Artificial Diuresis: animal studies on efficacy and safety of a new miniaturized device for extracorporeal ultrafiltration
Conclusions. This study opens the way for clinical trials in different settings including departments with low intensity of care and even in ambulatory centers or patient ’s home. (Source: Cardiorenal Medicine)
Source: Cardiorenal Medicine - March 28, 2023 Category: Urology & Nephrology Source Type: research

Prognosis of Patients with Acute Kidney Injury due to Type 1 Cardiorenal Syndrome Receiving Continuous Renal Replacement Therapy
Introduction The prognosis of patients with acute kidney injury (AKI) caused by type 1 cardiorenal syndrome (CRS) requiring continuous renal replacement therapy (CRRT) is unclear. We investigated the in-hospital mortality and prognostic factors in these patients. Methods We retrospectively identified 154 consecutive adult patients who received CRRT for AKI caused by type 1 CRS between January 1, 2013, and December 31, 2019. We excluded patients who underwent cardiovascular surgery and those with chronic kidney disease stage 5. The primary outcome was in-hospital mortality. Cox proportional hazards analysis was performed...
Source: Cardiorenal Medicine - March 24, 2023 Category: Urology & Nephrology Source Type: research

Usefulness of a Novel Vascular Access Management Method Using a Laser Blood Flowmeter
Introduction: Various methods for vascular access (VA) management have been studied. We investigated the usefulness a new, simple, and quantitative VA management method using the Pocket LDF ® laser blood flowmeter (hereinafter “LDF”) that non-invasively measures peripheral circulation flow. Methods: Peripheral circulation flow was measured in 82 patients (43 men) on maintenance hemodialysis with an arteriovenous fistula (AVF). The shunt symmetry index (SSI) was calculated as perip heral circulation flow in the AVF limb divided by that in the non-AVF limb. SSI was used for microcirculation evaluation and also compared ...
Source: Cardiorenal Medicine - March 23, 2023 Category: Urology & Nephrology Source Type: research

The relationship between vascular aging phenotypes and renal damage among individuals with type 2 diabetes
Objective: To investigate the relationship between vascular aging (VA) phenotypes and renal damage in type 2 diabetic population. Methods: In this cross-sectional study, we included 8,141 individuals with type 2 diabetes who participated in the Kailuan Study during 2010 to 2018 and completed the brachial-ankle pulse wave velocity (baPWV) assessment for arterial stiffness, an indicator for VA. The age- and sex-specific 10th and 90th percentiles of baPWV based on a reference cohort were used as cutoffs to define supernormal VA (SUPERNOVA, baPWV90th percentiles). The estimated glomerular filtration rate (eGFR) and proteinuria...
Source: Cardiorenal Medicine - February 24, 2023 Category: Urology & Nephrology Source Type: research

Aortic Stenosis and Aortic Valve Replacement Among Patients with Chronic Kidney Disease: A Narrative Review
Conclusion: The incidence of aortic stenosis increases with age but has also been independently associated with chronic kidney disease and furthermore with hemodialysis. Regular dialysis with hemodialysis vs. peritoneal dialysis and female gender have been associated with progression of AS. Management of aortic stenosis is multidisciplinary and requires planning and interventions by the “Heart-Kidney Team” to decrease risk of further inducing kidney injury among high-risk population. Both TAVR and SAVR are effective interventions for patients with severe symptomatic AS, but TAVR has been associated with better short-te...
Source: Cardiorenal Medicine - February 22, 2023 Category: Urology & Nephrology Source Type: research

Impact of dapagliflozin treatment on serum sodium concentrations in acute heart failure
Introduction The dynamics of serum sodium are important in acute heart failure (AHF), and hyponatremia is associated with a poor prognosis. The effect of sodium-glucose cotransporter type 2 inhibitors (SGLT2i) on serum sodium concentrations in AHF is unknown. Methods In a single-centre, controlled, randomized study, patients were prescribed dapagliflozin in addition to standard treatment during the first 24 hours of hospitalization, versus standard treatments. The pre-specified outcome was an absolute change in plasma sodium concentrations between randomization (first 24 hours after admission) and discharge. The seconda...
Source: Cardiorenal Medicine - February 20, 2023 Category: Urology & Nephrology Source Type: research

One heartbeat away from a prediction model for cardiovascular diseases in patients with chronic kidney disease: a systematic review
Discussion: A large quantity of prognostic studies has been published, yet their usefulness remains unclear due to incomplete presentation, and lack of externa l validation of prognostic models. Our review can be used to select the most appropriate prognostic model depending on the patient population, outcome, and risk of bias. Future collaborative efforts should aim at improving existing models by externally validating them, evaluate the addition of new p redictors, and assessment of the clinical impact. (Source: Cardiorenal Medicine)
Source: Cardiorenal Medicine - February 20, 2023 Category: Urology & Nephrology Source Type: research

Transcatheter Aortic Valve Replacement-Associated Acute Kidney Injury: An Update
This study reviews the current understanding of TAVR-associated AKI including its pathophysiology, risk factors, diagnostic modalities, and preventative management for patients. (Source: Cardiorenal Medicine)
Source: Cardiorenal Medicine - February 17, 2023 Category: Urology & Nephrology Source Type: research

Transcatheter Aortic Valve Replacement (TAVR)-associated Acute Kidney Injury: An Update
This study reviews the current understanding of TAVR-associated AKI including its pathophy siology, risk factors, diagnostic modalities, and preventative management for patients. (Source: Cardiorenal Medicine)
Source: Cardiorenal Medicine - February 17, 2023 Category: Urology & Nephrology Source Type: research

Tackling Congestion in Acute Heart Failure; Is It the Primetime for “Combo Diuretic Therapy”?
Symptoms and signs of congestion are the primary reason for hospitalization of patients with acute heart failure. Efficient fluid and sodium removal remains the main goal of therapy and loop diuretics are the recommended agents in this setting. However, the therapeutic response to these medications is known to be variable and a significant subset of patients are discharged from the hospital with residual fluid overload. Therefore, sequential blockade of nephron has been proposed as a more effective decongestive strategy. Pilot studies have suggested significant increase in diuresis and natriuresis with combination diuretic...
Source: Cardiorenal Medicine - February 14, 2023 Category: Urology & Nephrology Source Type: research

The Science of Extracorporeal Ultrafiltration: Introducing a Novel Miniaturized Device
Conclusions. This novel device allows to treat patients with fluid overload in a variety of settings, from low-intensity department such as long-term care facilities to the intensive care unit. The device is small and portable, has a simple design, and is user-friendly. Future studies will be needed to evaluate whether gentle ultrafiltration and treatment of volume overload will translate into improvement in clinical outcomes such as a reduction in congestion-related hospital admission. (Source: Cardiorenal Medicine)
Source: Cardiorenal Medicine - February 14, 2023 Category: Urology & Nephrology Source Type: research

Vascular calcification exacerbates abnormal blood pressure variability in chronic kidney disease: a “two-step” study in rats
Conclusion An increased BPV is observed in CKD rats, and VC further aggravates the abnormality of BPVs independent of CKD. (Source: Cardiorenal Medicine)
Source: Cardiorenal Medicine - February 10, 2023 Category: Urology & Nephrology Source Type: research

Prognosis of heart valve calcification on cardiovascular events in hemodialysis patients without central venous catheters
Introduction: Heart valvular calcification (HVC) is an important predictor of cardiovascular events (CEs) and all-cause mortality in dialysis patients. Patients in the early stage of dialysis or those with central venous catheters (CVCs) are also at high risk of cardiovascular and all-cause mortality. It could be a confounding factor for the prognosis of HVC on CE. Methods: From March 2017 to April 2022, the prognosis of HVC on CE and all-cause mortality was studied retrospectively in 158 hemodialysis (HD) patients who used arteriovenous fistulas (AVFs) or arteriovenous grafts (AVGs) as vascular access and entered HD for ...
Source: Cardiorenal Medicine - February 1, 2023 Category: Urology & Nephrology Source Type: research

Acknowledgement to Reviewers
Cardiorenal Med 2023;13:1 – (Source: Cardiorenal Medicine)
Source: Cardiorenal Medicine - January 26, 2023 Category: Urology & Nephrology Source Type: research

Diuretics and ultrafiltration in heart failure
Fluid overload is a risk factor for increased morbidity and mortality, especially in patients with heart disease. The treatment options for decongestion are limited to diuretics and mechanical fluid removal using ultrafiltration or renal replacement therapy. This paper provides an overview of the challenges of managing fluid overload, outlines the risks and benefits of different pharmacological options and extracorporeal techniques, and provides guidance for clinical practice. (Source: Cardiorenal Medicine)
Source: Cardiorenal Medicine - January 11, 2023 Category: Urology & Nephrology Source Type: research