Background: Chronic kidney disease (CKD) may be associated with fatal cardiovascular diseases (CVDs). We aim to identify CVD‐related mortality trends in patients with CKD in the US, examining the variation by sex, race, and region, and compare them to CVD‐related mortality trends in general.Methods: The CDC‐WONDER database was used to obtain age‐adjusted mortality rates (AAMRs) per 100,000 population. Annual percent change (APC) and average APC (AAPC) in these rates were calculated using Joinpoint regression and comparisons were done using pairwise comparison.Results: From 1999 to 2020, a total of 605,384 CVD‐related deaths were observed in patients with CKD. The AAMR was almost double in males (11.0) than females (6.3). NH (Non‐Hispanic) Blacks or African Americans displayed the highest overall AAMR while NH Asians or Pacific Islanders displayed the lowest. AAMRs also varied substantially by region (Midwest: 8.8; West: 8.6; South: 8.0; Northeast: 7.3). States with the highest AAMR was the District of Columbia. Nonmetropolitan regions exhibited a slightly higher AAMR (8.6) than metropolitan regions (8.1). The AAPC for CVD‐related deaths in patients with CKD differed significantly from that of the general population for the entire cohort, across both sexes, as well as among NH Whites, NH Black or African Americans, and Hispanics or Latinos. Regional differences were also observed in the Midwest, Northeast, and West.Conclusion: Significant differences in CVD‐related deaths in patients with CKD were observed. These high‐risk groups should be the point of focus for targeted interventions to reduce CVD‐related mortality in CKD patients.
Magnetic resonance-guided laser interstitial thermal therapy (MRg-LITT) is a promising new technique to ablate epileptic foci in patients with hypothalamic hamartoma (HH). We aim to systematically synthesize all available evidence and determine the effectiveness of MRg-LITT in reducing seizures in patients with HH. We systematically searched MEDLINE (PubMed), Embase (Ovid), Scopus, and Google Scholar for all relevant articles. We used Open[Meta]Analyst to pool the number of seizure free patients after MRg-LITT treatment in a Random Effects model. Risk ratios (RRs) were calculated, and subgroups were analyzed. Comprehensive Meta Analysis was used to assess publication bias via funnel plots, Egger's regression test and Begg's correlation test. This review complies with the PRISMA guidelines. After screening the titles, abstracts, and full texts, we included seventeen articles in our meta-analysis, which revealed a 77.1% rate of seizure freedom (95% CI 0.696 to 0.837, p < 0.001), with moderate heterogeneity (I2 = 49.46%). Subgroup analysis by study design and sensitivity analyses excluding one study at a time did not impact the results substantially, and we found no evidence of publication bias. Adverse effects included electrolyte imbalances, weight gain, and transient neurologic disturbances. Magnetic resonance-guided laser interstitial thermal therapy might be a feasible and effective technique for ablation of epileptic foci, leading to seizure freedom in a large proportion of patients with hypothalamic hamartoma. However, there is a paucity of literature on the topic, and prospective clinical trials with larger number of participants, comparing MRg-LITT to open surgery, are needed.
5 June 2024 in Diabetes Research and Clinical Practice