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“Background: Recent studies,
in which the cardiovascular risk and mortality associated with high and low hemoglobin target values, respectively, have been investigated, challenged the concept that hemoglobin normalization improves prognosis. Methods: The results of these studies are reviewed with respect to differences in study populations, study design and methodological limitations to provide guidance for their interpretation and relevance for clinical practice. Results: There are important differences with respect to enrolled populations, design and conduct of the studies. Each study has its find more specific, inherent methodological limitations. Importantly, there is no statistically significant and consistent pattern of negative results for cardiovascular and mortality outcomes, although in general outcomes are not in favor of hemoglobin normalization. On the other hand, the reported data on quality of life are consistently and significantly better with higher hemoglobin values. Conclusions: Recent evidence from large outcome studies suggested an increased risk associated with hemoglobin normalization.
On the other side, several study-inherent and methodological limitations must be considered before simply extrapolating the negative findings of these studies into clinical practice. However, until new evidence becomes available from ongoing and Danusertib cost future clinical studies, an upper Hb limit of 12 g/dl should not be exceeded. Copyright (C) 2009 S. Karger AG, Basel”
“Background: Chronic kidney disease is a major risk factor for patients with cardiovascular diseases (CVD). The aim of this study is to evaluate the relationship between clinical characteristics and renal histology in patients with abdominal aortic aneurysm (AAA). Methods: We studied 79 cases with AAA autopsied at the National Cardiovascular Center. They were classified into two groups: 14 subjects with renal artery stenosis (RAS) (group A) and 65 subjects without RAS (group B). Proteinuria, elevated serum Galactokinase creatinine and decreased estimated glomerular
filtration rate had been recorded. We evaluated renal parenchymal damage using a semiquantitative histological score (score 0-3; normal to severe) for glomerulosclerosis, interstitial fibrosis, tubular atrophy, and arteriolar hyalinosis (maximal score = 12). Results: Total histological score was 8.2 +/- 2.4 and significantly higher in the stenosed kidneys of group A than in the non-stenosed kidneys of group B (8.9 +/- 2.6 vs. 8.0 +/- 2.3). The histological score had a significant association with RAS, smoking, kidney function, proteinuria, kidney weight and the presence of other CVD. Conclusion: We demonstrated that renal parenchymal damage and deteriorated kidney function are closely associated in the patients with AAA.