Publications by authors named "Radovan Hojs"

Introduction: Hypertension is associated with higher cardiovascular morbidity and mortality in chronic haemodialysis patients. Altering dialysate sodium (dNa) concentration presents a possibility of sodium balance control and blood pressure (BP) management.

Methods: We performed a prospective, randomized, single-centre study, including 45 patients, divided into three groups of 15.

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Background: Hyperlactatemia is common in intensive care unit (ICU) patients. The aim of our retrospective observational study was to analyse the impact of serum lactate on admission on mortality in patients with acute kidney injury (AKI) treated with renal replacement therapy (RRT).

Methods: During the study period of 4 years, 2939 patients were admitted to the ICU, 503 patients were diagnosed with AKI and 209 of them required RRT.

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Nonalcoholic fatty liver disease (NAFLD) and chronic kidney disease are global public health issues associated with high morbidity and mortality. Both diseases are also interlinked. Little is known about the meaning of NAFLD in hemodialysis (HD) patients.

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Introduction: This retrospective study aimed to evaluate the 30 and 60-day survival of critically ill patients with COVID-19 and AKI.

Methods: Inflammatory and biochemical biomarkers, length of intensive care unit (ICU) stay and mortality at Day 30 and Day 60 after ICU admission were analyzed. A total of 44 patients treated with continuous renal replacement therapy (CRRT) with cytokine adsorber (CA group) were compared to 58 patients treated with CRRT alone (non-CA group).

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Article Synopsis
  • The study investigates the relationship between renal disease and metabolic syndrome (MS) by evaluating kidney histology in participants from the European Nephrectomy Biobank.
  • Researchers defined MS based on criteria like BMI, blood pressure, glucose levels, and cholesterol, excluding patients with diabetes or known renal disease.
  • Results show that individuals with MS are older, have a higher prevalence of chronic kidney disease, and display more severe renal morphological changes compared to those without MS, suggesting that ischemic renal disease and potential diabetic nephropathy may contribute to their kidney issues.
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Diabetic kidney disease is a frequent microvascular complication of diabetes and is currently the leading cause of chronic kidney disease and end-stage kidney disease worldwide. Although the prevalence of other complications of diabetes is falling, the number of diabetic patients with end-stage kidney disease in need of kidney replacement therapy is rising. In addition, these patients have extremely high cardiovascular risk.

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Acute kidney injury and chronic kidney disease are among the most common non-communicable diseases in the developed world, with increasing prevalence. Patients with acute kidney injury are at an increased risk of developing chronic kidney disease. One of kidney injury's most common clinical sequelae is increased cardiovascular morbidity and mortality.

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Background: Obesity is associated with several neurohumoral changes that play an essential role in organ damage. Increased arterial stiffness causes functional vessel wall changes and can therefore lead to accelerated target organ damage as well. Whether obesity causes an independent increase in central arterial stiffness is, however, not yet fully known.

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Chronic kidney disease (CKD) is one of the most common chronic diseases worldwide, with prevalence currently projected at 10% and rising. Cardiovascular disease is the leading cause of morbidity and mortality in CKD patients and is integrally linked with atherogenesis and vascular stiffness. Estimated glomerular filtration rate and the level of proteinuria are not only markers of kidney function but of cardiovascular risk, as well.

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Article Synopsis
  • There is a global obesity pandemic, with around 30% of adults in Europe classified as obese, which is linked to a higher risk of chronic kidney disease (CKD) and related complications.
  • Although obesity generally increases mortality risk, data on how weight impacts survival in CKD patients is mixed, with some evidence suggesting better survival in obese end-stage renal disease (ESRD) patients.
  • Management strategies for obesity include lifestyle changes, bariatric surgery, and medication, with new treatments showing promise for non-CKD patients, but more research is needed specifically for those with CKD.
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  • The study examines the impact of serum zinc levels and ankle-brachial index (ABI) on atherosclerosis and mortality in chronic haemodialysis patients.
  • Sixty-one patients were analyzed over an average of 2.8 years, revealing that those with lower zinc levels had lower ABI values, but higher zinc did not significantly affect survival rates.
  • The research concludes that while lower zinc correlates with worse ABI, it does not predict overall patient mortality, with only the use of oral nutritional supplements showing a significant relationship to survival.
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The current data on climate change and environmental degradation are dramatic. The consequences of these changes are already having a significant impact on people's health. Physicians - as advocates of the patients, but also as citizens - have an ethical obligation to be involved in efforts to stop these changes.

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Background: Lung ultrasound (LUS) is a non-invasive technique for estimating extravascular lung water in patients with end-stage renal disease and heart diseases. In this study, we examined an association between the severity of lung congestion as detected by LUS B-lines (LUS comets), anemia, and serum biomarker N-terminal pro-brain natriuretic peptide (NT-proBNP) in peritoneal dialysis (PD) patients.

Materials And Methods: 19 patients, who were treated with PD in our dialysis center were enrolled.

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Aims: Pulmonary congestion is a direct result of either general overhydration or cardiac dysfunction. Lung ultrasonography (LUS) with lung B-lines (LUS comets) can be used to assess extravascular lung water in patients with end-stage renal disease on hemodialysis or peritoneal dialysis (PD). Subendocardial viability ratio (SEVR) is a pulse wave analysis parameter that is a non-invasive measure of coronary perfusion and is related to cardiac work and oxygen consumption.

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Background: Optimal fluid management is a physician's everyday challenge in patients on maintenance hemodialysis (HD). Bioimpedance spectroscopy (BIS) is a non-invasive method to estimate body composition, including estimates of fluid overload (FO). Our study aimed to analyze the association between FO and the mortality rate in HD patients.

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Background: Cystatin C (cysC) is freely filtered in the glomeruli, and its serum concentration is independent of muscle mass, diet, gender, or age. In patients with chronic kidney disease (CKD), cysC is associated with advanced atherosclerosis and increased arterial stiffness. The purpose of this study was to define possible associations between arterial stiffness parameters and cysC in patients without CKD.

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Introduction: The clinical-histologic correlation in diabetic nephropathy is not completely known.

Methods: We analyzed nephrectomy specimens from 90 patients with diabetes and diverse degrees of proteinuria and glomerular filtration rate (GFR).

Results: Thirty-six (40%) subjects had normoalbuminuria, 33 (37%) microalbuminuria, and 21 (23%) non-nephrotic proteinuria.

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Lung congestion is a risk factor for all-cause and cardiovascular mortality in patients on chronic hemodialysis, and its estimation by ultrasound may be useful to guide ultrafiltration and drug therapy in this population. In an international, multi-center randomized controlled trial (NCT02310061) we investigated whether a lung ultrasound-guided treatment strategy improved a composite end point (all-cause death, non-fatal myocardial infarction, decompensated heart failure) vs usual care in patients receiving chronic hemodialysis with high cardiovascular risk. Patient-Reported Outcomes (Depression and the Standard Form 36 Quality of Life Questionnaire, SF36) were assessed as secondary outcomes.

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The prevalence and burden of diabetes mellitus and chronic kidney disease on global health and socioeconomic development is already heavy and still rising. Diabetes mellitus by itself is linked to adverse cardiovascular events, and the presence of concomitant chronic kidney disease further amplifies cardiovascular risk. The culmination of traditional (male gender, smoking, advanced age, obesity, arterial hypertension and dyslipidemia) and non-traditional risk factors (anemia, inflammation, proteinuria, volume overload, mineral metabolism abnormalities, oxidative stress, ) contributes to advanced atherosclerosis and increased cardiovascular risk.

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Statins or 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors are a mainstay of cardiovascular disease therapy. In addition to their lipid-lowering capabilities, they exhibit several pleiotropic effects. Their adverse reactions such as myalgias are not uncommon, but in rare cases, the resulting rhabdomyolysis can be fatal.

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Diabetes mellitus is a global health issue and main cause of chronic kidney disease. Both diseases are also linked through high cardiovascular morbidity and mortality. Diabetic kidney disease (DKD) is present in up to 40% of diabetic patients; therefore, prevention and treatment of DKD are of utmost importance.

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The ten most statistically significant estimated glomerular filtration rate (eGFRcrea)-associated loci from genome-wide association studies (GWAs) are tested for associations with chronic kidney disease (CKD) in 208 patients, including dialysis-independent CKD and dialysis-dependent end-stage renal disease (kidney failure). The allele A of intergenic SNP rs2453533 (near ) is more frequent in dialysis-independent CKD patients ( = 135, adjusted = 0.020) but not dialysis-dependent kidney failure patients ( = 73) compared to healthy controls ( = 309).

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