Browsing by Author "Liakopoulos, Vassilios"

Now showing 1 - 6 of 6
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    Assessment and Management of Hypertension among Patients on Peritoneal Dialysis
    (American Society of Nephrology., 2019-02-07) Vaios, Vasilios; Georgianos, Panagiotis I.; Liakopoulos, Vassilios; Agarwal, Rajiv; Medicine, School of Medicine
    Approximately 7%-10% of patients with ESKD worldwide undergo peritoneal dialysis (PD) as kidney replacement therapy. The continuous nature of this dialytic modality and the absence of acute shifts in pressure and volume parameters is an important differentiation between PD and in-center hemodialysis. However, the burden of hypertension and prognostic association of BP with mortality follow comparable patterns in both modalities. Although management of hypertension uses similar therapeutic principles, long-term preservation of residual diuresis and longevity of peritoneal membrane function require particular attention in the prescription of the appropriate dialysis regimen among those on PD. Dietary sodium restriction, appropriate use of icodextrin, and limited exposure of peritoneal membrane to bioincompatible solutions, as well as adaptation of the PD regimen to the peritoneal transport characteristics, are first-line therapeutic strategies to achieve adequate volume control with a potential long-term benefit on technique survival. Antihypertensive drug therapy is a second-line therapeutic approach, used when BP remains unresponsive to the above volume management strategies. In this article, we review the available evidence on epidemiology, diagnosis, and treatment of hypertension among patients on PD and discuss similarities and differences between PD and in-center hemodialysis. We conclude with a call for randomized trials aiming to elucidate several areas of uncertainty in management of hypertension in the PD population.
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    CORRECTION TO: Living Well with Kidney Disease by patient and care‑partner empowerment: Kidney Health for Everyone Everywhere
    (SpringerLink, 2021) Kalantar‑Zadeh, Kamyar; Li, Philip Kam‑Tao; Tantisattamo, Ekamol; Kumaraswami, Latha; Liakopoulos, Vassilios; Lui, Siu‑Fai; Ulasi, Ifeoma; Andreoli, Sharon; Balducci, Alessandro; Dupuis, Sophie; Harris, Tess; Hradsky, Anne; Knight, Richard; Kumar, Sajay; Ng, Maggie; Poidevin, Alice; Saadi, Gamal; Tong, Allison; Pediatrics, School of Medicine
    Correction to: Journal of Nephrology (2021) 34:381–388 10.1007/s40620-021-01000-6
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    Kidney Health for Everyone Everywhere - From Prevention to Detection and Equitable Access to Care
    (Medknow Publications, 2020-03) Li, Philip Kam-Tao; Garcia-Garcia, Guillermo; Lui, Siu-Fai; Andreoli, Sharon; Fung, Winston Wing-Shing; Hradsky, Anne; Kumaraswami, Latha; Liakopoulos, Vassilios; Rakhimova, Ziyoda; Saadi, Gamal; Strani, Luisa; Ulasi, Ifeoma; Kalantar-Zadeh, Kamyar; World Kidney Day Steering Committee; Medicine, School of Medicine
    The global burden of chronic kidney disease (CKD) is rapidly increasing with a projection of becoming the 5th most common cause of years of life lost globally by 2040. Aggravatingly, CKD is a major cause of catastrophic health expenditure. The costs of dialysis and transplantation consume up to 3% of the annual healthcare budget in high-income countries. Crucially, however, the onset and progression of CKD is often preventable. In 2020, the World Kidney Day campaign highlights the importance of preventive interventions - be it primary, secondary or tertiary. This complementing article focuses on outlining and analyzing measures that can be implemented in every country to promote and advance CKD prevention. Primary prevention of kidney disease should focus on the modification of risk factors and addressing structural abnormalities of the kidney and urinary tracts, as well as exposure to environmental risk factors and nephrotoxins. In persons with pre-existing kidney disease, secondary prevention, including blood pressure optimization and glycemic control, should be the main goal of education and clinical interventions. In patients with advanced CKD, management of co-morbidities such as uremia and cardiovascular disease is a highly recommended preventative intervention to avoid or delay dialysis or kidney transplantation. Political efforts are needed to proliferate the preventive approach. While national policies and strategies for non-communicable diseases might be present in a country, specific policies directed toward education and awareness about CKD screening, management and treatment are often lacking. Hence, there is an urgent need to increase the awareness of the importance of preventive measures throughout populations, professionals and policy makers.
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    Living well with kidney disease by patient and care partner empowerment: kidney health for everyone everywhere
    (Oxford, 2021-02) Kalantar-Zadeh, Kamyar; Li, Philip Kam-Tao; Tantisattamo, Ekamol; Kumaraswami, Latha; Liakopoulos, Vassilios; Lui, Siu-Fai; Ulasi, Ifeoma; Andreoli, Sharon; Balducci, Alessandro; Dupuis, Sophie; Harris, Tess; Hradsky, Anne; Knight, Richard; Kumar, Sajay; Ng, Maggie; Poidevin, Alice; Saadi, Gamal; Tong, Allison; Pediatrics, School of Medicine
    Living with chronic kidney disease (CKD) is associated with hardships for patients and their care partners. Empowering patients and their care partners, including family members or friends involved in their care, may help minimize the burden and consequences of CKD-related symptoms to enable life participation. There is a need to broaden the focus on living well with kidney disease and re-engagement in life, including an emphasis on patients being in control. The World Kidney Day (WKD) Joint Steering Committee has declared 2021 the year of ‘Living Well with Kidney Disease’ in an effort to increase education and awareness on the important goal of patient empowerment and life participation. This calls for the development and implementation of validated patient-reported outcome measures to assess and address areas of life participation in routine care. It could be supported by regulatory agencies as a metric for quality care or to support labeling claims for medicines and devices. Funding agencies could establish targeted calls for research that address the priorities of patients. Patients with kidney disease and their care partners should feel supported to live well through concerted efforts by kidney care communities including during pandemics. In the overall wellness program for kidney disease patients, the need for prevention should be reiterated. Early detection with a prolonged course of wellness despite kidney disease, after effective secondary and tertiary prevention programs, should be promoted. WKD 2021 continues to call for increased awareness of the importance of preventive measures throughout populations, professionals and policymakers, applicable to both developed and developing countries.
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    Living Well with Kidney Disease by Patient and Care-Partner Empowerment: Kidney Health for Everyone Everywhere
    (Oxford, 2021-02) Kalantar-Zadeh, Kamyar; Li, Philip Kam-Tao; Tantisattamo, Ekamol; Kumaraswami, Latha; Liakopoulos, Vassilios; Lui, Siu-Fai; Ulasi, Ifeoma; Andreoli, Sharon; Balducci, Alessandro; Dupuis, Sophie; Harris, Tess; Hradsky, Anne; Knight, Richard; Kumar, Sajay; Ng, Maggie; Poidevin, Alice; Saadi, Gamal; Tong, Allison; Pediatrics, School of Medicine
    Living with CKD is associated with hardships for patients and their care-partners. Empowering patients and care-partners may help minimize the burden and consequences of CKD related symptoms to enable life participation. There is a need to broaden the focus on living well with kidney disease and re-engagement in life. The World Kidney Day (WKD) Joint Steering Committee has declared 2021 the year of “Living Well with Kidney Disease” in an effort to increase education and awareness on the important goal of patient empowerment and life participation. This calls for the development and implementation of validated patient-reported outcome measures to address areas of life participation in routine care. It could be supported by regulatory agencies as a metric for quality care. Funding agencies could establish targeted calls for research that address the priorities of patients. Patients with kidney disease and their care-partners should feel supported to live well through concerted efforts by kidney care communities including during pandemics. In the overall wellness program for kidney disease patients, the need for prevention should be reiterated. WKD 2021 continues to call for increased awareness of the importance of preventive measures throughout populations, professionals, and policy makers, applicable to both developed and developing countries.
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    Oxidative Stress Genes in Diabetes Mellitus Type 2: Association with Diabetic Kidney Disease
    (Hindawi, 2021-09-02) Roumeliotis, Athanasios; Roumeliotis, Stefanos; Tsetsos, Fotis; Georgitsi, Marianthi; Georgianos, Panagiotis I.; Stamou, Aikaterini; Vasilakou, Anna; Kotsa, Kalliopi; Tsekmekidou, Xanthippi; Paschou, Peristera; Panagoutsos, Stylianos; Liakopoulos, Vassilios; Biology, School of Science
    Diabetic type 2 patients compared to nondiabetic patients exhibit an increased risk of developing diabetic kidney disease (DKD), the leading cause of end-stage renal disease. Hyperglycemia, hypertension, oxidative stress (OS), and genetic background are some of the mechanisms and pathways implicated in DKD pathogenesis. However, data on OS pathway susceptibility genes show limited success and conflicting or inconclusive results. Our study is aimed at exploring OS pathway genes and variants which could be associated with DKD. We recruited 121 diabetes mellitus type 2 (DM2) patients with DKD (cases) and 220 DM2, non-DKD patients (control) of Greek origin and performed a case-control association study using genome-wide association data. PLINK and EIGENSOFT were used to analyze the data. Our results indicate 43 single nucleotide polymorphisms with their 21 corresponding genes on the OS pathway possibly contributing or protecting from DKD: SPP1, TPO, TTN, SGO2, NOS3, PDLIM1, CLU, CCS, GPX4, TXNRD2, EPHX2, MTL5, EPX, GPX3, ALOX12, IPCEF1, GSTA, OXR1, GPX6, AOX1, and PRNP. Therefore, a genetic OS background might underlie the complex pathogenesis of DKD in DM2 patients.