[Atrial fibrillation - what should be taken into account with chronic kidney disease and hemodialysis?].

CKD is a common comorbidity in patients with atrial fibrillation. The CHA2DS2-VASc score is not validated in patients with severe CKD and has a low predictive value in dialysis patients. As NOACs are partly eliminated by the kidneys the dosage has to be adapted in CKD.

Interactive exploration of adverse events and multimorbidity in CKD.

Background: Persons with chronic kidney disease (CKD) are at increased risk of adverse events, early mortality and multimorbidity. A detailed overview of adverse event types and rates from a large CKD cohort under regular nephrological care is missing. We generated an interactive tool to enable exploration of adverse events and their combinations in the prospective, observational German CKD (GCKD) study.

Increased levels of a mycophenolic acid metabolite in patients with kidney failure negatively affect cardiomyocyte health.

Chronic kidney disease (CKD) significantly increases cardiovascular risk and mortality, and the accumulation of uremic toxins in the circulation upon kidney failure contributes to this increased risk. We thus performed a screening for potential novel mediators of reduced cardiovascular health starting from dialysate obtained after hemodialysis of patients with CKD. The dialysate was gradually fractionated to increased purity using orthogonal chromatography steps, with each fraction screened for a potential negative impact on the metabolic activity of cardiomyocytes using a high-throughput MTT-assay, until ultimately a highly purified fraction with strong effects on cardiomyocyte health was retained.

The German Lipoprotein Apheresis Registry-Summary of the ninth annual report.

During 2012-2020, 89 German apheresis centers collected retrospective and prospective observational data of 2028 patients undergoing regular lipoprotein apheresis (LA) for the German Lipoprotein Apheresis Registry (GLAR). More than 47 500 LA sessions are documented in GLAR. In 2020, all patients treated with LA showed a high immediate median reduction rate of LDL-C (68.

Educational Attainment Is Associated With Kidney and Cardiovascular Outcomes in the German CKD (GCKD) Cohort.

Introduction: Prospective data on impact of educational attainment on prognosis in patients with chronic kidney disease (CKD) are scarce. We investigated the association between educational attainment and all-cause mortality, major adverse cardiovascular (CV) events (MACEs), kidney failure requiring dialysis, and CKD etiology.

Methods: Participants ( = 5095, aged 18-74 years) of the ongoing multicenter German Chronic Kidney Disease (GCKD) cohort, enrolled on the basis of an estimated glomerular filtration rate (eGFR) of 30 to 60 ml/min (stages G3, A1-A3) or overt proteinuria (stages G1-G2, A3), were divided into 3 categories according to their educational attainment and were followed for 6.

Speckle-tracking echocardiography in comparison with ejection fraction for prediction of cardiovascular mortality in patients with end-stage renal disease.

Background: Cardiovascular disease is the major cause of death in end-stage renal disease (ESRD). To develop better means to assess cardiovascular risk in these patients, we compared conventional echocardiography-derived left ventricular ejection fraction (EF) with the novel method of 2D speckle-tracking echocardiography to determine cardiac strain.

Methods: Predictive performances of conventional EF and speckle-tracking echocardiography-derived global longitudinal strain (GLS) were compared using receiver-operator curve (ROC) analyses and calibration by calibration plots.

Cardiovascular evaluation in advanced chronic kidney disease.

Patients with chronic kidney disease (CKD) display an increased cardiovascular comorbidity, which is often underdiagnosed. Thus, effective cardiovascular diagnostic testing is of particular importance for this group of patients. Data from prospective randomized trials with cardiovascular diagnostic testing in CKD patients and improved outcome are limited.

[Contrast medium-induced acute kidney injury-Consensus paper of the working group "Heart and Kidney" of the German Cardiac Society and the German Society of Nephrology].

This consensus paper summarizes the expert consensus and recommendations of the working group "Heart and Kidney" of the German Cardiac Society (DGK) and the German Society of Nephrology (DGfN) on contrast medium-induced acute kidney injury. Potentially nephrotoxic contrast agents containing iodine are frequently used in interventional medicine and for computer tomography diagnostics. Acute kidney injury occurs in approximately 8-17% of patients exposed to contrast media.

[Cardiovascular diagnostic testing in advanced chronic kidney disease: which tests are useful?].

Against the background of drastically increased cardiovascular comorbidity in patients with chronic kidney disease (CKD), an effective cardiovascular diagnostic approach appears essential. However, patients with CKD are often underdiagnosed. Prospective randomized studies showing an improved outcome for cardiovascular diagnostic in patients with CKD are limited.

Trends of renal diseases in Germany: review of a regional renal biopsy database from 1990 to 2013.

Background: Several renal biopsy registries in Europe have shown geographical and temporal variations in the patterns of renal diseases. However, there is a lack of current data on trends of renal disease in Central Europe.

Methods: After exclusion of transplant and re-biopsies, the renal biopsy registry of the German RWTH Aachen University Hospital included data of 1208 biopsies over a period of 24 years (1990-2013).

Association Between Dietary Patterns and Kidney Function in Patients With Chronic Kidney Disease: A Cross-Sectional Analysis of the German Chronic Kidney Disease Study.

Objective: In the general population, "healthy" dietary patterns are associated with improved health outcomes, but data on associations between observance of specific dietary patterns and kidney function in patients with chronic kidney disease (CKD) are sparse.

Methods: Dietary intake was evaluated using food frequency questionnaires in patients with moderately severe CKD under nephrology care enrolled into the observational multicenter German CKD study. The Dietary Approaches to Stop Hypertension (DASH) diet score, Mediterranean diet score, and German Food Pyramid Index (GFPI) were calculated and their association with estimated glomerular filtration rate (eGFR) and albuminuria was assessed by multivariable linear regression analysis, adjusted for gender, age, body mass index, energy intake, smoking status, alcohol intake, education, high-density lipoprotein-cholesterol (HDL- cholesterol), low-density lipoprotein-cholesterol (LDL-cholesterol), hypertension, and diabetes mellitus.

Erratum: Trends of renal diseases in Germany: review of a regional renal biopsy database from 1990 to 2013.

[This corrects the article DOI: 10.1093/ckj/sfz023.][This corrects the article DOI: 10.

Patterns of medication use and the burden of polypharmacy in patients with chronic kidney disease: the German Chronic Kidney Disease study.

Background: Patients with chronic kidney disease (CKD) bear a substantial burden of comorbidities leading to the prescription of multiple drugs and a risk of polypharmacy. However, data on medication use in this population are scarce.

Methods: A total of 5217 adults with an estimated glomerular filtration rate (eGFR) between 30 and 60 mL/min/1.

Monitoring transcellular fluid shifts during episodes of intradialytic hypotension using bioimpedance spectroscopy.

Background: Transcellular fluid shifts during dialysis treatment could be related to the frequency and severity of intradialytic hypotension (IDH). We investigated that (i) in addition to ultrafiltration, extracellular fluid (ECF) is further depleted by transcellular fluid shifts and (ii) changes in intracellular fluid (ICF), which have been overlooked so far, or if they were considered, are not understood, might be due to these fluid shifts.

Methods: Thirty-six patients were categorized as haemodynamically stable, asymptomatic IDH or unstable (symptomatic IDH) according to their changes in systolic blood pressure and associated clinical symptoms.

Knee-to-knee Bioimpedance Measurements to Monitor Changes in Extracellular Fluid in Haemodynamic-unstable Patients During Dialysis.

The feasibility of bioimpedance spectroscopy (BIS) techniques for monitoring intradialytic changes in body fluids is advancing. The aim of this study was to compare the knee-to-knee (kkBIS) with the traditional whole-body (whBIS) with respect to continuous assessment of fluid volume status in hemodialysis patients. Twenty patients divided into two groups, hemodynamically stable and unstable, were recruited.

Speckle Tracking Echocardiography and All-Cause and Cardiovascular Mortality Risk in Chronic Kidney Disease Patients.

Background And Objectives: Patients with chronic kidney disease (CKD) exhibit a highly increased risk of cardiovascular (CV) morbidity and mortality. Subtle changes in left ventricular function can be detected by two-dimensional (2D) speckle tracking echocardiography (STE). This study investigated whether myocardial dysfunction detected by 2D STE may aid in CV and all-cause mortality risk assessment in patients with CKD stages 3 and 4.

Non-invasive evaluation of coronary heart disease in patients with chronic kidney disease using photoplethysmography.

Background: Chronic kidney disease (CKD) patients have an increased risk for coronary artery disease (CAD) and myocardial infarction. Therefore, there is a need to identify CKD patients at high risk of CAD. Coronary angiography, the gold standard for detecting CAD, carries a risk of serious adverse events.

Strategies for Improving Influenza Vaccination Rates in Patients with Chronic Renal Disease.

Background: The influenza vaccination rate among older and chronically ill patients in Germany has declined in the past decade in spite of vaccination campaigns.

Methods: The influenza vaccination rate among persons with chronic renal disease was studied with the aid of billing data from various Associations of Statutory Health Insurance Physicians (Kassenärztliche Vereinigungen, ASHIPs) in Germany. It was tested in a randomized controlled trial whether a written vaccination appeal, sent by physicians to patients, led to an increase in the vaccination rate.

Evaluation of Electrocardiographic Parameters Predicting Cardiovascular Events in Patients with End-Stage Renal Disease before and after Transplantation.

Background And Objectives: Cardiovascular (CV) mortality represents the leading cause of death in patients with end-stage renal disease (ESRD). Efficient screening is required to detect CV disease at an early stage, but the best diagnostic work-up is uncertain. The aim of this study was to identify electrocardiographic parameters in dialysis patients associated with an increased frequency of CV events.

Epicardial fat, cardiovascular risk factors and calcifications in patients with chronic kidney disease.

Background: Epicardial adipose tissue (EAT) exerts cardiopathogenic effects, but the independent association between EAT and cardiovascular (CV) calcification in patients with chronic kidney disease (CKD) remains controversial. We therefore assessed the association between EAT, CV risk factors and CV calcifications.

Methods: 257 patients with CKD Stage 3 and/or overt proteinuria underwent quantification of EAT, coronary artery calcification and aortic valve calcification by computed tomography.

Left Ventricular Structure in Patients With Mild-to-Moderate CKD-a Magnetic Resonance Imaging Study.

Introduction: The high burden of left ventricular (LV) abnormalities in patients with advanced chronic kidney disease (CKD) is well established. However, less is known about the prevalence, patterns, and determinants of LV abnormalities in patients with early CKD.

Methods: We examined LV structure in 290 patients with a median estimated glomerular filtration rate (eGFR) of 51 ml/min per 1.