The Journal of Bucharest College of Physicians and the Romanian Academy of Medical Sciences

Andra Elena Balcangiu-Stroescu

Andra Elena Balcangiu-Stroescu

Is the Importance of Magnesium in Chronic Kidney Disease Underappreciated?

Magnesium (Mg) is one of the most important cations in the organism, essential for regulating vascular tone, cardiac rhythm, and endothelial functions. In patients with advanced stage chronic kidney disease (CKD) Mg deficit was associated in various studies with vascular calcifications and increased cardiovascular morbidity and mortality. Patients with CKD frequently have hyperparathyroidism, parathormone (PTH) being an important risk factor for vascular calcifications. Increased serum Mg levels inhibit PTH secretion and stimulate left ventricular hypertrophy, while low serum Mg levels stimulate PTH secretion. Correcting Mg de deficiency results in reduced cardiovascular mortality in these patients.

Read More »

Gastrointestinal Angiodysplasia in Patients with Chronic Kidney Disease and Hepatic Cirrhosis

Angiodysplasia (AD), gastric antral vascular ectasia (GAVE or watermelon stomach), radiation-induced vascular ectasia and Dieulafoy's lesions are considered sporadic lesions and they can induce gastrointestinal bleeding (1). AD is the most common vascular abnormality of the gastrointestinal tract, probably the most common cause of recurrent gastrointestinal hemorrhage in patients with renal failure (2) and an important cause of erythropoiet-inresistant anaemia in dialyzed patients. Angiodysplasia injuries developed in the gastric antrum were first described in 1953 and named GAVE, being characterized as submucosal capillary dilatation and fibromuscular hyperplasia (3).

Read More »

Nutritional Impact on Cardiovascular Risk in Chronic Hemodialysed Patients - A Systematic Review

Protein-energy malnutrition is a frequent clinical condition in chronic hemodialysis patients (1). The causes of protein-energy malnutrition are: interaction between blood and dialyzer with subsequent activation of the complement, amino acids and peptides losses when undergoing hemodialysis, metabolic acidosis, chronic inflammation and anorexia (2). There are two types of protein-energy malnutrition. Type 1 protein-energy malnutrition is characterized by patients’ poor food intake. This occurs along with slow decrease of serum albumin and loss of muscle mass, the presence of normal levels of C-reactive protein and response to nutritional interventions. The second type of protein-energy malnutrition is characterized by an increased serum level of C-reactive protein and lower serum albumin level than in type 1, even with an optimal food intake. This type of protein-caloric malnutrition is strongly associated with chronic inflammation and does not respond to nutritional intervention (3).

Read More »