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Focusing largely on end-stage renal disease, this Viewpoint outlines some echocardiographic indices of left ventricular function, and examines their prognostic value in chronic kidney disease. Recommendations are provided for optimal indexing of estimates of left ventricular mass to body size in this population. The role of echocardiography as an outcome measure in interventional studies and in the longitudinal monitoring of cardiac risk are also briefly considered.
Decreased libido, difficulty becoming aroused and achieving orgasm, erectile and ejaculatory dysfunction, and lack of vaginal lubrication are common problems that have a substantial impact on the quality of life of people with chronic kidney disease. This guide to the assessment and management of sexual dysfunction in renal patients emphasizes the multifactorial nature of such problems, and the need for medical teams to initiate discussion of sexual issues as part of routine care.
Kinins are endogenous vasodilators, through which at least some of the beneficial cardiovascular effect of ACE inhibitors is exerted. In the past 15 years, development of new research tools has contributed to the generation of many genetic, biochemical and clinical data. Here, these new findings are brought together to illustrate the potential for manipulation of the kallikrein–kinin system to ameliorate hypertension and its complications, including cardiac hypertrophy and renal failure.
