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Background. Abnormalities of the left ventricle are common in patients with end-stage renal disease (ESRD) both before and after the start of renal replacement therapy. The purpose of this study is to identify possible causes of subclinical left ventricular (LV) dysfunction in patients with ESRD. In particular, we sought to determine whether the presence of ESRD was itself associated with dysfunction independent of LV hypertrophy and coronary artery disease. Methods: Assessment of cardiovascular risk factors and dialysis adequacy was completed in 145 unselected patients with ESRD who were recruited from the renal dialysis unit and compared with age- and sex-matched controls. Among the 68 patients with ESRD who had undergone a dobutamine stress echocardiogram with normal findings, regional cardiac function was quantified by myocar...
Background. Nonmelanoma skin cancer (NMSC) is a significant clinical problem after renal transplantation, particularly in areas of high UV light exposure. A single-center prospective study of a population of Queensland renal transplant recipients was performed with the alms of: (1) establishing NMSC incidence and tumor accrual post-renal transplantation, and (2) developing a clinically derived predictive index to identify transplant recipients at greatest risk. Methods: Three hundred ten of 398 transplant recipients (78%) who underwent baseline assessment between July 1999 and April 2000 were reassessed a mean of 18 +/- 3.5 (SD) months later. A structured interview, full skin examination, biopsy of suspicious lesions, and review of medical and pathological records were used to determine the number and types of NMSC arising betwee...
Background Cardiac mortality is the main cause of death in patients with chronic kidney disease (CKD). In this study, we sought the efficacy of long-term intensive lipid level lowering on atherosclerotic burden in patients with CKD. Methods: Patients with CKD (n = 38; age, 64 +/- 11 years) and a similar group of patients with coronary artery disease (CAD; n = 31) were treated prospectively with atorvastatin, up to 80 mg/d. Lipid profile, carotid intima-media thickness (IMT; a marker of atherosclerotic burden), and dobutamine echocardiography were measured at baseline and 2 years. Predictors of change in maximal IMT were sought in a linear model. Results: Despite similar cholesterol level lowering, patients with CAD showed an improvement in maximum IMT, whereas those with CKD did not (mean between-group difference, 0.07 mm; 95% co...
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