Hypertension and nephrology

[Stroke is a common, severe, but preventable cardiovascular disease in chronic kidney disease]

NAGY Judit, KOVÁCS Tibor, KÉSŐI István, TÓTH Péter, SÁGI Balázs, SZAPÁRY László, VAS Tibor, KOMOLY Sámuel, KOLLER Ákos, WITTMANN István, BERECZKI Dániel, KISS István

MAY 20, 2010

Hypertension and nephrology - 2010;14(02)

[In chronic kidney disease (CKD) patients the high risk for cardiovascular events represents the major cause for morbidity and mortality. Stroke is the third most common manifestation of cardiovascular diseases and cause of death. The risk of cerebrovascular diseases persists in CKD patient in predialysis increases by 1.5-3 times whereas in patients on dialysis is increases by 4-10 times. The combination of classical cardiovascular risk factors and the pathomechanisms present in CKD and activated by dialysis treatment may explain the increased risk. The outcome of stroke is more severe in CKD, than in other populations. There are only a few data regarding early identification, primary and secondary prevention. and proper treatment of stroke in CKD patients with and without dialysis. In this review we summarize the diagnostic and treatment strategies that are based on the existing state of knowledge. However, additional studies are needed to address the poor prognosis through early identification of risk developing potential preventions and treatments of stroke in CKD.]

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Hypertension and nephrology

[Cerebrovascular diseases in patients with chronic kidney disease]

KISS István, NAGY Judit

[The reason of the unfavourable life expectancy of patients with chronic kidney disease (CKD) is not only the development of end-stage renal failure but the frequent appearance of cardiovascular diseases (CVD). Chronic kidney damage itself is a cardiovascular risk state and the occurrence of CVD/associated diseases is significantly higher in chronic kidney failure. Beside risk stratification and valid treatment of CVD (hypertension, diabetes mellitus, ischemic heart disease e.g.) we and the international nephrological community have left the cerebrovascular diseases of CKD patients out of consideration. However, up to 50% of patients suffering a stroke will die immediately, only 10% of stroke survivors can continue his/her profession, but the others will be permanently disabled. High blood pressure is a strong predictor of stroke and of other CVD in most of the patients. In stroke risk reduction it is particularly important to reach the target blood pressure values. The main object of the “Live under 140/90 mmHg” programme of the Hungarian Society of Hypertension is to familiarize with target blood pressure itself and how to reach target blood pressure. In 2010, prevention, early diagnosis and management of stroke are the most important challenges of this programme (The Brain Control Programme). We think it is advisable to prepare and publish a clinical practice guideline in collaboration with stroke societies which is similar to the guidelines of international societies and of the Hungarian Society of Stroke but specific for CKD patients. This guideline would help to give a uniform, up-to-date treatment for the cerebrovascular diseases of CKD patients.]

Hypertension and nephrology

[Attracted by science III. - My scientific life product of 55 years: what have I achieved?]

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[Author analyses the scientific results of his own clinical research work by evaluating his product in a „traditional way”, and only after then supplemented by scientometric data (citedness). From the 148 articles which has been published in foreign language (mostly in English) in abroad, 10 was grouped into the category of “new procedure/ recognition”, 40 into “original data/significant new statement”, and 98 into “new observation (statement) in a detailed question”. He has found close correlation between the values of the publications grouped by the traditional evaluation and the corresponding numbers of citations. Author discusses in the light of his own data the evaluating role of citedness with the hope to help by this motivated young scholars to plan their own future.]

Hypertension and nephrology

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[Stroke is the third most frequent cause of death and the most important cause of disability and dependency worldwide. There are marked differences in the incidence, prevalence and mortality between the populations of Eastern and Western Europe. In Hungary, between 1998-2003, the incidence of stroke was 1,5-2 times higher than in the Western part of the continent. The early recognition of signs and symptoms of TIA and stroke and the urgent transportation of the patient to neurology, preferably to the nearest stroke-center are the key points of successful treatment, reduction of consequences and increased survival. The “time is brain” concept means that the management of TIA/stroke patients should be considered as emergency. This review briefly summarizes the epidemiology, key elements of the etiology, risk factors, up-to-dated diagnosis, primary and secondary prevention and treatment of TIA/stroke to provide information regarding the development of this field targeting the optimal management of TIA/stroke patients.]

Hypertension and nephrology

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[According to World Health Organization data 250 million people suffer from chronic obstructive pulmonary disease (COPD) worldwide, and the diseases accounts for 5% of total mortality. It is the only cause of death with increasing incidence and is estimated to be the third most prevalent one after stroke and myocardial infarction by 2030. In Hungary the estimated number of patients is 500 000 and projected to the number of habitants the highest number of death is caused by COPD in our country in Europe. Hypertension is a public health problem also in Hungary and it is estimated that 2.5-3.5 million adult are affected. Most of them are not aware of their disease or their treatment is insufficient. Hypertension also accounts for a great percentage of cardiovascular morbidity and mortality. Coincidence of the two diseases is significant in the adult population. According to international data the prevalence of COPD among patients with hypertension is similar to that of the general population, thus the coincidence of the two diseases may affect 2.5% of the adult population. Separate guidelines are available for the diagnosis and the treatment of the diseases, however these issues are not discussed jointly neither in international nor in Hungarian guidelines. In this review epidemiology of coincidence, the raising effect of COPD in cardiovascular risk and the potential therapeutic suggestions are summarized.]

Hypertension and nephrology

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Hypertension and nephrology

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Hypertension and nephrology

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