Diabetic kidney disease and the cardiorenal syndrome: old disease, new perspectives.

In this article, the literature is reviewed regarding the role of blood pressure variability and nocturnal nondipping of blood pressure as well as the presence of diabetic kidney disease (DKD), in the absence of albuminuria, as risk predictors for progressive DKD. The importance of glycemic and blood pressure control in patients with diabetes and chronic kidney disease, and the use of oral hypoglycemic agents and antihypertensive agents in this patient cohort, are also discussed.

Lithium-associated hyperthyroidism.

Goiters and hypothyroidism are well-known patient complications of the use of lithium for treatment of bipolar disease. However, the occurrence of lithium-induced hyperthyroidism is a more rare event. Many times, the condition can be confused with a flare of mania.

DPP-4 Inhibitors as Therapeutic Modulators of Immune Cell Function and Associated Cardiovascular and Renal Insulin Resistance in Obesity and Diabetes.

The prevalence of obesity and diabetes continues to rise in the United States and worldwide. These findings parallel the expansion of childhood obesity and diabetes. Obesity is a central component of the cardiorenal metabolic syndrome (CRS) which increases the risk for cardiovascular disease (CVD) and chronic kidney disease (CKD).

Evidence-based hypertension treatment in patients with diabetes.

Both impaired glucose tolerance and diabetes are associated with substantially increased prevalence of hypertension, cardiovascular and renal disease. The goal for hypertension treatment in diabetic patients is in evolution, because of recent clinical trials. For example, the results of the recent Action to Control Cardiovascular Risk in Diabetes-BP Arm (ACCORD BP) trial failed to show an additional benefit on cardiovascular event reduction at a mean systolic BP of 119 mm Hg.

Preventing and treating the accelerated ageing of obesity.

Advances in the molecular biology of ageing, insulin resistance, inflammation, carcinogenesis and caloric restriction have elucidated commonalities relevant to the chronic overnutrition syndrome termed obesity. Not until the expanded acceptance and availability of surgical treatment of obesity ("bariatric surgery") has it been possible to explore the beneficial effects of sustained voluntary weight loss through controlled undernutrition in freely living people. Bariatric surgery is 58 years old and has undergone dramatic improvements recently becoming significantly safer and more accessible owing to the development of minimally invasive approaches and other advances.

Active ghrelin levels and active to total ghrelin ratio in cancer-induced cachexia.

Anorexia and weight loss are negative prognostic factors in patients with cancer. Although total ghrelin levels are increased in energy-negative states, levels of the biologically active octanoylated ghrelin and the anorexigenic peptide YY (PYY) have not been reported in patients with cancer-induced cachexia. We hypothesized that abnormal ghrelin and/or PYY levels contribute to cancer-induced cachexia.