Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende
Erweiterte Suche
Anmelden
nach oben
Current Hypertension Reports
Erschienen in: Current Hypertension Reports 3/2015

01.03.2015 | Hypertension and Metabolic Syndrome (JR Sowers and A Whaley-Connell, Section Editors)

The Western Diet and Chronic Kidney Disease

verfasst von: Divya Hariharan, Kavitha Vellanki, Holly Kramer

Erschienen in: Current Hypertension Reports | Ausgabe 3/2015

Einloggen, um Zugang zu erhalten

Abstract

Characteristics of the Western diet that fueled the obesity epidemic may also impact kidney disease incidence and progression. Enlarging portion sizes over the past half century has been accompanied by increased intake of protein, sodium, and processed foods while consumption of fruits and vegetables has declined. Overall dietary patterns play a strong role for chronic disease risk including chronic kidney disease. While dietary patterns high in fresh fruits and vegetables and low in red meats, such as the Mediterranean diet, decrease the risk of chronic diseases, the Western diet, characterized by high intake of red meat, animal fat, sweets, and desserts and low intake of fresh fruits and vegetables and low-fat dairy products, increases risk of chronic diseases. In this article, we review the potential mechanisms whereby several key characteristics of the typical Western diet may impact kidney disease incidence and progression. We also discuss a public health policy initiative to improve dietary choices. Reducing protein intake to the recommended daily allowance of 0.8 g/kg/day and increasing intake of fruit and vegetables and fiber may mitigate kidney disease progression and reduce risk of cardiovascular disease and mortality.
Literatur
1.
2.
3.
Finkelstein EA, Zuckerman L. The fattening of America. Hoboken: John Wiley and Sons, Inc; 2008.
4.
Pollen M. Omnivores dilemma: a tale of four meals. New York: Penguin Press; 2006.
5.
Narayan KM, Boyle JP, Thompson TJ, Sorensen SW, Williamson DF. Lifetime risk for diabetes mellitus in the United States. JAMA. 2003;290(14):1884–90.CrossRefPubMed
6.
Flegal KM, Carroll MD, Ogden CL, Curtin LR. Prevalence and trends in obesity among US adults, 1999-2008. JAMA. 2010;303(3):235–41.CrossRefPubMed
7.
Sturm R. Increases in clinically severe obesity in the United States, 1986-2000. Arch Intern Med. 2003;163(18):2146–8.CrossRefPubMed
8.
Hsu CY, McCulloch CE, Iribarren C, Darbinian J, Go AS. Body mass index and risk for end-stage renal disease. Ann Intern Med. 2006;144(1):21–8.CrossRefPubMed
9.
Kramer HJ, Saranathan A, Luke A, Durazo-Arvizu RA, Guichan C, Hou S, et al. Increasing body mass index and obesity in the incident ESRD population. J Am Soc Nephrol. 2006;17(5):1453–9.CrossRefPubMed
10.
11.
U S Renal Data System. USRDS 2010 annual data report: atlas of chronic kidney disease and end-stage renal disease in the United States. Bethesda: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases; 2010.
12.•
Odermatt A. The Western-style diet: a major risk factor for impaired kidney function and chronic kidney disease. Am J Physiol Ren Physiol. 2011;301(5):F919–31. Excellent review which summarizes the physiologic principles whereby multiple aspects of the Western style diet may impact kidney function and disease.CrossRef
13.
Centers for Disease Control and Prevention (CDC). State-specific trends in fruit and vegetable consumption among adults-united states, 2000-2009. MMWR Morb Mortal Wkly Rep. 2010;59(35):1125–30.
14.•
Kasiske BL, Lakatua JD, Ma JZ, Louis TA. A meta-analysis of the effects of dietary protein restriction on the rate of decline in renal function. Am J Kidney Dis. 1998;31(6):954–61. Classic meta-analysis summarizing 13 clinical trials of protein restriction and kidney function decline among adults with established kidney disease.CrossRefPubMed
15.
16.
Nettleton JA, Steffen LM, Palmas W, Burke GL, Jacobs Jr DR. Associations between microalbuminuria and animal foods, plant foods, and dietary patterns in the multiethnic study of atherosclerosis. Am J Clin Nutr. 2008;87(6):1825–36.PubMedCentralPubMed
17.•
Lin J, Fung TT, Hu FB, Curhan GC. Association of dietary patterns with albuminuria and kidney function decline in older white women: a subgroup analysis from the Nurses’ Health Study. Am J Kidney Dis. 2011;57(2):245–54. Observational study which examined dietary patterns and decline of glomerular filtration rate in the Nurses’ Health Study.CrossRefPubMedCentralPubMed
18.
Fung TT, Rimm EB, Spiegelman D, Rifai N, Tofler GH, Willett WC, et al. Association between dietary patterns and plasma biomarkers of obesity and cardiovascular disease risk. Am J Clin Nutr. 2001;73(1):61–7.PubMed
19.
Fung TT, Stampfer MJ, Manson JE, Rexrode KM, Willett WC, Hu FB. Prospective study of major dietary patterns and stroke risk in women. Stroke. 2004;35(9):2014–9.CrossRefPubMed
20.
Hu FB, Rimm EB, Stampfer MJ, Ascherio A, Spiegelman D, Willett WC. Prospective study of major dietary patterns and risk of coronary heart disease in men. Am J Clin Nutr. 2000;72(4):912–21.PubMed
21.
Heidemann C, Schulze MB, Franco OH, van Dam RM, Mantzoros CS, Hu FB. Dietary patterns and risk of mortality from cardiovascular disease, cancer, and all causes in a prospective cohort of women. Circulation. 2008;118(3):230–7.CrossRefPubMedCentralPubMed
22.
23.•
Sabatino A, Regolisti G, Brusasco I, Cabassi A, Morabito S, Fiaccadori E. Alterations of intestinal barrier and microbiota in chronic kidney disease. Nephrology, Dialysis and Transplantation Advance access published September, 4, 2014. One of the first studies which demonstrates that adults with chronic kidney disease have alterations in the gastrointestinal microbiome and these alterations disrupt the normal intestinal barrier.
24.
Ando A, Kawata T, Hara Y, Yaegashi M, Arai J, Sugino N. Effects of dietary protein intake on renal function in humans. Kidney Int Suppl. 1989;27:S64–7.PubMed
25.
Landau D, Rabkin R. Effect of nutritional status and changes in protein intake on renal function. In: Kopple JD, Massry SG, Kalantar-Zadeh K, editors. Nutritional management of renal disease. 3rd ed. Amsterdam: Elsevier; 2013. p. 197–207.CrossRef
26.
Don BR, Blake S, Hutchison FN, Kaysen GA, Schambelan M. Dietary protein intake modulates glomerular eicosanoid production in the rat. Am J Physiol. 1989;256(4 Pt 2):F711–8.PubMed
27.
King AJ, Troy JL, Anderson S, Neuringer JR, Gunning M, Brenner BM. Nitric oxide: a potential mediator of amino acid-induced renal hyperemia and hyperfiltration. J Am Soc Nephrol. 1991;1(12):1271–7.PubMed
28.
Murakami M, Suzuki H, Ichihara A, Naitoh M, Nakamoto H, Saruta T. Effects of L-arginine on systemic and renal haemodynamics in conscious dogs. Clin Sci. 1991;81(6):727–32.PubMed
29.•
Klahr S, Levey AS, Beck GJ, Caggiula AW, Hunsicker L, Kusek JW, et al. The effects of dietary protein restriction and blood-pressure control on the progression of chronic renal disease. Modification of diet in Renal Disease Study Group. N Engl J Med. 1994;330(13):877–84. Seminal randomized clinical trial which examines the effects of moderate and severe protein restriction for glomerular filtration rate loss among adults with established chronic kidney disease.CrossRefPubMed
30.•
Scialla JJ, Anderson CA. Dietary acid load: a novel nutritional target in chronic kidney disease? Adv Chron Kidney Dis. 2013;20(2):141–9. Excellent review summarizing the impact of endogenous acid load on kidney disease and progression.CrossRef
31.
Wesson DE, Jo CH, Simoni J. Angiotensin II receptors mediate increased distal nephron acidification caused by acid retention. Kidney Int. 2012;82(11):1184–94.CrossRefPubMed
32.
Wesson DE, Simoni J, Broglio K, Sheather S. Acid retention accompanies reduced GFR in humans and increases plasma levels of endothelin and aldosterone. Am J Physiol Ren Physiol. 2011;300(4):F830–7.CrossRef
33.
Wesson DE, Simoni J. Acid retention during kidney failure induces endothelin and aldosterone production which lead to progressive GFR decline, a situation ameliorated by alkali diet. Kidney Int. 2010;78(11):1128–35.CrossRefPubMed
34.
Wesson DE, Simoni J, Prabhakar S. Endothelin-induced increased nitric oxide mediates augmented distal nephron acidification as a result of dietary protein. J Am Soc Nephrol. 2006;17(2):406–13.CrossRefPubMed
35.
Khanna A, Simoni J, Wesson DE. Endothelin-induced increased aldosterone activity mediates augmented distal nephron acidification as a result of dietary protein. J Am Soc Nephrol. 2005;16(7):1929–35.CrossRefPubMed
36.
Khanna A, Simoni J, Hacker C, Duran MJ, Wesson DE. Increased endothelin activity mediates augmented distal nephron acidification induced by dietary protein. J Am Soc Nephrol. 2004;15(9):2266–75.CrossRefPubMed
37.
Nath KA, Hostetter MK, Hostetter TH. Pathophysiology of chronic tubulo-interstitial disease in rats. interactions of dietary acid load, ammonia, and complement component C3. J Clin Invest. 1985;76(2):667–75.CrossRefPubMedCentralPubMed
38.•
Goraya N, Simoni J, Jo CH, Wesson DE. A comparison of treating metabolic acidosis in CKD stage 4 hypertensive kidney disease with fruits and vegetables or sodium bicarbonate. Clin J Am Soc Nephrol. 2013;8(3):371–81. Observational study demonstrating that the addition of fruits and vegetables or sodium bicarbonate reduces the net endogenous acid productions in adults with chronic kidney disease.CrossRefPubMedCentralPubMed
39.
Goraya N, Simoni J, Jo C, Wesson DE. Dietary acid reduction with fruits and vegetables or bicarbonate attenuates kidney injury in patients with a moderately reduced glomerular filtration rate due to hypertensive nephropathy. Kidney Int. 2012;81(1):86–93.CrossRefPubMed
40.
Mahajan A, Simoni J, Sheather SJ, Broglio KR, Rajab MH, Wesson DE. Daily oral sodium bicarbonate preserves glomerular filtration rate by slowing its decline in early hypertensive nephropathy. Kidney Int. 2010;78(3):303–9.CrossRefPubMed
41.
Phisitkul S, Hacker C, Simoni J, Tran RM, Wesson DE. Dietary protein causes a decline in the glomerular filtration rate of the remnant kidney mediated by metabolic acidosis and endothelin receptors. Kidney Int. 2008;73(2):192–9.CrossRefPubMed
42.•
Slavin JL. Position of the American Dietetic Association: health implications of dietary fiber. J Am Diet Assoc. 2008;108(10):1716–31. Excellent summary of the health benefits of fiber and existing evidence supporting the current dietary recommendations.CrossRefPubMed
43.•
Kuo SM. The interplay between fiber and the intestinal microbiome in the inflammatory response. Adv Nutr Res. 2013;4(1):16–28. Comprehensive review which summarizes the interactions between dietary fiber, inflammation and the gut microbiome.CrossRef
44.
Ajani UA, Ford ES, Mokdad AH. Dietary fiber and C-reactive protein: findings from national health and nutrition examination survey data. J Nutr. 2004;134(5):1181–5.PubMed
45.
Johansson-Persson A, Ulmius M, Cloetens L, Karhu T, Herzig KH, Onning G. A high intake of dietary fiber influences C-reactive protein and fibrinogen, but not glucose and lipid metabolism, in mildly hypercholesterolemic subjects. Eur J Nutr. 2014;53(1):39–48.CrossRefPubMed
46.
Ma Y, Griffith JA, Chasan-Taber L, Olendzki BC, Jackson E, Stanek EJ, et al. Association between dietary fiber and serum C-reactive protein. Am J Clin Nutr. 2006;83(4):760–66.PubMedCentralPubMed
47.
Ma Y, Hebert JR, Li W, Bertone-Johnson ER, Olendzki B, Pagoto SL, et al. Association between dietary fiber and markers of systemic inflammation in the Women’s Health Initiative Observational Study. Nutrition. 2008;24(10):941–9.CrossRefPubMedCentralPubMed
48.
Ahmadi-Abhari S, Luben RN, Wareham NJ, Khaw KT. Seventeen year risk of all-cause and cause-specific mortality associated with C-reactive protein, fibrinogen and leukocyte count in men and women: the EPIC-Norfolk Study. Eur J Epidemiol. 2013;28(7):541–50.CrossRefPubMed
49.
Oluleye OW, Folsom AR, Nambi V, Lutsey PL, Ballantyne CM. ARIC Study I. Troponin T, B-type natriuretic peptide, C-reactive protein, and cause-specific mortality. Ann Epidemiol. 2013;23(2):66–73.CrossRefPubMedCentralPubMed
50.
de Boer IH, Katz R, Chonchol MB, Fried LF, Ix JH, Kestenbaum B, et al. Insulin resistance, cystatin C, and mortality among older adults. Diabetes Care. 2012;35(6):1355–60.CrossRefPubMedCentralPubMed
51.
Ning H, Van Horn L, Shay CM, Lloyd-Jones DM. Associations of dietary fiber intake with long-term predicted cardiovascular disease risk and C-reactive protein levels (from the National Health and Nutrition Examination Survey data [2005-2010]). Am J Cardiol. 2014;113(2):287–91.CrossRefPubMed
52.
Hamer M, Stamatakis E. Metabolically healthy obesity and risk of all-cause and cardiovascular disease mortality. J Clin Endocrinol Metab. 2012;97(7):2482–8.CrossRefPubMedCentralPubMed
53.
Shlipak MG, Fried LF, Cushman M, Manolio TA, Peterson D, Stehman-Breen C, et al. Cardiovascular mortality risk in chronic kidney disease: comparison of traditional and novel risk factors. JAMA. 2005;293(14):1737–45.CrossRefPubMed
54.
Lin J, Hu FB, Mantzoros C, Curhan GC. Lipid and inflammatory biomarkers and kidney function decline in type 2 diabetes. Diabetologia. 2010;53(2):263–7.CrossRefPubMedCentralPubMed
55.
Shankar A, Sun L, Klein BE, Lee KE, Muntner P, Nieto FJ, et al. Markers of inflammation predict the long-term risk of developing chronic kidney disease: a population-based cohort study. Kidney Int. 2011;80(11):1231–8.CrossRefPubMedCentralPubMed
56.
Bash LD, Erlinger TP, Coresh J, Marsh-Manzi J, Folsom AR, Astor BC. Inflammation, hemostasis, and the risk of kidney function decline in the Atherosclerosis Risk in Communities (ARIC) study. Am J Kidney Dis. 2009;53(4):596–605.CrossRefPubMedCentralPubMed
57.
Hiramoto JS, Katz R, Peralta CA, Ix JH, Fried L, Cushman M, et al. Inflammation and coagulation markers and kidney function decline: the Multi-Ethnic Study of Atherosclerosis (MESA). Am J Kidney Dis. 2012;60(2):225–32.CrossRefPubMedCentralPubMed
58.
Streppel MT, Ocke MC, Boshuizen HC, Kok FJ, Kromhout D. Dietary fiber intake in relation to coronary heart disease and all-cause mortality over 40 y: the Zutphen study. Am J Clin Nutr. 2008;88(4):1119–25.PubMed
59.
Eshak ES, Iso H, Date C, Kikuchi S, Watanabe Y, Wada Y, et al. JACC Study G. Dietary fiber intake is associated with reduced risk of mortality from cardiovascular disease among Japanese men and women. J Nutr. 2010;140(8):1445–53.CrossRefPubMed
60.
Park Y, Subar AF, Hollenbeck A, Schatzkin A. Dietary fiber intake and mortality in the NIH-AARP diet and health study. Arch Intern Med. 2011;171(12):1061–8.CrossRefPubMedCentralPubMed
61.
Li S, Flint A, Pai JK, Forman JP, Hu FB, Willett WC, et al. Dietary fiber intake and mortality among survivors of myocardial infarction: prospective cohort study. BMJ. 2014;348:g2659.CrossRefPubMedCentralPubMed
62.
Krishnamurthy VM, Wei G, Baird BC, Murtaugh M, Chonchol MB, Raphael KL, et al. High dietary fiber intake is associated with decreased inflammation and all-cause mortality in patients with chronic kidney disease. Kidney Int. 2012;81(3):300–6.CrossRefPubMed
63.
64.
Vaziri ND, Wong J, Pahl M, Piceno YM, Yuan J, DeSantis TZ, et al. Chronic kidney disease alters intestinal microbial flora. Kidney Int. 2013;83(2):308–15.CrossRefPubMed
65.
Lievin V, Peiffer I, Hudault S, Rochat F, Brassart D, Neeser JR, et al. Bifidobacterium strains from resident infant human gastrointestinal microflora exert antimicrobial activity. Gut. 2000;47(5):646–52.CrossRefPubMedCentralPubMed
66.
Costabile A, Kolida S, Klinder A, Gietl E, Bauerlein M, Frohberg C, et al. A double-blind, placebo-controlled, cross-over study to establish the bifidogenic effect of a very-long-chain inulin extracted from globe artichoke (Cynara scolymus) in healthy human subjects. Br J Nutr. 2010;104(7):1007–17.CrossRefPubMed
67.
Koleva PT, Valcheva RS, Sun X, Ganzle MG, Dieleman LA. Inulin and fructo-oligosaccharides have divergent effects on colitis and commensal microbiota in HLA-B27 transgenic rats. Br J Nutr. 2012;108(9):1633–43.CrossRefPubMed
68.
Davis LM, Martinez I, Walter J, Goin C, Goin C, Hutkins RW. Barcoded pyrosequencing reveals that consumption of galactooligosaccharides results in a highly specific bifidogenic response in humans. PLoS ONE. 2011;6(9):e25200.CrossRefPubMedCentralPubMed
69.
Langlands SJ, Hopkins MJ, Coleman N, Cummings JH. Prebiotic carbohydrates modify the mucosa associated microflora of the human large bowel. Gut. 2004;53(11):1610–6.CrossRefPubMedCentralPubMed
70.
Appel LJ, Moore TJ, Obarzanek E, Vollmer WM, Svetkey LP, Sacks FM, et al. A clinical trial of the effects of dietary patterns on blood pressure. DASH collaborative research group. N Engl J Med. 1997;336(16):1117–24.CrossRefPubMed
71.
Shimamoto T, Komachi Y, Inada H, Doi M, Iso H, Sato S, et al. Trends for coronary heart disease and stroke and their risk factors in Japan. Circulation. 1989;79(3):503–15.CrossRefPubMed
72.
Buckland G, Agudo A, Travier N, Huerta JM, Cirera L, Tormo MJ, et al. Adherence to the Mediterranean diet reduces mortality in the Spanish cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC-Spain). Br J Nutr. 2011;106(10):1581–91.CrossRefPubMed
73.
Trichopoulou A, Kouris-Blazos A, Vassilakou T, Gnardellis C, Polychronopoulos E, Venizelos M, et al. Diet and survival of elderly Greeks: a link to the past. Am J Clin Nutr. 1995;61(6 Suppl):1346S–50S.PubMed
74.
McNaughton SA, Bates CJ, Mishra GD. Diet quality is associated with all-cause mortality in adults aged 65 years and older. J Nutr. 2012;142(2):320–5.CrossRefPubMedCentralPubMed
75.
Knoops KT, de Groot LC, Kromhout D, Perrin AE, Moreiras-Varela O, Menotti A, et al. Mediterranean diet, lifestyle factors, and 10-year mortality in elderly European men and women: the HALE project. JAMA. 2004;292(12):1433–9.CrossRefPubMed
76.
77.
Jacobs Jr DR, Gross MD, Steffen L, Steffes MW, Yu X, Svetkey LP, et al. The effects of dietary patterns on urinary albumin excretion: results of the Dietary Approaches to Stop Hypertension (DASH) trial. Am J Kidney Dis. 2009;53(4):638–46.CrossRefPubMedCentralPubMed
78.
Huang X, Jimenez-Moleon J, Lindholm B, Cederholm T, Arnlov J, Riserus U, Sjogren P, Carrero J. Mediterranean diet, kidney function, and mortality in men with CKD. Clin J Am Soc Nephrology In Press2013.
79.•
Estruch R, Ros E, Salas-Salvado J, Covas MI, Corella D, Aros F, et al. PREDIMED Study I. Primary prevention of cardiovascular disease with a Mediterranean diet. N Engl J Med. 2013;368(14):1279–90. Seminal clinical trial showing that a Mediterranean diet with added olive oil or nuts reduces mortality.CrossRefPubMed
80.
Estruch R, Martinez-Gonzalez MA, Corella D, Salas-Salvado J, Ruiz-Gutierrez V, Covas MI, et al. PREDIMED Study I. Effects of a Mediterranean-style diet on cardiovascular risk factors: a randomized trial. Ann Intern Med. 2006;145(1):1–11.CrossRefPubMed
81.
Ravera M, Re M, Deferrari L, Vettoretti S, Deferrari G. Importance of blood pressure control in chronic kidney disease. J Am Soc Nephrol. 2006;17(4 Suppl 2):S98–103.CrossRefPubMed
82.
Kidney Disease Outcomes Quality Initiative (K/DOQI). K/DOQI clinical practice guidelines on hypertension and antihypertensive agents in chronic kidney disease. Am J Kidney Dis. 2004;43(5 Suppl 1):S1–290.
83.
American Diabetes A, Bantle JP, Wylie-Rosett J, Albright AL, Apovian CM, Clark NG, et al. Nutrition recommendations and interventions for diabetes: a position statement of the American Diabetes Association. Diabetes Care. 2008;31 Suppl 1:S61–78.CrossRef
84.
Kidney Disease Outcomes Quality Initiative (KDOQI). KDOQI clinical practice guidelines and clinical practice recommendations for diabetes and chronic kidney disease. Am J Kidney Dis. 2007;49(2 Suppl 2):S12–154.
85.
Chang A, Van Horn L, Jacobs D, Liu K, Bibbins-Domingo K, Newsom B, Shoham D, Durazo R, Kramer HJ. Lifestyle behaviors and incident chronic kidney disease: the CARDIA study. Am J Kidney Dis In Press2013.
86.
Mohan S, Campbell NR, Willis K. Effective population-wide public health interventions to promote sodium reduction. Can Med Assoc J. 2009;181(9):605–9.CrossRef
87.
Ezzati M, Riboli E. Behavioral and dietary risk factors for noncommunicable diseases. N Engl J Med. 2013;369(10):954–64.CrossRefPubMed
88.
89.
Gutierrez OM. Sodium- and phosphorus-based food additives: persistent but surmountable hurdles in the management of nutrition in chronic kidney disease. Adv Chron Kidney Dis. 2013;20(2):150–6.CrossRef
Metadaten
Titel
The Western Diet and Chronic Kidney Disease
verfasst von
Divya Hariharan
Kavitha Vellanki
Holly Kramer
Publikationsdatum
01.03.2015
Verlag
Springer US
Erschienen in
Current Hypertension Reports / Ausgabe 3/2015
Print ISSN: 1522-6417
Elektronische ISSN: 1534-3111
DOI
https://doi.org/10.1007/s11906-014-0529-6

Weitere Artikel der Ausgabe 3/2015

Current Hypertension Reports 3/2015 Zur Ausgabe

Hypertension and Metabolic Syndrome (JR Sowers and A Whaley-Connell, Section Editors)

Understanding the Importance of Race/Ethnicity in the Care of the Hypertensive Patient

Antihypertensive Agents: Mechanisms of Drug Action (ME Ernst, Section Editor)

Thiazide Diuretics in Chronic Kidney Disease

Hypertension and Metabolic Syndrome (JR Sowers and A Whaley-Connell, Section Editors)

Natriuretic Peptides as a Novel Target in Resistant Hypertension

Pulmonary Hypertension (N Hill, Section Editor)

Metabolic Dysfunction in Pulmonary Arterial Hypertension

Hypertension and Metabolic Syndrome (JR Sowers and A Whaley-Connell, Section Editors)

Visit-to-Visit Variability of Systolic Blood Pressure and Cardiovascular Disease

Secondary Hypertension: Nervous System Mechanisms (J Bisognano, Section Editor)

Renal Denervation in Heart Failure

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Kostenlos registrieren

Neu im Fachgebiet Innere Medizin

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Bei schweren Reaktionen auf Insektenstiche empfiehlt sich eine spezifische Immuntherapie

25.04.2024 Allergien und Intoleranzreaktionen Nachrichten

Insektenstiche sind bei Erwachsenen die häufigsten Auslöser einer Anaphylaxie. Einen wirksamen Schutz vor schweren anaphylaktischen Reaktionen bietet die allergenspezifische Immuntherapie. Jedoch kommt sie noch viel zu selten zum Einsatz.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen
Bildnachweise