacotherapies have shown to be effective for both cardiac and kidney outcomes. Although risk prediction is important in treatment decision-making, few studies have evaluated prediction models for composite cardiovascular and kidney outcomes.

Methods: This study included 2,195,341 Korean adults from a nationwide cohort for chronic kidney disease and a representative sample of the general population, with a 9-year follow-up.

Hypertension Management in Patients with Chronic Kidney Disease in the Post-SPRINT Era.

The management of high blood pressure (BP) is crucial for improving outcomes in patients with chronic kidney disease (CKD). The updated Kidney Disease: Improving Global Outcomes 2021 BP guideline proposes treating adults with CKD to a target systolic BP (SBP) of <120 mmHg based on the standardized office BP measurement. This suggestion is largely based on the finding of SPRINT (Systolic Blood Pressure Intervention Trial) that targeting an SBP of <120 mmHg versus <140 mmHg is beneficial for cardiovascular and mortality outcomes, regardless of the patient's kidney disease status.

SGLT2 Inhibitors and Kidney and Cardiac Outcomes According to Estimated GFR and Albuminuria Levels: A Meta-analysis of Randomized Controlled Trials.

Rationale & Objective: There are few data on the absolute effects of sodium/glucose cotransporter 2 (SGLT2) inhibitors, despite their importance in treatment decision making. We investigated absolute treatment effects according to baseline kidney disease status.

Study Design: Meta-analysis.

Evaluation of Serum Glucose and Kidney Disease Progression Among Patients With Diabetes.

Importance: The appropriate target of glycemic control in diabetic kidney disease is unclear.

Objective: To investigate optimal on-treatment glycemic levels associated with slowing of diabetic kidney disease progression.

Design, Setting, And Participants: This retrospective cohort study was conducted using nationwide Korean cohorts from the National Health Information Database from 2005 to 2019.

On-treatment blood pressure and long-term outcomes in chronic kidney disease.

Background: The treatment blood pressure (BP) target in chronic kidney disease (CKD) remains unclear, and whether the benefit of intensive BP-lowering is comparable between CKD and non-CKD patients is debated.

Methods: Using the Korean National Health Information Database, 359 492 CKD patients who had received antihypertensives regularly were identified from 12.1 million participants of nationwide health screening.

Statin use and outcome risks according to predicted CVD risk in Korea: A retrospective cohort study.

Background: The validity of cardiovascular disease (CVD) risk calculators in decision for statin therapy has not been fully evaluated at a population level. This study aimed to examine the net benefits of statins according to predicted CVD risk.

Methods And Findings: A cohort of 40 to 79-year-old Korean adults without CVD was generated from the National Health Information Database 2006-2017.

Optimal fasting glucose levels with regard to cardiovascular and mortality outcomes in people treated with or without antidiabetic medication.

Aims: To investigate the optimal fasting blood glucose (FBG) levels among individuals actively treated or untreated with antidiabetic drugs.

Methods: In two population-based cohorts of Korean adults extracted from the National Health Information Database, multivariable-adjusted hazard ratios of outcomes over 10 and 8 years of follow-up were estimated according to achieved FBG levels and antidiabetic drug use. The primary outcomes were major cardiovascular disease (CVD) events and all-cause mortality.

Association of Optimal Blood Pressure With Critical Cardiorenal Events and Mortality in High-Risk and Low-Risk Patients Treated With Antihypertension Medications.

Importance: There are few studies comparing the optimal level of treated blood pressure (BP) between high- and low-risk patients.

Objective: To examine whether optimally treated BP is different according to risk status.

Design, Setting, And Participants: Population-based cohort study using data from the National Health Information Database in Korea from 2002 to 2015 and 2006 to 2017.

Blood Pressure-Related Risk Among Users Versus Nonusers of Antihypertensives: A Population-Based Cohort in Korea.

There have been few studies comparing blood pressure (BP)-related outcomes between users and nonusers of antihypertensive drugs. We constructed a population-based cohort of 492 540 Koreans aged 40 to 79 years, who had no preexisting cardiorenal diseases, from the National Health Insurance Service-Health Screening database. The primary composite outcome was death (or critical care unit admission) from cardiorenal causes, revascularization for myocardial infarction or stroke, and new-onset end-stage renal disease.

Incidence of diabetes and its mortality according to body mass index in South Koreans aged 40-79 years.

Purpose: The purpose of this study was to assess diabetes incidence and all-cause mortality according to baseline body mass index (BMI) and to compare relative risks of mortality associated with incident diabetes across various BMI classes in a cohort of South Korean adults.

Patients And Methods: Based on data from the National Health Insurance database of Korean individuals aged 40-79 years without preexisting diabetes, we calculated BMI at the baseline health examination. We estimated the relative risk of mortality associated with incident diabetes using time-dependent Cox models and considering the time of diabetes diagnosis.

Estimation of years lived with disability due to noncommunicable diseases and injuries using a population-representative survey.

The Global Burden of Disease 2010 and the WHO Global Health Estimates of years lived with disability (YLDs) uses disability-weights obtained from lay health-state descriptions, which cannot fully reflect different disease manifestations, according to severity, treatment, and environment. The aim of this study was to provide population-representative YLDs of noncommunicable diseases and injuries using a prevalence-based approach, with the disability weight measured in subjects with specific diseases or injuries. We included a total of 44969 adults, who completed the EQ-5D questionnaire as participation in the Korea National Health and Nutrition Examination Survey 2007-2014.

Comparison of urine dipstick and albumin:creatinine ratio for chronic kidney disease screening: A population-based study.

Chronic kidney disease (CKD) is usually diagnosed using the estimated glomerular filtration rate (eGFR) or kidney damage markers. The urine dipstick test is a widely used screening tool for albuminuria, a CKD marker. Although the urine albumin:creatinine ratio (ACR) has advantages over the dipstick test in sensitivity and quantification of levels, the two methods have not been compared in the general population.

Prevalence of Chronic Kidney Disease in Korea: the Korean National Health and Nutritional Examination Survey 2011-2013.

Chronic kidney disease is a leading public health problem related to poor quality of life and premature death. As a resource for evidence-informed health policy-making, we evaluated the prevalence of chronic kidney disease using the data of non-institutionalized adults aged ≥ 20 years (n = 15,319) from the Korean National Health and Nutrition Examination Survey in 2011-2013. Chronic kidney disease was defined as a urine albumin-to-creatinine ratio ≥ 30 mg/g or an estimated glomerular filtration rate < 60 mL/min/1.

CKD and Health-Related Quality of Life: The Korea National Health and Nutrition Examination Survey.

Background: Quality of life is increasingly viewed as an important health outcome. However, the association of chronic kidney disease (CKD) and its severity with health-related quality of life is uncertain.

Study Design: Nationwide population-based cross-sectional study.

Acute serum sodium concentration changes in pediatric patients undergoing cardiopulmonary bypass and the association with postoperative outcomes.

The objective of this study is to investigate the degree of serum sodium changes and its association with patient outcomes in pediatrics undergoing heart surgery with cardiopulmonary bypass (CPB). We reviewed the medical records of 275 pediatric patients who underwent heart surgery with CPB. Prior to CPB, hyponatremia (≤135 mmol/L) was observed in 21 of 275 patients.

Effects of Renal Replacement Therapy in Patients Receiving Extracorporeal Membrane Oxygenation: A Meta-Analysis.

The use of renal replacement therapy (RRT) in patients receiving extracorporeal membrane oxygenation (ECMO) is increasing, but the effect of RRT on ECMO is controversial. We performed a meta-analysis to determine whether RRT is related to higher mortality in patients receiving ECMO. We searched MEDLINE, EMBASE, the Cochrane Library, and KoreaMed and found 43 observational studies with 21,624 patients receiving ECMO and then compared inpatient mortality rates of patients receiving ECMO both with and without RRT.

Nocturnal hypoxemia and periodic limb movement predict mortality in patients on maintenance hemodialysis.

Background And Objectives: Sleep disorders, including sleep-disordered breathing and periodic limb movements during sleep, are associated with an increased risk for cardiovascular diseases, which are the leading causes of death in patients with ESRD. This study investigated the association between sleep disorders and mortality in patients with ESRD.

Design, Setting, Participants, & Measurements: Thirty patients on maintenance hemodialysis, who were clinically stable for >2 months, underwent overnight polysomnography to evaluate sleep parameters.

Nocturnal sleep related with metabolic markers in end-stage renal disease patients receiving hemodialysis.

Objective: It has been suggested that oxidative stress and inflammation are associated with the pathophysiology of sleep disorders in end-stage renal disease (ESRD) patients. We examined the relationship of the sleep variables reflecting sleep breathing disorder and limb movements during sleep with the clinical variables reflecting the metabolic abnormalities in ESRD patients receiving hemodialysis.

Methods: Nocturnal polysomnography was conducted in 30 ESRD patients (21 men, 9 women), who were receiving hemodialysis.

Improvement of sleep-related breathing disorder in patients with end-stage renal disease after kidney transplantation.

Sleep-related breathing disorder (SRBD) is a common symptom of end-stage renal disease (ESRD). The aim of this study was to determine whether kidney transplantation improves SRBD. Twenty-four patients with ESRD, who were admitted for kidney transplantation, underwent a sleep study using a portable ventilation effort recorder on the night before transplantation.

Inability of volatile anesthetics to inhibit oxygen-glucose deprivation-induced glutamate release via glutamate transporters and anion channels in rat corticostriatal slices.

Ischemia-induced extracellular glutamate accumulation and the subsequent excitotoxicity contribute significantly to ischemic brain injury. Volatile anesthetics have been shown to reduce ischemic brain injury. Here, we showed that oxygen-glucose deprivation (OGD, to simulate ischemia in vitro) increased extracellular glutamate accumulation in the corticostriatal slices of adult rats.

Postconditioning with isoflurane reduced ischemia-induced brain injury in rats.

Background: Preexposure of brain to isoflurane, a commonly used anesthetic, induces ischemic tolerance. This phenomenon is called isoflurane preconditioning. However, it is not known whether isoflurane application after ischemia provides neuroprotection.

Pretreatment with volatile anesthetics, but not with the nonimmobilizer 1,2-dichlorohexafluorocyclobutane, reduced cell injury in rat cerebellar slices after an in vitro simulated ischemia.

A prior exposure to the volatile anesthetic isoflurane has been shown to induce neuroprotection in rats. This phenomenon is called preconditioning. We designed this study to determine whether the potency of volatile anesthetics in inducing neuropreconditioning is related to their potency to induce anesthesia.

Inflammation, mineral metabolism and progressive coronary artery calcification in patients on haemodialysis.

Background: Coronary artery calcification (CAC) is an extensive and common complication in patients with end-stage renal disease (ESRD). The aim of this study was to assess prospectively the change in CAC over a 2-year period and to identify the factors that may be associated with CAC progression in ESRD patients.

Methods: The final analysis was performed on 40 of 43 stable haemodialysis patients who initially entered into the study.