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Laurynas Rimševičius, Diana Aksionova, Marius Miglinas, Jolita Badarienė, Ligita Ryliškytė, Alma Čypienė, Vytautas Kasiulevičius, Mantė Barzdenytė, Justina Tracevičiūtė and Aleksandras Laucevičius

Summary

Increased awareness of chronic kidney disease stimulates an interest towards early detection and prevention. The true prevalence of kidney injury varies from 10 to 40%, mostly depending on the methodology of the study and the population enrolled. A screening strategy targeting the highest risk groups, those with diabetes or hypertension, family history of diabetes, hypertension, or kidney disease, is likely to be most efficient and cost effective. Quantification for albuminuria should be performed using laboratorymethods or albumin to creatinine ratio and should be monitored at regular intervals. The most correct equations calculating glomerular filtration rate differ in separate populations, and the most accurate equations in patients with high cardiovascular risk are MDRD and CKD-EPI. Markers of early kidney damage have association with other target organs damage, even in subclinical or preclinical mode. Individuals at stage 4 and 5 chronic kidney disease, with higher levels of proteinuria, proteinuria together with haematuria, rapidly declining glomerular filtration rate, or poorly controlled hypertension should be referred to a nephrologist in order to identify the cause, provide recommendations, slow progression, or treat complications.

Open access

Jolita Badarienė, Jelena Čelutkienė, Dovilė Petrikonytė, Jūratė Balsytė, Egidija Rinkūnienė, Ligita Ryliškytė, Vilma Dženkevičiūtė, Alma Čypienė, Romualdas Kizlaitis, Roma Puronaitė and Aleksandras Laucevičius

Summary

Objectives:The aim of this study was to assess the diagnostic value of exercise stress testing to detect coronary heart disease (CHD) in the group of patients with metabolic syndrome.

Design and methods: 2803 patients without prior diagnosis of CHD and identified metabolic syndrome were investigated. Subjects underwent electrocardiogram (ECG) stress testing and, depending on the results, coronary angiography and/or coronary computed tomography angiography to detect hemodynamically significant stenosis. CHD was confirmed, if lumen narrowing ≥ 50% of coronary arteries was found.

Results: Exercise stress testing was interpreted as positive in 12% patients (71.7% women and 28.3% men). CHD was diagnosed in 45 patients (1.6%), 23 of them had positive exercise stress testing. ECG stress testing was more frequently positive in patients, who had typical/atypical anginal chest pain, dyspnea and/or non-anginal chest pain, in comparison to asymptomatic patients (16.6% vs 8.9%, p <0.001). CHD was more often diagnosed in symptomatic patients compared to patients with no symptoms (6.1% vs 0.7%, p < 0.001, women 5.3% vs 0.6%, p < 0.001, men respectively 8% vs 0.8%, p < 0.001).

Conclusions: Diagnostic value of exercise stress testing for detecting CHD is limited in population with metabolic syndrome. CHD was more prevalent in patients with chest pain or dyspnea than in asymptomatic patients.