Cardiorenal Medicine最新文献

{"title":"Review of Hyperkalemia Profile for Mineralocorticoid Receptor Antagonist in Patients with Chronic Kidney Disease and Type 2 Diabetes.","authors":"Jessica B Kendrick, Angelina Magreni Dixon","doi":"10.1159/000552030","DOIUrl":"https://doi.org/10.1159/000552030","url":null,"abstract":"<p><strong>Background: </strong>Type 2 diabetes (T2D) frequently coexists with chronic kidney disease (CKD), magnifying the risk of both cardiovascular and renal complications. Although therapies targeting the renin-angiotensin-aldosterone system (RAAS) slow CKD progression and reduce cardiovascular events, they also raise the risk of hyperkalemia. Finerenone, a newer nonsteroidal mineralocorticoid receptor antagonist (MRA), offers potent cardiorenal protection with relatively low hyperkalemia risk.</p><p><strong>Methods: </strong>We conducted a narrative review of randomized controlled trials (RCTs) published up to September 2024 which evaluated spironolactone, eplerenone, or finerenone in populations with T2D, CKD, or heart failure. Studies that reported explicit data on hyperkalemia incidence, severity, and management were included. The findings were synthesized narratively with the consideration of heterogeneity in study population and hyperkalemia definition.</p><p><strong>Results: </strong>Evidence from spironolactone and eplerenone trials underscores the survival benefits of steroidal MRAs in heart failure patients but also demonstrates a notable hyperkalemia risk, especially in patients with advanced CKD. Finerenone, studied in FIDELIO-DKD, FIGARO-DKD, and subsequently pooled in FIDELITY, demonstrated robust efficacy in reducing cardiovascular and kidney outcomes. It was associated predominantly with mild-to-moderate hyperkalemia which stabilized with regular monitoring. The incidence of severe events and therapy discontinuations due to hyperkalemia were low. A risk-prediction model from FIDELITY further stratified patients by hyperkalemia risk, revealing consistent relative hyperkalemia risk of finerenone across all strata.</p><p><strong>Conclusions: </strong>Hyperkalemia remains a pivotal challenge when prescribing MRAs in patients with T2D and CKD, often leading to underutilization of these lifesaving agents. However, finerenone's safety profile, combined with diligent potassium surveillance and proactive management strategies (e.g., dietary guidance, potassium binders, use of diuretics), enables sustained cardiorenal benefits. Future research should explore real-world applicability of these trial findings and further refine risk-based treatment algorithms to optimize outcomes in this high-risk population.</p>","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"1-18"},"PeriodicalIF":2.9,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic Kidney Disease, Circulating Ceramides and Coronary Microvascular Dysfunction: Insights from the CRUISE-MET Study.","authors":"Qiang Chen, Xuexi Li, Yingying Xie, Yike Li, Zhaoxue Sheng, Wuqiang Che, Shuoyan An, Sunjing Fu, Lining He, Cui Fang, Wenjun Dong, Jingang Zheng, Yanxiang Gao","doi":"10.1159/000552268","DOIUrl":"https://doi.org/10.1159/000552268","url":null,"abstract":"<p><strong>Background: </strong>Ceramides and chronic kidney disease (CKD) independently associate with coronary microvascular dysfunction (CMD), but their combined association remains unestablished, warranting investigation.</p><p><strong>Method: </strong>This cross-sectional analysis included coronary artery disease (CAD) patients from the CRUISE-MET trial (NCT06383208) who underwent coronary angiography and ceramide profiling measurement. The microvascular resistance was assessed in all patients using the angiography-derived microcirculatory resistance (AMR). CKD was classified based on both estimated glomerular filtration rate (eGFR) and urine albumin-to-creatinine ratio (UACR). The combined associations and statistical mediation of ceramides and renal dysfunction on CMD was examined, with sensitivity analyses to ensure the robustness.</p><p><strong>Result: </strong>In this analysis of 794 CAD patients, CKD patients demonstrated significantly higher AMR values [2.56 ± 0.51 vs 2.46 ± 0.48, p = 0.003] and CMD prevalence (57.1% vs 41.7%, p<0.001). Three ceramide species - Cer(18:1/16:0), Cer(18:1/18:0), and Cer(18:1/24:1) - showed strong positive correlations with AMR (all p < 0.05). LASSO regression identified 14 factors associated with CMD, with E/e', CKD, and Cer(18:1/16:0) emerging as top correlates. Cer(18:1/16:0) demonstrated superior predictive performance (AUC=0.609, 95%CI: 0.570-0.648, p<0.001), with its addition to baseline models significantly improving reclassification (δAUC=0.03, p=0.010; cNRI＞0=0.23, p<0.001; IDI=0.03, p<0.001). Notably, patients with concurrent CKD and elevated Cer(18:1/16:0) exhibited significantly higher odds of CMD (OR=3.74, 95%CI: 2.39-5.84). Statistical mediation analysis suggested that Cer(18:1/16:0) mediated 13.8% of the association between CKD and CMD.</p><p><strong>Conclusion: </strong>Ceramides, particularly Cer(18:1/16:0), partially mediated the statistical association between CKD and CMD. These findings highlight the potential role of sphingolipid metabolism in cardiorenal pathophysiology.</p>","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"1-20"},"PeriodicalIF":2.9,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrated Ultrasound Approach to Fluid Assessment and Nutritional Status in Hemodialysis.","authors":"Jose C De La Flor, Avinash Chandu Nanwani, Celia Rodríguez Tudero, Elena Jiménez Mayor, Irwing R Benites Flores, Juan LLuncor Vásquez, Susan F Alcalde-Ruiz, Hugo J Espinoza-Rojas, Katia Hernández Torres, Patricia Muñoz-Ramos, Gregorio Romero-González, Jesús Angel Hernandez Vaquero","doi":"10.1159/000552121","DOIUrl":"https://doi.org/10.1159/000552121","url":null,"abstract":"<p><strong>Background and aims: </strong>Fluid overload is a major determinant of morbidity and mortality in maintenance hemodialysis (MHD) patients. This exploratory study describes the integration of lung ultrasound (LUS), modified Venous Excess Ultrasound Score (mVExUS), and bioimpedance analysis (BIA) for non-invasive fluid status assessment in MHD. Additionally, this study aimed to correlate congestion with malnutrition using echographic parameters (Nutritional Ultrasound (NUS)) in congestive and non-congestive patients.</p><p><strong>Materials and methods: </strong>In this single-center retrospective observational cohort study, 47 adult patients on MHD underwent pre-dialysis evaluation with LUS, mVExUS, NUS and BIA. Patients were classified as congestive if they had a mVExUS score ≥2, LUS with ≥3 B-lines in ≥3 thoracic zones and BIA with the ratio of extracellular water to total body water ECW/TBW ≥ 0.39. NUS was used to assess the quadriceps rectus femoris (QRF) and preperitoneal visceral fat (PPVF), measuring Y-axis, Y-axis/height, cross-sectional muscle area rectus femoris (CS-MARF) and supramuscular fat (SMF). Demographic, biochemical, functional and dialysis-related parameters were collected. Frailty, sarcopenia and nutritional status were evaluated. Congestive patients were reassessed after five weeks.</p><p><strong>Results: </strong>Eight patients (17%) met criteria for congestion. As expected by the predefined congestion criteria, patients classified as congestive showed higher mVExUS grades (p < 0.001), greater B-line burden (11.9 vs. 2.9), and higher ECW/TBW ratios (0.42 vs 0.40; p=0.004). After five weeks, congestive patients exhibited improvements in N-terminal pro-B-type natriuretic peptide (NT-proBNP), portal vein pulsatility index and pulmonary congestion, without adverse hemodynamic events. The CS-MARF was 1.81 ± 0.11 cm² in congestive versus 2.91 ± 0.78 cm² in non-congestive (p = 0.0004).</p><p><strong>Conclusions: </strong>The integration of LUS, mVExUS, BIA and NUS provide a descriptive framework for multimodal assessment of fluid and nutritional status in MHD patients. These findings should be considered hypothesis-generating and require validation in prospective studies.</p>","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"1-17"},"PeriodicalIF":2.9,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147728413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Persistent Organic Pollutants Polychlorinated Biphenyls and Dioxins with Cardiovascular-Kidney-Metabolic Syndrome and Its Prognosis: A Nationally Representative Study.","authors":"Wen Chen, Debin Chen, Yining Li, Yizhou Zhuang, Yaojie Wang, Youlan Chen, Yongju Ye, Qijun Zhang, Jianhui Zhao","doi":"10.1159/000551670","DOIUrl":"https://doi.org/10.1159/000551670","url":null,"abstract":"<p><strong>Background: </strong>Persistent organic pollutants (POPs) may be risk factors for the development and progression of cardiovascular-kidney-metabolic (CKM) syndrome. This study aimed to evaluate the effects of polychlorinated biphenyls (PCBs) and dioxins on CKM syndrome, as well as the mediating role of inflammatory cells in these associations.</p><p><strong>Methods: </strong>Data on PCB and dioxin-like compound exposure and CKM syndrome were obtained from the National Health and Nutrition Examination Survey 2005-2012. We applied multivariable logistic regression, weighted quantile sum regression, quantile g-computation, and subgroup analyses to assess the individual and combined health effects of PCBs and dioxin-like compounds on CKM syndrome. Mediation analyses evaluated the role of inflammatory cells in the relationship between these pollutants and CKM syndrome. Cox proportional hazards regression was performed to explore the impact of PCB and dioxin exposure on mortality risk among patients at different CKM syndrome stages.</p><p><strong>Results: </strong>Exposure to PCB138, PCB153, PCB180, 1,2,3,6,7,8-hexachlorodibenzo-p-dioxin (hexa-CDDs), and 1,2,3,4,6,7,8-heptachlorodibenzo-p-dioxin (hepta-CDDs) was associated with increased risk of advanced CKM syndrome by approximately 4%, 3%, 3%, ,3% and 2%, respectively. In the mixture effect analysis, a combination of PCBs and dioxins was found to synergistically increase the risk of advanced CKM syndrome. Weighted quantile sum regression identified 1,2,3,4,6,7,8-heptachlorodibenzofuran (HXCDF) as the most significant contributor to this increased risk. Furthermore, white blood cells, lymphocytes and neutrophils mediated the associations between PCBs, dioxin-like compounds, and advanced CKM syndrome, with mediation proportions ranging from 1.77% to 3.95%. Exposure to PCBs (except HXCDF) and dioxins was associated with increased mortality risk in CKM stage 0-2 patients, while exposure to hexa-CDDs was associated with increased all-cause mortality risk in CKM stage 3-4 patients.</p><p><strong>Conclusion: </strong>Exposure to PCBs and dioxin-like compounds increases the risk of advanced CKM syndrome and mortality across different CKM syndrome stages. Inflammatory cells play a mediating role in the relationship between these pollutants and advanced CKM syndrome.</p>","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"1-35"},"PeriodicalIF":2.9,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147688425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Kidney Transplant outcomes in patients with and without type 2 diabetes mellitus.","authors":"Jan H N Lindeman, Rutger J Ploeg, Edward Sharples, Ian P Alwayn, Frederieke J Bemelman, Stefan P Berger, Maarten H L Christiaans, Cynthia Konijn, Aiko P J De Vries, Jacqueline Van de Wetering, Arjan D Van Zuilen, James P Hunter, Dorothea P Touwen, Esther Bastiaannet, Alexander F M Schaapherder","doi":"10.1159/000551839","DOIUrl":"https://doi.org/10.1159/000551839","url":null,"abstract":"<p><strong>Introduction: </strong>This study aims to estimate the impact of type-II diabetes (DM-II) on kidney transplant outcomes and graft utility.</p><p><strong>Methods: </strong>A nation-wide, registry-based study that compares outcomes for all primary kidney transplantations performed between 2000 and 2022 in the Netherlands in DM-II patients (761 deceased and 364 living donor procedures) with non-diabetic controls.</p><p><strong>Results: </strong>Short-term (≤90 days) transplant outcomes for living donor procedures were similar for DM-II and non-diabetic controls. Deceased donor transplantions in DM-II patients were associated with an increased incidence of delayed graft function (p<0.0002), and a doubling of 90-days mortality (HR: 2.19 (95% CI: 1.49-3.23), p< 0.0001). Evaluation of long-term graft survival, with death as competing risk indicated an equal (sub-distribution Hazard Rate (sHR) 0.95 [0.74-1.23]); respectively compromised (sHR 1.91 [1.37-2.65]; p<0.001) survival for grafts from deceased or living donors. DM-II profoundly impacted recipient survival (HR for death 1.63 [1.45-1.82] and 1.81 [1.51-2.17]; p<0.001 for recipients of a deceased or living donor graft respectively (non-diabetic recipients reference):, with cardiovascular and infection as dominant causes of death. The compromised recipient survival profoundly impacted the utility of kidney transplantations (p<0.001).</p><p><strong>Conclusions: </strong>Despite excellent graft survival, the efficacy of kidney transplantations in DM-II patients is compromised by reduced recipient survival. Cause of death distribution suggests a role for immunosuppressive regimens in the excess mortality observed. A shift in focus from optimized transplant- to optimized patient survival is warranted for DM-II patients. Moreover, the conflict between increasing incidences of DM-II, a lower transplant utility, but persistent donor organ shortages calls for development of novel organ allocation strategies.</p>","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"1-24"},"PeriodicalIF":2.9,"publicationDate":"2026-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147618336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intra-dialytic Hypotension and the VExUS Assessment in Hospitalized Patients: A Prospective Cohort Study.","authors":"Rose Joyal, Josiane Proulx, Michel Gouin, Karel Huard, Lawrence Ledoux-Hutchinson, Sophie Gilbert, Emmanuel Charbonney, Andre Denault, William Beaubien-Souligny","doi":"10.1159/000551739","DOIUrl":"https://doi.org/10.1159/000551739","url":null,"abstract":"<p><strong>Introduction: </strong>Predicting tolerance to fluid removal is particularly challenging in hospitalized, acutely ill patients. This study evaluated the association between the Venous Excess Ultrasound (VExUS) and IDHE in hospitalized patients.</p><p><strong>Methods: </strong>This single-center prospective cohort included hospitalized between 2022 and 2024 receiving hemodialysis. Ultrasound of the inferior vena cava (IVC), hepatic, portal, and femoral veins was performed. Patients were classified into four VExUS grades (0 to 3) based on IVC dimensions and venous Doppler waveforms. Follow-up at 3 months was conducted to evaluate outcomes across the different groups.</p><p><strong>Results: </strong>The cohort consisted of 93 patients for whom underwent ultrasound assessment. VExUS grading showed grade 0 in 52 patients (55.9%), grade 1 in 22 patients (23.7%), grade 2 in 11 patients (11.8%), and grade 3 in 8 patients (8.6%). The incidence of IDHE was tended to be higher in VExUS grade 0 (40.4%) and VExUS grade 3 (50.0%) patients compared with VExUS grade 1 (18.2%) or 2 (18.2%) (p=0.145). The cumulative duration of hypotension (sBP < 90 mmHg) differed between VExUS groups (p=0.03), with VExUS grade 3 patients experiencing longer median duration of hypotension compared to participants with a VExUS grade 1 (16.4 [0; 47.5] vs 0 [0; 0] minutes, p=0.04).</p><p><strong>Discussion: </strong>Our findings showed a trend toward more frequent IDHE in both VExUS grade 0 and grade 3, with grade 3 patients experiencing a significantly longer cumulative duration of hypotension. High VExUS scores may identify patients at increased risk of hypotension due to impaired hemodynamic adaptability.</p>","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"1-20"},"PeriodicalIF":2.9,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147615918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Albuminuria and acute heart failure. A new biomarker for congestion and follow-up?","authors":"Mario Galván-Ruiz, Patricia Nogueira-Salgueiro, Belén Rojas-Escrivá, María Del Val Groba-Marco, Miguel Fernández-de-Sanmamed-Girón, Jesús María González-Martín, Jonathan Déniz-Rosario, Daesub Chung-Kwon, Marco Antonio Suarez-Benítez, Elvira Martín-Bou, Sara Aladro-Escribano, Juan Carlos Quevedo-Reina, Ruth Martín-Alfaro, Casimira Domínguez-Cabrera, Eduardo Caballero-Dorta, Antonio García-Quintana, Alicia Conde-Martel","doi":"10.1159/000551740","DOIUrl":"https://doi.org/10.1159/000551740","url":null,"abstract":"<p><strong>Introduction: </strong>This study evaluated the trajectory of the urine albumin-to-creatinine ratio (UACR) in patients hospitalized with acute Heart Failure (HF) from pre-admission (baseline), through hospital admission, discharge and two weeks post-discharge. We also assessed its association with congestion-related biomarkers, including NT-proBNP, CA 125 and the neutrophil-to-lymphocyte (N/L) ratio.</p><p><strong>Methods: </strong>Prospective, observational study including ninety-nine consecutive patients admitted with acute HF. Blood and urine analyses were performed at admission, at discharge and two weeks post-discharge. Patients were stratified according to UACR at admission and the trajectories of UACR and biomarkers were evaluated. The clinical, analytical and echocardiographic predictors of UACR were analysed.</p><p><strong>Results: </strong>Mean age was 70.812.2 years, 57% were men. At admission albuminuria was present in 65.7% of patients (45.5% microalbuminuria, 20.2% macroalbuminuria, respectively). A higher UACR at admission was associated with diabetes, lower eGFR, previous HF admission, higher clinical congestion score, mixed or right-sided congestive phenotype, higher NT-proBNP and CA 125 levels. The UACR worsened from baseline to admission and improved at discharge, reflecting the congestion dynamics. NT-proBNP, CA 125 and N/L ratio showed similar patterns. Independent predictors of higher UACR at admission were diabetes, reduced renal function, higher AST and lower vitamin D levels. In the mixed linear regression analysis, lower eGFR, and higher AST levels remained independently associated with UACR trajectory. Admission UACR correlated with congestion score and predicted higher in-hospital mortality and early HF readmissions (<30 days).</p><p><strong>Conclusions: </strong>Albuminuria is common in acute HF and exhibits a dynamic change in relation to congestion. These findings suggest a potential role as a biomarker for congestion monitoring. However, given the study limitations, the results should be considered exploratory and warrant confirmation in larger prospective studies.</p>","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"1-24"},"PeriodicalIF":2.9,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147607939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Functional Mitral Regurgitation following Successful Living Donor Kidney Transplant: The VINTAGE Study.","authors":"Sumi Hidaka, Mizuki Yamano, Yasuhiro Mochida, Kazunari Tanabe, Shuzo Kobayashi","doi":"10.1159/000551778","DOIUrl":"https://doi.org/10.1159/000551778","url":null,"abstract":"<p><p>Introduction Functional mitral regurgitation (FMR) is prevalent in CKD patients, but few studies have evaluated the effect of kidney transplant (KT) on FMR. This study aimed to clarify KT's effect on FMR. Methods This study included 115 living donor KT recipients (2012-2023). Primary outcome was change in FMR severity (5 categories: none to severe) based on echocardiographic findings before and 1 year post-KT. Aortic regurgitation (AR) severity and changes in left atrial diameter (LAD), left ventricular end-diastolic dimension (LVDd), ANP, and BNP levels were also assessed. Change in FMR and AR severity was assessed using Wilcoxon signed-rank tests. Multivariable logistic regression models were used to identify factors associated with the worsening of FMR and AR. Results At baseline, 76.5% had trivial FMR; 22.6% had mild/moderate/severe FMR. One year post-KT, moderate/severe FMR disappeared. Overall, FMR improved in 19.1%, remained unchanged in 73.1%, and worsened in 7.8%. FMR severity distribution significantly changed (P=0.004). Reductions in LAD/LVDd aligned with decreased ANP/BNP. Multivariable analysis identified acute ABMR as an independent factor for worsening FMR (OR 4.02, 95% CI 1.81-8.91, P < 0.001). No significant AR improvement was observed (P=0.377). A history of arrhythmia (OR 2.68, 95% CI 1.28-5.64, P = 0.009) and stroke (OR 2.27, 95% CI 1.12-4.59, P = 0.023) were identified as an independent factor for worsening AR. Conclusions KT is associated with an improvement in FMR among patients with kidney failure (KF). This is likely due to LA/LV reverse remodeling from reduced volume/pressure overload. However, this benefit may diminish with graft dysfunction (e.g., acute rejection). Conversely, KT is not associated with an improvement in AR. Our findings highlight another important cardioprotective benefit of successful KT. Further prospective studies are needed to better understand this association.</p>","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"1-22"},"PeriodicalIF":2.9,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147590230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advances in Cardiorenal Medicine; The Year 2025 in Review.","authors":"Amir Kazory, Claudio Ronco","doi":"10.1159/000551756","DOIUrl":"https://doi.org/10.1159/000551756","url":null,"abstract":"","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"1-15"},"PeriodicalIF":2.9,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147509661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Effectiveness of Ivabradine Versus Digoxin in Patients With Heart Failure With Reduced Ejection Fraction and Chronic Kidney Disease: A Real-World Multicenter Cohort Study.","authors":"Jheng-Yan Wu, Keng-Wei Lee, Sheng-Chi Huang, Hsuan-Yuan Chang, Yu-Min Lin","doi":"10.1159/000551617","DOIUrl":"https://doi.org/10.1159/000551617","url":null,"abstract":"<p><strong>Background: </strong>Heart failure with reduced ejection fraction (HFrEF) commonly coexists with chronic kidney disease (CKD), conferring a markedly increased risk of adverse outcomes. Ivabradine and digoxin are both used for heart rate control in HFrEF, but their comparative effectiveness in patients with CKD remains uncertain.</p><p><strong>Objectives: </strong>To compare the risk of major adverse cardiovascular events (MACE), including heart failure exacerbation (HFE) and all-cause mortality, between ivabradine and digoxin in patients with concomitant HFrEF and CKD.</p><p><strong>Methods: </strong>Using the TriNetX global research network, we conducted a retrospective cohort study including adults with HFrEF and CKD between 2015 and 2025. Patients prescribed ivabradine were propensity-score-matched 1:1 to those receiving digoxin based on demographic, clinical, laboratory, and medication variables. The primary outcome was MACE (composite of HFE or all-cause mortality). Secondary outcomes included each component separately. Cox proportional hazards models estimated hazard ratios (HRs) with 95% confidence intervals (CIs).</p><p><strong>Results: </strong>After matching, 3,140 patients were included (1,570 per group). Ivabradine use was associated with a significantly lower risk of MACE compared with digoxin (26.8% vs 31.6%; HR 0.79, 95% CI 0.70-0.90; p<0.001). Ivabradine also reduced the risk of HFE (HR 0.83, 95% CI 0.72-0.97; p=0.015) and all-cause mortality (HR 0.69, 95% CI 0.56-0.85; p<0.001). Subgroup and negative-control analyses yielded consistent results.</p><p><strong>Conclusions: </strong>In this large, real-world cohort of patients with HFrEF and CKD, ivabradine was associated with lower risks of MACE, HFE, and all-cause mortality compared with digoxin. Ivabradine may represent a safer and more effective heart-rate-lowering option for this high-risk population.</p>","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"1-25"},"PeriodicalIF":2.9,"publicationDate":"2026-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147493858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}