Publications by authors named "Sarafidis P"
Introduction Physical inactivity is common in chronic kidney disease (CKD) patients; several patient- and disease-related factors are linked to a sedentary lifestyle, but social and environmental influences remain unexplored. This study evaluates the level of physical activity in patients with CKD and investigates the associations with caregivers' physical activity levels, characteristics of the residential environment, and objective measures of exercise capacity. Methods Eighty CKD patients (20 per CKD stage 2-4) were included; patients and their carers filled out the International Physical Activity Questionnaire (IPAQ), questionnaires about residential environment and past exercise habits.
View Article and Find Full Text PDFBackground: Adults with congenital heart disease (ACHD) can face a lifelong risk of premature cardiovascular events. Endothelial dysfunction and arterial stiffness may be some of the key mechanisms involved. Early identification of endothelial damage in ACHD could be crucial to mitigate the adverse events.
View Article and Find Full Text PDFArticle Synopsis
- Kidney diseases are linked to aging and the effects of decreased estrogen due to ovarian senescence, leading to reduced kidney function and increased cardiometabolic risks that can result in chronic kidney disease (CKD).
- CKD can negatively impact ovarian function in women during their reproductive years.
- An individualized menopause management approach for women with CKD includes hormone therapy based on personal preferences and cardiovascular risks, lifestyle modifications, regular monitoring, and tailored guidance for those with additional health issues.
Purpose Of Review: To summarize the current evidence regarding epidemiology, clinical pathophysiology, and latest therapeutic approaches for the management of intradialytic hypertension (IDH).
Recent Findings: IDH is a rather common complication of dialysis, affecting 10-15% of the patient population and significantly increasing the cardiovascular risk. Its pathophysiology involves multiple mechanisms, including volume and sodium overload, sympathetic nervous system (SNS) and renin-angiotensin-aldosterone system (RAAS) overactivity, endothelial dysfunction, and arterial stiffness.
Until recently, major bodies producing guidelines for the management of hypertension in patients with chronic kidney disease (CKD) disagreed in some key issues. In June 2023, the European Society of Hypertension (ESH) published the new 2023 ESH Guidelines for the management of arterial hypertension a document that was endorsed by the European Renal Association. Several novel recommendations relevant to the management of hypertension in patients with CKD appeared in these guidelines, which have been updated to reflect the latest evidence-based practices in managing hypertension in CKD patients.
View Article and Find Full Text PDFPurpose: Heart failure (HF) and atrial fibrillation (AF) are highly prevalent in hemodialysis. They are well-known significant modifiers of the disease associations with cardiovascular outcomes, but there is a lack of evidence regarding the effects of HF and AF on cardiorespiratory fitness. This study is the first to examine the possible association of the presence of HF and AF with exercise intolerance in patients undergoing hemodialysis.
View Article and Find Full Text PDFArticle Synopsis
- Sodium-glucose co-transporter-2 inhibitors (SGLT2is) were found to significantly lower cardiovascular and all-cause mortality in people with chronic kidney disease (CKD) based on a systematic review of 11 studies involving over 83,000 participants.
- These medications reduced the risk of cardiovascular death by 14%, all-cause death by 15%, and major adverse cardiac events (MACE) by 13%, showing consistent effects across different levels of kidney function and risk categories.
- The findings suggest that SGLT2is could be beneficial for CKD patients, regardless of their baseline kidney function or cardiovascular risk level, highlighting their potential in improving health outcomes in this population.
Left ventricular (LV) thrombus formation remains a post-acute myocardial infarction (AMI) complication even in the modern era of early reperfusion. The optimal anticoagulation regimen in this clinical scenario is poorly defined. The present meta-analysis sought to investigate the efficacy and safety profile of direct oral anticoagulants (DOACs) compared with vitamin K antagonists (VKAs) for the management of LV thrombus after AMI.
View Article and Find Full Text PDFArticle Synopsis
- Male patients with pre-dialysis chronic kidney disease (CKD) show worse blood pressure control and higher mortality compared to females, a trend that continues in hemodialysis patients with men generally exhibiting higher blood pressure levels.
- A study involving 129 male and 91 female hemodialysis patients revealed that women had a lower cumulative freedom from cardiovascular mortality, though the overall event risk between genders was not significantly different after adjusting for factors like age and diabetes.
- Ultimately, while crude mortality rates appeared higher in women, after accounting for key risk factors, both male and female hemodialysis patients have similar adjusted cardiovascular mortality rates, contrasting with the more pronounced gender differences seen in pre-dialysis CKD.
Article Synopsis
- Frequent hemodialysis (more than three times a week) may lower mortality and improve quality of life for kidney failure patients, but the evidence is not clear.
- A systematic review of available studies found only seven eligible trials with a total of 518 participants, indicating limited data on the health effects of frequent hemodialysis.
- The analysis suggested a possibly lower risk of death with frequent hemodialysis, but results were uncertain, and important outcomes like cardiovascular events and patient-reported well-being were largely missing.
Article Synopsis
- Increased blood pressure variability (BPV) in hemodialysis patients is linked to higher cardiovascular risks, particularly in those with intradialytic hypertension (IDH).
- A study tested the effects of low (137 mEq/L) versus standard (140 mEq/L) dialysate sodium concentrations on BPV among 29 IDH patients through a crossover design.
- Results showed that while mean blood pressure was lower with low sodium, BPV levels did not significantly differ between the two sodium concentrations, suggesting the need for further research into different interventions for managing BP and BPV in these patients.
Article Synopsis
- - The study investigates how different levels of sodium in dialysate affect blood pressure (BP) in patients undergoing hemodialysis, as hypertension is linked to serious health issues in these patients.
- - Results indicate that increasing dialysate sodium concentrations led to a significant rise in both systolic and diastolic BP over a 72-hour period in the patients monitored.
- - The findings suggest that using lower dialysate sodium concentrations could potentially help maintain better blood pressure control in hemodialysis patients.
Background: Increased aortic blood pressure (BP) and arterial stiffness are associated with higher cardiovascular risk in hemodialysis. Previous works showed that lower dialysate sodium is associated with lower brachial-BP; data on aortic-BP and arterial stiffness are limited. This study aimed to investigate the effects of different dialysate sodium concentrations on 72-hour aortic-BP and arterial stiffness parameters in hemodialysis patients.
View Article and Find Full Text PDFBackground: In acute heart failure (HF), low cardiac output and venous congestion are pathophysiological mechanisms that contribute to renal function impairment. This study investigated the association between advanced echocardiographic measures of right ventricular and atrial function and renal impairment in patients with acute HF.
Methods And Results: A total of 377 patients hospitalized for acute HF were prospectively evaluated.
Background: Risk prediction in haemodialysis (HD) patients is challenging due to the impact of the dialysis regime on the patient's volume status and the complex interplay with cardiac function, comorbidities and hypertension. Cardiac function as a key predictor of cardiovascular (CV) mortality in HD patients is challenging to assess in daily routine. Thus the aim of this study was to investigate the association of a novel, non-invasive relative index of systolic function with mortality and to assess its interplay with volume removal.
View Article and Find Full Text PDFArticle Synopsis
- Early diagnosis of chronic kidney disease (CKD) is crucial, as even patients with a normal albumin-to-creatinine ratio (ACR) show increased health risks, indicating the need for better assessment tools.
- This study focuses on identifying glycoproteins linked to kidney damage in patients with high-normal ACR using mass spectrometry, revealing significant differences between these patients and those with lower ACR.
- Findings show that certain glycoproteins, particularly related to iron metabolism, could be early indicators of CKD progression, with implications for both male and female patients.
Background: The study aimed to determine the most crucial parameters associated with CVD and employ a novel data ensemble refinement procedure to uncover the optimal pattern of these parameters that can result in a high prediction accuracy.
Methods And Results: Data were collected from 369 patients in total, 281 patients with CVD or at risk of developing it, compared to 88 otherwise healthy individuals. Within the group of 281 CVD or at-risk patients, 53 were diagnosed with coronary artery disease (CAD), 16 with end-stage renal disease, 47 newly diagnosed with diabetes mellitus 2 and 92 with chronic inflammatory disorders (21 rheumatoid arthritis, 41 psoriasis, 30 angiitis).
Objective Real-life management of patients with hypertension and chronic kidney disease (CKD) among European Society of Hypertension Excellence Centres (ESH-ECs) is unclear : we aimed to investigate it. Methods A survey was conducted in 2023. The questionnaire contained 64 questions asking ESH-ECs representatives to estimate how patients with CKD are managed.
View Article and Find Full Text PDFArticle Synopsis
- Finerenone, a non-steroidal mineralocorticoid receptor antagonist, showed promise in improving kidney and cardiovascular health in patients with chronic kidney disease (CKD) and type 2 diabetes, leading to the FIND-CKD study examining its effects in non-diabetic patients with CKD.
- The FIND-CKD trial is a Phase 3, randomized, double-blind study involving adults with specific eGFR and urinary albumin-creatinine ratio criteria, focused on the efficacy of finerenone versus a placebo over 32 months.
- The trial screened over 3,200 patients, with 1,584 participating; the majority had chronic glomerulonephritis or hypertensive nephrop
Article Synopsis
- The study aimed to assess the impact of the COVID-19 pandemic on hypertension awareness and treatment in Greece, analyzing data collected in 2019 and 2022 during the May Measurement Month (MMM) initiative.
- Data from over 12,000 adults revealed consistent hypertension prevalence rates (around 41-43%) before and after the pandemic, but an increase in undiagnosed cases was observed, rising from 21.3% to 27.5%.
- The findings suggest that while the overall prevalence of hypertension remained stable, there is a pressing need for improved national strategies to detect and manage hypertension effectively in Greece, especially post-pandemic.
Article Synopsis
- - A 2023 survey by the European Society of Hypertension assessed the management of chronic kidney disease (CKD) patients with hypertension across 88 centers in 27 countries, finding that only 28% had preexisting CKD, and 30% exhibited resistant hypertension.
- - The survey indicated inconsistent rates of recent kidney function tests and varying usage of important medications, showing higher rates of certain drugs when nephrologists were involved in the care team.
- - Overall, the study highlighted significant gaps in CKD screening and treatment prior to referral for specialized care, suggesting that tailored initiatives could enhance management for patients with hypertension and CKD.