Browsing by Author "Grodzicki, T"
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- Cognitive Disorders in Patients with Chronic Kidney Disease: Approaches to Prevention and TreatmentPublication . Pépin, M; Klimkowicz‐Mrowiec, A; Godefroy, O; Delgado, P; Carriazo, S; Ferreira, AC; Golenia, A; Malyszko, J; Grodzicki, T; Giannakou, K; Paolisso, G; Barbieri, M; Garneata, L; Mocanu, CA; Liabeuf, S; Spasovski, G; Zoccali, C; Bruchfeld, A; Farinha, A; Arici, M; Capasso, G; Wiecek, A; Massy, ZABackground: Cognitive impairment is common in patients with chronic kidney disease (CKD), and early intervention may prevent the progression of this condition. Methods: Here, we review interventions for the complications of CKD (anemia, secondary hyperparathyroidism, metabolic acidosis, harmful effects of dialysis, the accumulation of uremic toxins) and for prevention of vascular events, interventions that may potentially be protective against cognitive impairment. Furthermore, we discuss nonpharmacological and pharmacological methods to prevent cognitive impairment and/or minimize the latter's impact on CKD patients' daily lives. Results: A particular attention on kidney function assessment is suggested during work-up for cognitive impairment. Different approaches are promising to reduce cognitive burden in patients with CKD but the availabe dedicated data are scarce. Conclusions: There is a need for studies assessing the effect of interventions on the cognitive function of patients with CKD.
- Protecting Older Patients with Cardiovascular Diseases from COVID-19 Complications Using Current MedicationsPublication . Alves, M; Fernandes, M; Bahat, G; Benetos, A; Clemente, H; Grodzicki, T; Martínez-Sellés, M; Mattace-Raso, F; Rajkumar, C; Ungar, A; Werner, N; Strandberg, T; EuGMS Special Interest Group in Cardiovascular MedicinePurpose: In the pathogenesis of severe COVID-19 complications, derangements of renin-angiotensin-aldosterone system (RAAS), vascular endothelial dysfunction leading to inflammation and coagulopathy, and arrhythmias play an important role. Therefore, it is worth considering the use of currently available drugs to protect COVID-19 patients with cardiovascular diseases. Methods: We review the current experience of conventional cardiovascular drugs [angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers, anticoagulants, acetosalicylic acid, antiarrhythmic drugs, statins] as well as some other drug classes (antidiabetic drugs, vitamin D and NSAIDs) frequently used by older patients with cardiovascular diseases. Data were sought from clinical databases for COVID-19 and appropriate key words. Conclusions and recommendations are based on a consensus among all authors. Results: Several cardiovascular drugs have a potential to protect patients with COVID-19, although evidence is largely based on retrospective, observational studies. Despite propensity score adjustments used in many analyses observational studies are not equivalent to randomised controlled trials (RCTs). Ongoing RCTs include treatment with antithrombotics, pulmonary vasodilators, RAAS-related drugs, and colchicine. RCTs in the acute phase of COVID-19 may not, however, recognise the benefits of long term anti-atherogenic therapies, such as statins. Conclusions: Most current cardiovascular drugs can be safely continued during COVID-19. Some drug classes may even be protective. Age-specific data are scarce, though, and conditions which are common in older patients (frailty, comorbidities, polypharmacy) must be individually considered for each drug group.