Rationale and Need for Simpler and Effective Miniaturized Bedside Ultrafiltration Devices
Fluid overload in different acute or chronic clinical settings results in unfavorable outcomes. The use of restrictive strategies for fluid control or the use of diuretics is frequently ineffective and requires extracorporeal ultrafiltration for the removal of excess volume. These extracorporeal treatments are performed with bulky machinery and require highly specialized personnel. The creation of a miniaturized device for extracorporeal ultrafiltration (artificial diuresis) would fill the technological gap in this sector by responding to the needs of cost containment and rehabilitation of the patient. In this article, we ...
Source: Cardiorenal Medicine - December 15, 2022 Category: Urology & Nephrology Source Type: research
Rationale and need for simpler and effective miniaturized bedside
ultrafiltration devices
Fluid overload in different acute or chronic clinical settings results in unfavorable outcomes. The use of restrictive strategies for fluid control or the use of diuretics is frequently ineffective and requires extracorporeal ultrafiltration for the removal of excess volume. These extracorporeal treatments are performed with bulky machinery and require highly specialized personnel. The creation of a miniaturized device for extracorporeal ultrafiltration (Artificial Diuresis) would fill the technological gap in this sector by responding to the needs of cost containment and rehabilitation of the patient. In this article we e...
Source: Cardiorenal Medicine - December 15, 2022 Category: Urology & Nephrology Source Type: research
Acute and chronic cardiovascular consequences of acute kidney injury: a systematic review and meta-analysis.
We examined whether patients with acute kidney injury (AKI) have a higher risk of developing atrial fibrillation (AF), heart failure (HF), acute coronary syndrome (ACS) and major adverse cardiac events (MACE) in the short- and long-term compared to patients without AKI, and if that risk is relate d to the severity of AKI. Furthermore, we investigated the influence of a cardiac event following AKI on the risk of all-cause mortality, length of stay in the intensive care unit and in the hospital.
METHODS: We included English and Dutch retrospective and prospective cohort studies on adults (≥ 15 years) with AKI. Studies lac...
Source: Cardiorenal Medicine - November 18, 2022 Category: Urology & Nephrology Source Type: research
Extracorporeal Ultrafiltration for Acute Heart Failure
Acute decompensated heart failure (ADHF) has the highest rate of hospital re-admission among all medical conditions and portends a significant financial burden on healthcare systems worldwide. Hospitalization for ADHF is primarily driven by congestion, with intravenous loop diuretics representing the cornerstone of therapy. However, it is well described that a significant subset of patients are discharged with residual fluid overload. While the cause of the incomplete decongestion is multifactorial, development of diuretic resistance is a well-characterized contributing factor with consequent poor outcomes. Moreover, the t...
Source: Cardiorenal Medicine - November 2, 2022 Category: Urology & Nephrology Source Type: research
< b > < i > APOL1 < /i > < /b > G3 Variant Is Associated with Cardiovascular Mortality and Sudden Cardiac Death in Patients Receiving Maintenance Hemodialysis of European Ancestry
Conclusions: G3 inAPOL1 variant was associated with cardiovascular events and cardiovascular mortality in the EA patients receiving dialysis. This suggests that variations in theAPOL1 gene that differ in populations of different ancestry may contribute to cardiovascular disease.Cardiorenal Med (Source: Cardiorenal Medicine)
Source: Cardiorenal Medicine - October 28, 2022 Category: Urology & Nephrology Source Type: research
Long-Term Prognostic Impact of Estimated Glomerular Filtration Rate on Admission in Patients Hospitalized for Acute Heart Failure
Conclusion: Data from this large study provide evidence that an eGFR below 30 mL ·min−1·1.73 m−2 on admission could be an independent predictor for long-term mortality and readmissions in patients with AHF.Cardiorenal Med (Source: Cardiorenal Medicine)
Source: Cardiorenal Medicine - October 25, 2022 Category: Urology & Nephrology Source Type: research
The vascular disease of diabetic kidney disease
The incidence of cardiovascular disease (CVD) is increased in patients with diabetic kidney disease (DKD). Aortic stiffness is a well-accepted biomarker for cardiovascular (CV) events in all stages of CKD. The worldwide prevalence of diabetes continues to grow, as does the prevalence of DKD. Insulin resistance, hyperglycaemia, hypertension and the metabolic abnormalities of type-2 diabetes are all involved in the pathogenesis of CVD. The effect of these toxins on cardiac and vascular function is amplified by the worsening of renal function and the parallel rise of uraemic toxins. In this narrative review, we analysed why a...
Source: Cardiorenal Medicine - October 24, 2022 Category: Urology & Nephrology Source Type: research
Association of cancer antigen 125 with long-term prognosis in light-chain cardiorenal amyloidosis
Conclusions: Serum CA125 level was associated with long-term prognosis of AL cardiorenal amyloidosis. (Source: Cardiorenal Medicine)
Source: Cardiorenal Medicine - October 10, 2022 Category: Urology & Nephrology Source Type: research
Stanniocalcin 2 is upregulated by calcium-sensing receptor and protects human vascular smooth muscle cells from high
phosphate-induced apoptosis
Conclusion
This is the first evidence that STC2 is regulated by CaSR in HAoSMCs. CaSR activation and the subsequent STC2 increase have putative anti-apoptotic effects against high phosphate. Thus, calcimimetics are promising agents to treat vascular injury associated with uremia. (Source: Cardiorenal Medicine)
Source: Cardiorenal Medicine - October 10, 2022 Category: Urology & Nephrology Source Type: research
Estimation of Plasma Renin Activity on the Basis of Serum and Urinary Chloride Concentrations versus Sodium Concentrations
Introduction: The present study examined the possible estimation of plasma renin activity (PRA) by serum and urinary concentrations of chloride vs. sodium in acute and chronic heart failure (HF).
Methods: Data from 29 patients with acute HF (48% men;80.3 ±12 years-old) and 26 patients with recovery of HF after decongestive therapy (50% men;81.2±12 years-old) were analyzed. Blood and urine samples were obtained immediately before decongestive therapy in acute HF patients. Clinical tests included peripheral blood tests, serum and spot urinary electr olytes, and plasma neurohormones. Sodium- or chloride-related indices inc...
Source: Cardiorenal Medicine - October 10, 2022 Category: Urology & Nephrology Source Type: research
Fluid Overload and Precision Net Ultrafiltration in Critically Ill Patients
Background: Fluid overload is present in two-thirds of critically ill patients with acute kidney injury and is associated with morbidity, mortality, and increased healthcare resource utilization. Kidney replacement therapy is frequently used for net fluid removal (i.e., net ultrafiltration) in patients with severe oliguric acute kidney injury. However, ultrafiltration has considerable risks associated with it and there is a need for newer technology to perform ultrafiltration safely and to improve outcomes.
Summary: Caring for a critically ill patient with oliguric acute kidney injury and fluid overload is one of the mos...
Source: Cardiorenal Medicine - October 6, 2022 Category: Urology & Nephrology Source Type: research
Diagnosis of Fluid Overload: from Conventional to Contemporary Concepts
Fluid overload has been associated with morbidity and mortality in various clinical scenarios including heart failure and critical illness. It exerts pathologic sequelae in almost all the organ systems. Proper management of patients with fluid overload requires knowledge of the underlying pathophysiology, objective evaluation of volume status, selection of appropriate therapeutic options, and maintenance and modulation of tissue perfusion. There are several methods to appraise volume status but none without limitations. In this review, we discuss the diagnostic utility, prognostic significance, and shortcomings of various ...
Source: Cardiorenal Medicine - September 12, 2022 Category: Urology & Nephrology Source Type: research
Experience of a bespoke hyperkalaemia clinic to facilitate prescribing of renin-angiotensin-aldosterone system inhibitors in patients with heart failure with reduced ejection fraction
Discussion/Conclusio n
Patiromer prescribing in a nephrology-led hyperkalaemia clinic facilitated RAASi up-titration in patients with HFrEF by controlling potassium levels. (Source: Cardiorenal Medicine)
Source: Cardiorenal Medicine - August 31, 2022 Category: Urology & Nephrology Source Type: research
Interaction between hyperuricemia and admission lactate increases the risk of acute kidney injury in patients with ST-segment elevation myocardial infarction
Abstract
Background and Objective: Acute kidney injury (AKI) is a common complication associated with adverse outcomes among patients with ST-segment elevation myocardial infarction (STEMI). This is conflicting information about the relationship between hyperuricemia and AKI in STEMI. This work aims to investigate the effect of the interaction between hyperuricemia and lactate on the risk of AKI.
Methods: We analyzed 2,008 consecutive STEMI patients between January 2014 and January 2019. Hyperuricemia was defined as a serum uric acid (SUA) level>7 mg/dl for males and>6 mg/dl for females. AKI was defined based on the Kidn...
Source: Cardiorenal Medicine - August 2, 2022 Category: Urology & Nephrology Source Type: research
Roles for SGLT2 Inhibitors in Cardiorenal Disease
This article aims to provide a comprehensive overview of the efficacy of SGLT2i therapy in patients at risk of cardiorenal disease. A literature review of large outcome studies of patients who had CKD or heart failure with reduced ejection fraction (HFrEF, defined as having a left ventricle ejection fraction [LVEF] (Source: Cardiorenal Medicine)
Source: Cardiorenal Medicine - July 14, 2022 Category: Urology & Nephrology Source Type: research
