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Cardiorenal Medicine

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https://read.qxmd.com/read/30726844/customization-of-peritoneal-dialysis-in-cardiorenal-syndrome-by-optimization-of-sodium-extraction
#1
REVIEW
Amir Kazory, Abhilash Koratala, Claudio Ronco
BACKGROUND: Peritoneal dialysis (PD) has emerged as a mechanistically relevant therapeutic option for patients with heart failure (HF), volume overload, and varying degrees of renal dysfunction (i.e., chronic cardiorenal syndrome). Congestion has been identified as a potent ominous prognostic factor in this patient population, outperforming a number of established risk factors. As such, excess fluid removal is recognized as a relevant therapeutic target in this setting. METHODS: Accumulating evidence points to the importance of sodium removal as part of any decongestive strategy because extraction of sodium-free water has little or no impact on the outcomes of these patients...
February 6, 2019: Cardiorenal Medicine
https://read.qxmd.com/read/30726840/nt-probnp-in-the-prognosis-of-death-or-need-for-renal-replacement-therapy-in-patients-with-stage-3-5-chronic-kidney-disease
#2
Leszek Gromadziński, Beata Januszko-Giergielewicz, Kamila Czarnacka, Piotr Pruszczyk
BACKGROUND: The risk of cardiovascular (CV) complications is much greater in patients with chronic kidney disease (CKD). The aim of this study was to assess predictors of mortality, renal failure progression, and the need for dialysis in patients with CKD. METHODS: The study group consisted of 70 patients with stage 3-5 CKD, followed up on average for 33.4 ± 15.6 months. Laboratory tests and echocardiography were performed on all patients. Composite endpoints were defined as (1) all-cause mortality and (2) mortality or renal replacement therapy (RRT), defined as the initiation of dialysis therapy...
February 6, 2019: Cardiorenal Medicine
https://read.qxmd.com/read/30699407/biomarkers-of-inflammation-fibrosis-and-acute-kidney-injury-in-patients-with-heart-failure-with-and-without-left-ventricular-assist-device-implantation
#3
Liza Grosman-Rimon, Sarah Genevieve Hui, Danit Freedman, Gabby Elbaz-Greener, David Cherney, Vivek Rao
BACKGROUND/AIMS: Renal dysfunction or renal failure is a common complication in left ventricular assist device (LVAD) recipients and is associated with reduced survival. To date, serum creatinine and glomerular filtration rate (GFR) are used for the evaluation of kidney function. However, serum creatinine and GFR have limitations. The objective of our study is to assess the levels of kidney biomarkers in LVAD recipients compared to heart failure patients and healthy controls and to examine their association with conventional clinical biomarkers...
January 30, 2019: Cardiorenal Medicine
https://read.qxmd.com/read/30673661/outcomes-of-moderate-to-severe-acute-kidney-injury-following-left-ventricular-assist-device-implantation
#4
David M Harmon, Kristen M Tecson, Brian Lima, Justin D G Collier, Asad F Shaikh, Sasha Still, Ronald D Baxter, Nicole Lew, Richa Thakur, Joost Felius, Shelley A Hall, Gonzalo V Gonzalez-Stawinski, Susan M Joseph
BACKGROUND: Although acute kidney injury (AKI) is a common complication following cardiac surgery, less is known about the occurrence and consequences of moderate/severe AKI following left ventricular assist device (LVAD) implantation. METHODS: All patients who had an LVAD implanted at our center from 2008 to 2016 were reviewed to determine the incidence of, and risk factors for, moderate/severe (stage 2/3) AKI and to compare postoperative complications and mortality rates between those with and those without moderate/severe AKI...
January 23, 2019: Cardiorenal Medicine
https://read.qxmd.com/read/30636246/prolonged-hyperglycemia-and-renal-failure-after-primary-percutaneous-coronary-intervention
#5
Elena Izkhakov, Zach Rozenbaum, Gilad Margolis, Shafik Khoury, Gad Keren, Yacov Shacham
BACKGROUND: There are limited data regarding the effect of long-standing hyperglycemia on the occurrence of acute kidney injury (AKI) in ST segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI). METHODS: We retrospectively studied 723 STEMI patients undergoing primary PCI. Patients were stratified into two groups according to glycated hemoglobin (HbA1c) levels as a marker of prolonged hyperglycemia: those with HbA1c < 7% and those with HbA1c ≥7%...
January 11, 2019: Cardiorenal Medicine
https://read.qxmd.com/read/30544108/echocardiographic-and-hemodynamic-parameters-associated-with-diminishing-renal-filtration-among-patients-with-heart-failure-with-preserved-ejection-fraction
#6
Kevin Bryan Lo, Kene Mezue, Pradhum Ram, Abhinav Goyal, Mahek Shah, Parasuram Krishnamoorthy, Shuchita Gupta, Gregg S Pressman, Janani Rangaswami
BACKGROUND: Renal dysfunction is an important predictor of poor outcomes in patients with heart failure with preserved ejection fraction (HFpEF). Right ventricular (RV) dysfunction is implicated as one of the explanations for worsening renal function in cardiorenal syndrome. Novel right heart catheterization (RHC) parameters such as pulmonary artery pulsatility index (PAPi) and right atrial to pulmonary capillary wedge pressure ratio (RA:PCWP) have been found as predictors of RV dysfunction...
December 13, 2018: Cardiorenal Medicine
https://read.qxmd.com/read/30537709/individualized-hemodialysis-treatment-a-perspective-on-residual-kidney-function-and-precision-medicine-in-nephrology
#7
REVIEW
Inkyong Hur, Yong Kyu Lee, Kamyar Kalantar-Zadeh, Yoshitsugu Obi
BACKGROUND: Residual kidney function (RKF) is often expected to inevitably and rapidly decline among hemodialysis patients and, hence, has been inadvertently ignored in clinical practice. The importance of RKF has been revisited in some recent studies. Given that patients with end-stage renal disease now tend to initiate maintenance hemodialysis therapy with higher RKF levels, there seem to be important opportunities for incremental hemo-dialysis by individualizing the dose and frequency according to their RKF levels...
December 11, 2018: Cardiorenal Medicine
https://read.qxmd.com/read/30485849/impaired-left-ventricular-global-longitudinal-strain-among-patients-with-chronic-kidney-disease-and-end-stage-renal-disease-and-renal-transplant-recipients
#8
Maura Ravera, Gian Marco Rosa, Paolo Fontanive, Elisabetta Bussalino, Ulrico Dorighi, Daniela Picciotto, Luca Di Lullo, Frank Lloyd Dini, Ernesto Paoletti
BACKGROUND: Although heart failure is the most prevalent cardiovascular disease associated with adverse outcome in chronic kidney disease (CKD) and after kidney transplantation, left ventricular (LV) systolic function is often preserved in renal patients. The aim of this study was to evaluate global longitudinal strain (GLS), which is reportedly a more accurate tool for detecting subclinical LV systolic dysfunction, in patients with various degrees of renal function impairment, including kidney transplant recipients (KTRs)...
2019: Cardiorenal Medicine
https://read.qxmd.com/read/30359977/chronic-hyperkalemia-in-cardiorenal-patients-risk-factors-diagnosis-and-new-treatment-options
#9
REVIEW
Luca Di Lullo, Claudio Ronco, Antonio Granata, Ernesto Paoletti, Vincenzo Barbera, Mario Cozzolino, Maura Ravera, Maria Fusaro, Antonio Bellasi
Chronic hyperkalemia (HK) is a serious medical condition that often manifests in patients with chronic kidney disease (CKD) and heart failure (HF) leading to poor outcomes and necessitating careful management by cardionephrologists. CKD, HF, diabetes, and renin-angiotensin-aldosterone system inhibitors use is known to induce HK. Current therapeutic options are not optimal, as pointed out by a large number of CKD and HF patients with HK. The following review will focus on the main risk factors for developing HK and also aims to provide a guide for a correct diagnosis and present new approaches to therapy...
2019: Cardiorenal Medicine
https://read.qxmd.com/read/30223273/hepatorenal-syndrome-or-hepatocardiorenal-syndrome-revisiting-basic-concepts-in-view-of-emerging-data
#10
REVIEW
Amir Kazory, Claudio Ronco
BACKGROUND: Accumulating evidence on the pathophysiology of hepatorenal syndrome has challenged the conventional model of liver-kidney connection. While liver cirrhosis is traditionally considered the origin of a cascade of pathophysiologic mechanisms directly affecting other organs such as the kidney, emerging data point to the heart as the potential mediator of the untoward renal effects. SUMMARY: Herein, we briefly review the often-overlooked contribution of the heart to circulatory dysfunction in hepatorenal syndrome and put forward evidence arguing for the involvement of systemic inflammation and endothelial dysfunction in this setting...
2019: Cardiorenal Medicine
https://read.qxmd.com/read/30428461/in-hospital-mortality-and-major-adverse-cardiovascular-events-after-kidney-transplantation-in-the-united-states
#11
Abhinav Goyal, Kshitij Chatterjee, Roy O Mathew, Mandeep S Sidhu, Sripal Bangalore, Peter A McCullough, Janani Rangaswami
BACKGROUND: Kidney transplantation (KT) is the treatment of choice for end-stage kidney disease. Cardiovascular disease is a major determinant of morbidity and mortality in patients with KT. Temporal trends in perioperative cardiovascular outcomes after KT are understudied, especially in light of an aging KT waitlist population. METHODS: We performed a retrospective observational cohort study using the National Inpatient Sample for the years 2004-2013. All adult patients undergoing KT were identified using the appropriate International Classification of Diseases, 9th Revision, Clinical Modification codes...
November 14, 2018: Cardiorenal Medicine
https://read.qxmd.com/read/30408781/derived-subendocardial-viability-ratio-and-cardiovascular-events-in-patients-with-chronic-kidney-disease
#12
Robert Ekart, Sebastjan Bevc, Nina Hojs, Radovan Hojs
BACKGROUND: Chronic kidney disease (CKD) is a well-known mortality risk factor. The subendocardial viability ratio (SEVR) is one of the pulse wave analysis parameters that constitutes a non-invasive measure of coronary perfusion. We aimed to assess the prognostic value of the SEVR for cardiovascular outcome in non-dialysis CKD patients. METHODS: A total of 98 CKD patients (mean age 60 years) were prospectively followed up from the date of the SEVR measurement until their death or the start of dialysis/transplantation, maximally up to 7...
November 8, 2018: Cardiorenal Medicine
https://read.qxmd.com/read/30404080/enteral-baicalin-a-flavone-glycoside-reduces-indicators-of-cardiac-surgery-associated-acute-kidney-injury-in-rats
#13
Jing Shi, Guofeng Wu, Xiaohua Zou, Ke Jiang
BACKGROUND/AIMS: Cardiac surgery-associated acute kidney injury (CSA-AKI) is one of the most common postoperative complications in intensive care medicine. Baicalin has been shown to have anti-inflammatory and antioxidant roles in various disorders. We aimed to test the protective effects of baicalin on CSA-AKI using a rat model. METHODS: Sprague-Dawley rats underwent 75 min of cardiopulmonary bypass (CPB) with 45 min of cardioplegic arrest (CA) to establish the AKI model...
November 7, 2018: Cardiorenal Medicine
https://read.qxmd.com/read/30380539/early-left-ventricular-dysfunction-detected-by-speckle-tracking-in-long-term-hemodialysis-patients-with-valvular-calcification
#14
Jiahui Li, Aili Li, Jiali Wang, Yu Zhang, Ying Zhou
PURPOSE: Cardiac valve calcification (VC) is very common in patients on hemodialysis. However, the definite effect of VC on left ventricular (LV) geometry and function in this population is unknown, especially when LV ejection fraction (LVEF) is normal. The aim of this study was to determine the effect of VC on LV geometry and function in long-term hemodialysis patients by conventional echocardiography and two-dimensional speckle tracking echocardiography (2D-STE). METHODS: A total of 47 hemodialysis patients (2-3 times weekly for 5 years or more) were enrolled in this study...
October 31, 2018: Cardiorenal Medicine
https://read.qxmd.com/read/30223269/impact-of-kdigo-defined-acute-kidney-injury-on-mortality-after-percutaneous-coronary-intervention-for-acute-myocardial-infarction
#15
Vojko Kanic, Gregor Kompara, David Suran, Robert Ekart, Sebastjan Bevc, Radovan Hojs
BACKGROUND: There are limited data regarding the incidence and long-term impact of acute kidney injury (AKI) according to the KDIGO guidelines on the outcome in patients with myocardial infarction (MI) treated with percutaneous coronary intervention (PCI). The aim of the study was to evaluate the prevalence of AKI, as classified by the KDIGO criteria, and its association with long-term mortality. METHODS: Data from 5,859 MI patients undergoing PCI at our institution were analyzed...
2018: Cardiorenal Medicine
https://read.qxmd.com/read/30205401/levels-of-proinflammatory-cytokines-oxidative-stress-and-tissue-damage-markers-in-patients-with-acute-heart-failure-with-and-without-cardiorenal-syndrome-type-1
#16
Grazia Maria Virzì, Andrea Breglia, Alessandra Brocca, Massimo de Cal, Chiara Bolin, Giorgio Vescovo, Claudio Ronco
BACKGROUND: Cardiorenal syndrome type 1 (CRS type 1) is characterized by a rapid worsening of cardiac function leading to acute kidney injury (AKI). Inflammation and oxidative stress seem to play a pivotal role in its pathophysiology. In this in vivo study, we examined the putative role of inflammation and humoral markers in the pathogenesis of the CRS type 1. METHODS: We enrolled 53 patients with acute heart failure (AHF); 17 of them developed AKI (CRS type 1)...
2018: Cardiorenal Medicine
https://read.qxmd.com/read/30121654/urine-cofilin-1-detection-for-predicting-type-1-cardiorenal-syndrome-in-the-coronary-care-unit-a-gold-nanoparticle-and-laser-based-approach
#17
Hsing-Yu Chen, Chien Chou, Chih-Hsiang Chang, Nien-Gen Lee, Pei-Chun Yu, Yu-Chi Chen, Heng-Chih Pan, Pei-Chun Fan, Chih-Wei Yang, Wen-Jin Cherng, Yung-Chang Chen
BACKGROUND: Type 1 cardiorenal syndrome (CRS) is a severe complication for acute decompensated heart failure patients. This study aimed at evaluating the feasibility of using the gold nanoparticle-based localized surface plasmon-coupled fluorescence biosensor (LSPCFB) to detect urine cofilin-1 as a biomarker for predicting CRS among patients in the coronary care unit (CCU). METHODS: A total of 44 patients were included with prospectively collected urine and blood samples...
2018: Cardiorenal Medicine
https://read.qxmd.com/read/30121647/relationship-between-plasma-proprotein-convertase-subtilisin-kexin-type-9-and-estimated-glomerular-filtration-rate-in-the-general-chinese-population
#18
Hui-Wen Zhang, Xi Zhao, Rui-Xia Xu, Yuan-Lin Guo, Cheng-Gang Zhu, Na-Qiong Wu, Chuan-Jue Cui, Qian Dong, Jian-Jun Li
BACKGROUND: Elevated levels of proprotein convertase subtilisin/kexin type 9 (PCSK9) have been reported to be related to dyslipidemia, including patients with kidney dysfunction. However, its association with estimated glomerular filtration rate (eGFR) in individuals with normal serum creatinine (SCr) has not been determined. METHODS: A total of 2,089 subjects with normal SCr and without lipid-lowering treatment were consecutively enrolled in this study. Plasma PCSK9 levels were measured by ELISA kit and eGFR was evaluated by the Chronic Kidney Disease Epidemiology Collaboration equation...
2018: Cardiorenal Medicine
https://read.qxmd.com/read/30089281/cardionephrology-proposal-for-a-futuristic-educational-approach-to-a-contemporary-need
#19
REVIEW
Amir Kazory, Peter A McCullough, Janani Rangaswami, Claudio Ronco
The field of cardiorenal medicine is vast, rapidly expanding, and complex. Conventional nephrology training programs provide the fellows with the necessary core knowledge to provide general care for patients with renal and cardiovascular diseases. However, there is a need for focused training of interested physicians to master the specialized aspects of these exceedingly common clinical scenarios and optimize the care of such patients. A cardionephrology-focused training can add value to the nephrology subspecialty and potentially increase its attractiveness for a significant subset of trainees...
2018: Cardiorenal Medicine
https://read.qxmd.com/read/30078001/detection-of-atherosclerotic-cardiovascular-disease-in-patients-with-advanced-chronic-kidney-disease-in-the-cardiology-and-nephrology-communities
#20
Rafia I Chaudhry, Roy O Mathew, Mandeep S Sidhu, Preety Sidhu-Adler, Radmila Lyubarova, Janani Rangaswami, Loay Salman, Arif Asif, Jerome L Fleg, Peter A McCullough, Frank Maddux, Sripal Bangalore
BACKGROUND: Atherosclerotic cardiovascular disease (ASCVD) is a leading cause of morbidity and mortality among patients with chronic kidney disease (CKD) with a glomerular filtration rate of < 60 mL/min/1.73 m2 body surface area. The availability of high-quality randomized controlled trial data to guide management for the population with CKD and ASCVD is limited. Understanding current practice patterns among providers caring for individuals with CKD and CVD is important in guiding future trial questions...
2018: Cardiorenal Medicine
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