Subclinical Primary Aldosteronism and Major Adverse Cardiovascular Events: A Longitudinal Population-Based Cohort Study.

Background: Primary aldosteronism (PA), an overt form of renin-independent aldosterone production, leads to a disproportionately high rate of major adverse cardiovascular events (MACEs). Mounting evidence suggests that milder forms of renin-independent aldosterone production (subclinical PA) are highly prevalent; however, the link between subclinical PA and MACE remains uncertain.

Methods: This prospective study included 2017 Canadian adults 40 to 69 years of age from the randomly sampled, population-based CARTaGENE cohort (Québec, Canada), in which aldosterone and renin concentrations at enrollment (2009-2010) were measured.

A Comparison of Hospitalization Outcomes Between Peritoneal Dialysis and Home Hemodialysis Patients by Sex and Race.

Introduction: As interest in home dialysis as an initial dialysis modality grows, it remains unclear how the different home dialysis modalities may impact hospitalization outcomes, or how this relationship may change depending on patient sex and race.

Methods: We compared all-cause hospitalization rates and days in hospital between incident peritoneal dialysis (PD, = 14,643) and home hemodialysis (HHD patients, = 875) between January 2005 and December 2018 (last follow-up was in July 2020) using a nationally representative cohort of incident dialysis patients.

Results: The overall hospitalization rate was 0.

Transitions to and from peritoneal dialysis: Your questions answered.

Modality transitions are very common in patients undergoing peritoneal dialysis (PD); they can either occur before the initiation of PD, following its termination, or as a temporary interruption during PD treatment. Transfers to and from facility hemodialysis represent the majority of these transitions. In addition to their impact on the quality of life of patients and their caregivers, modality transitions are often linked with hospitalizations, mortality, and increased health expenditures.

Integrated home dialysis model: facilitating home-to-home transition.

Peritoneal dialysis (PD) and home hemodialysis (HHD) are the two home dialysis modalities offered to patients. They promote patient autonomy, enhance independence, and are generally associated with better quality of life compared to facility hemodialysis. PD offers some advantages (enhanced flexibility, ability to travel, preservation of residual kidney function, and vascular access sites) but few patients remain on PD indefinitely due to peritonitis and other complications.

Differences in Antihypertensive Medication Prescription Profiles Between 2009 and 2021: A Retrospective Cohort Study of CARTaGENE.

Background: Although blood pressure (BP) control is critical to prevent cardiovascular diseases, hypertension control rates in Canada are in decline.

Objective: To assess this issue, we sought to evaluate the differences in antihypertensive medication prescription profiles in the province of Quebec between 2009 and 2021.

Design: This is a retrospective cohort study.

Individual versus integration of multiple components of central blood pressure and aortic stiffness in predicting cardiovascular mortality in end-stage renal diseases.

Aortic stiffness, measured by carotid-femoral pulse wave velocity (PWV), is a predictor of cardiovascular (CV) mortality in patients with end-stage renal disease (ESRD). Aortic stiffness increases aortic systolic and pulse pressures (cSBP, cPP) and augmentation index adjusted for a heart rate of 75 beats per minute (AIx@75). In this study, we examined if the integration of multiple components of central blood pressure and aortic stiffness (ICPS) into risk score categories could improve CV mortality prediction in ESRD.

Outcomes of Integrated Home Dialysis Care: Results From the Canadian Organ Replacement Register.

Rationale & Objective: The integrated home dialysis model proposes the initiation of kidney replacement therapy (KRT) with peritoneal dialysis (PD) and a timely transition to home hemodialysis (HHD) after PD ends. We compared the outcomes of patients transitioning from PD to HHD with those initiating KRT with HHD.

Study Design: Observational analysis of the Canadian Organ Replacement Register (CORR).

Impact of Successive Office Blood Pressure Measurements During a Single Visit on Cardiovascular Risk Prediction: Analysis of CARTaGENE.

Background: Multiple office blood pressure (BP) readings correlate more closely with ambulatory BP than single readings. Whether they are associated with long-term outcomes and improve cardiovascular risk prediction is unknown. Our objective was to assess the long-term impact of multiple office BP readings.

Enhancing central blood pressure accuracy through statistical modeling: A proof-of-concept study.

Background: Non-invasive estimation of central blood pressure (BP) may have better prognostic value than brachial BP. The accuracy of central BP is limited in certain populations, such as in females and the elderly. This study aims to examine whether statistical modeling of central BP for clinical and hemodynamic parameters results in enhanced accuracy.

Thiazide Diuretics and Fracture Risk: A Systematic Review and Meta-Analysis of Randomized Clinical Trials.

Thiazide diuretics are commonly used antihypertensive agents. Until today, whether their use reduces fracture risk remains unclear. Our objective was to conduct a systematic review of thiazide diuretics' effects on fractures and bone mineral density (BMD) in randomized clinical trials (RCT) of adults.

Prediction of Cardiovascular Events by Pulse Waveform Parameters: Analysis of CARTaGENE.

Background Waveform parameters provide approximate data about aortic wave reflection. However, their association with cardiovascular events remains controversial and their role in cardiovascular prediction is unknown. Methods and Results We analyzed participants aged between 40 and 69 from the population-based CARTaGENE cohort.

Accuracy Difference of Noninvasive Blood Pressure Measurements by Sex and Height.

Importance: Women are at higher risk of cardiovascular events than men with similar blood pressure (BP). Whether this discrepancy in risk is associated with the accuracy of brachial cuff BP measurements is unknown.

Objectives: To examine the difference in brachial cuff BP accuracy in men and women compared with invasively measured aortic BP and to evaluate whether noninvasive central BP estimation varies with sex.

Vitamin D Analogues and Fracture Risk in Chronic Kidney Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Vitamin D receptor agonists (VDRAs) are commonly prescribed in chronic kidney disease (CKD). However, their protective effects on bone remain controversial. We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the effect of VDRAs on fracture risk and bone mineral density (BMD) in adult patients with CKD.

FGF23-Klotho Axis and Fractures in Patients Without and With Early CKD: A Case-Cohort Analysis of CARTaGENE.

Context: Whether fibroblast growth factor-23 (FGF23) and α-Klotho are associated with fractures, especially in chronic kidney disease (CKD), remains controversial.

Objective: We evaluated how FGF23, α-Klotho, and traditional mineral parameters predict fractures in individuals with and without early CKD.

Methods: We conducted a stratified case-cohort analysis using CARTaGENE, a population-based survey from Quebec, Canada.

Type of subtotal parathyroidectomy and evolution of parathyroid hormone levels in end-stage renal disease patients: a retrospective cohort study.

Purpose: Parathyroidectomy (PTX) is performed in end-stage renal disease (ESRD) for the treatment of secondary hyperparathyroidism. Whether and how the number of glands removed affects parathyroid hormone (PTH) levels remain controversial. The objective of this study is to compare the biochemical and pharmacological evolution after subtotal PTX according to the number of glands removed in ESRD.

Iliac crest bone biopsy by interventional radiologists to improve access to bone biopsy in chronic kidney disease populations: technical note and a case series.

Introduction: Chronic kidney disease-mineral and bone disorder (CKD-MBD) leads to increased fracture risk. Iliac crest biopsy remains the gold standard for diagnosing bone disease in CKD. Unfortunately, bone biopsy is rarely performed which is mainly due to the inability of clinicians to perform the procedure.

Comparison of Fracture Prediction Tools in Individuals Without and With Early Chronic Kidney Disease: A Population-Based Analysis of CARTaGENE.

Whether fracture prediction tools developed for the management of osteoporosis can be used in chronic kidney disease (CKD) is poorly known. We aimed to compare the performance of fracture prediction tools in non-CKD and CKD. We analyzed CARTaGENE, a population-based survey of 40-year-old to 69-year-old individuals recruited between 2009 and 2010.

Incidence of fractures in middle-aged individuals with early chronic kidney disease: a population-based analysis of CARTaGENE.

Background: Previous studies evaluating fractures in chronic kidney disease (CKD) have mostly focused on hip or major fractures in aged populations with moderate to advanced CKD. We aimed at evaluating the association between early CKD and fracture incidence at all sites across age and sex in middle-aged individuals.

Methods: We analyzed CARTaGENE, a prospective population-based survey of 40- to 69-year-old individuals from Quebec (Canada).

Predictive value of quantitative ultrasound parameters in individuals with chronic kidney disease: A population-based analysis of CARTaGENE.

Background: The use of calcaneal quantitative ultrasound (QUS) to predict fractures has not been well studied in early CKD populations. We compared the association of QUS with incidental fractures and its predictive properties in non-CKD and CKD individuals.

Methods: Analysis of a prospective population-based survey of 40- to 69-year-old individuals recruited between 2009 and 2010.

Prognostic Value of Carotid and Radial Artery Reservoir-Wave Parameters in End-Stage Renal Disease.

Background Reservoir-wave approach is an alternative model of arterial hemodynamics based on the assumption that measured arterial pressure is composed of volume-related (reservoir pressure) and wave-related components (excess pressure). However, the clinical utility of reservoir-wave approach remains debatable. Methods and Results In a single-center cohort of 260 dialysis patients, we examined whether carotid and radial reservoir-wave parameters were associated with all-cause and cardiovascular mortality.

Fracture Risk in Dialysis and Kidney Transplanted Patients: A Systematic Review.

Chronic kidney disease is associated with an increased risk of fracture and cardiovascular mortality. The risk of fracture in hemodialysis (HD), peritoneal dialysis (PD) and kidney transplant (KT) patients is higher when compared with the general population. However, there exists a knowledge gap concerning which group has the highest risk of fracture.