Cardiorenal Medicine最新文献

{"title":"Circulating Humanin Improves the Prognostic Accuracy of Cardiovascular Risk Models in Chronic Hemodialysis Patients.","authors":"Davide Bolignano, Marta Greco, Sara Pugliese, Anila Duni, Pierangela Presta, Antonietta Errante, Efthymios Pappas, Lampros Lakkas, Roberta Misiti, Katerina K Naka, Daniela Patrizia Foti, Michele Andreucci, Giuseppe Coppolino, Evangelia Dounousi","doi":"10.1159/000551517","DOIUrl":"https://doi.org/10.1159/000551517","url":null,"abstract":"<p><p>INTRODUCTION Cardiovascular morbidity and mortality (CVMM) remain highly prevalent among end-stage kidney disease (ESKD) patients undergoing chronic hemodialysis (HD). Nevertheless, risk prediction in this setting is limited by the complexity of factors involved and the individual patients' characteristics. In this study, we evaluated whether circulating levels of Humanin, a micropeptide reflecting mitochondrial dysfunction, could refine CVMM prediction when included in established risk models for CVMM in ESKD-HD. METHODS Eighty-three chronic HD patients (mean age 67±12 years; 74.7% male) were enrolled in a 24-month prospective multicenter study. CVMM occurred in 33 patients (39.7%). The performances of an internal prognostic model based on cohort-related risk predictors and four externally generated and validated risk scores (AROii-2, jDOPPS, You et al., and Zhang et al.) were compared before and after the inclusion of Humanin. RESULTS Humanin displayed a curvilinear association with CVMM, with both low (<462 pg/mL) and high (>778 pg/mL) levels linked to an increased risk. CVMM was best predicted by the internal model (AUC 0.671; R2 0.13), followed by the Zhang (0.669; 0.12), AROii-2 (0.632; 0.05), You (0.628; 0.07), and jDOPPS (0.610; 0.03) scores. All models were well calibrated. Humanin inclusion remarkably improved discrimination (ΔAUC spanning from 0.083 to 0.109), calibration, explained variance (R2 gain from 9 to 15%), and reclassification (NRI 8 to 27.9%; IDI 4.4 to 7.3%) of all models considered. CONCLUSIONS Integration of Humanin significantly enhances the predictive accuracy of CVMM risk models in HD patients, supporting its potential role as an additive biomarker in this high-risk population.</p>","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"1-17"},"PeriodicalIF":2.9,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147479964","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":"A State-of-the Art Review Exploring the Cardiovascular Outcomes of Renin-Angiotensin Inhibitors in Acute Kidney Injury.","authors":"Farah Yasmin, Sharjeel Ahmad, Adina Jabeen, Abdul Moeed, Muhammad Sohaib Asghar, Afsana Ansari Shaik, Mohammed Mahmmoud Fadelallah Eljack, M Chadi Alraies","doi":"10.1159/000551326","DOIUrl":"https://doi.org/10.1159/000551326","url":null,"abstract":"<p><p>Renin-angiotensin system (RAS) inhibitors, including ACE inhibitors, ARBs, and ARNIs, are essential in managing cardiovascular and renal diseases. The purpose of this narrative review is to comprehensively evaluate the cardiovascular outcomes associated with the use of RAS inhibitors in patients who have experienced AKI. The study highlighted cardiovascular complications of acute kidney injury, role of renin-angiotensin inhibitors for cardioprotection post-acute kidney injury, reviewed clinical considerations for RAS inhibitors use post-AKI to prevent cardiovascular complications, and discussed mechanistic Basis of RAS inhibitors in post- acute kidney injury cardioprotection as well as cardiovascular safety concerns of RAS inhibitors post-acute kidney injury. Finally, by highlighting areas for future research, this review intended to stimulate further studies that will ultimately enhance patient care and outcomes.</p>","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"1-17"},"PeriodicalIF":2.9,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147389621","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":"Preventing Cardiac Surgery-Associated Acute Kidney Injury with the 4-B Approach: Biomarkers, Bundles, Blood Purification, and Blockage of the Complement Cascade.","authors":"Maria Gabriela Guimarães, Thiago Reis, Irene L Noronha, Paulo Novis Rocha, Claudio Ronco","doi":"10.1159/000551447","DOIUrl":"https://doi.org/10.1159/000551447","url":null,"abstract":"","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"1-7"},"PeriodicalIF":2.9,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147389593","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":"Pan-Immune Inflammatory Value as a Systemic Inflammation Marker Associated with Cardiovascular-Kidney-Metabolic Syndrome: Evidence from a Cross-Sectional Study of 751 Patients.","authors":"Qing Li, Jiaqi Lu, Xinyi Dong, Fang Liu, Wei Nie, Zhifeng Dong","doi":"10.1159/000551234","DOIUrl":"https://doi.org/10.1159/000551234","url":null,"abstract":"<p><strong>Introduction: </strong>Cardiovascular-kidney-metabolic syndrome (CKM) is associated with a high risk of renal insufficiency and cardiovascular events, with chronic inflammation being a critical factor in its pathogenesis. The pan-immune inflammatory value (PIV), a novel systemic inflammatory marker that synthesizes data from various immune cell counts, and its relationship with CKM has not yet been elucidated.</p><p><strong>Methods: </strong>A total of 751 patients were recruited. The relationship between PIV and CKM was investigated. The trends in CKM prevalence across PIV quartiles were assessed using trend tests. To identify associations within specific subpopulations, subgroup analysis and interaction tests were performed. To construct a prediction model, feature selection was performed using least absolute shrinkage and selection operator (LASSO) regression and multivariable logistic regression. A nomogram was constructed for visualization. Predictive performance was evaluated using receiver operating characteristic (ROC) curves, calibration plots, and decision curve analysis. The study was designed, executed, and reported in strict accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. A fully completed STROBE checklist, with line-by-line cross-references to the corresponding sections of the manuscript, is provided as supplementary material 3 to ensure maximal transparency and reproducibility.</p><p><strong>Results: </strong>The median PIV was significantly higher in the CKM Stage 4 group than in the Stage 2-3 group (449.91 vs. 210.66, P < 0.001). Subsequent to full adjustments, each 1-unit increase in PIV associated with a 26% higher odds of stage 4 CKM (OR = 1.26, 95% CI: 1.17-1.36, P < 0.001) with a dose-response relationship (P for trend < 0.001). Subgroup analysis demonstrated that the association was stronger among patients younger than 60 years compared with those aged ≥60 years (OR = 1.50 vs. 1.19), suggesting that PIV may have greater predictive value in younger individuals. Based on LASSO regression for feature selection, a multivariable CKM prediction model was developed, incorporating PIV as the principal independent predictor, and achieved an area under the curve (AUC) of 0.797 (95% CI: 0.760-0.833). The model exhibited good discrimination and calibration performance.</p><p><strong>Conclusion: </strong>This study indicates that elevated PIV levels are independently associated with a higher likelihood of advanced (stage 4) CKM. The predictive model demonstrates that PIV, when combined with other readily available clinical variables, is strongly associated with CKM severity, suggesting that PIV may serve as a valuable marker for risk stratification in patients with CKM.</p>","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"1-36"},"PeriodicalIF":2.9,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147389572","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":"Ten Hot Topics in Cardiovascular Risk Management for Chronic Kidney Disease.","authors":"María Marques, Alberto Ortiz, Gregorio Romero-González, Javier Díez, Rafael Santamaría, Adriana Puente-García, Roberto Alcázar, Patricia de Sequera, José Luis Górriz, Borja Quiroga","doi":"10.1159/000550943","DOIUrl":"10.1159/000550943","url":null,"abstract":"<p><strong>Background: </strong>Chronic kidney disease (CKD) is associated with a markedly increased risk of cardiovascular disease (CVD). Despite this, cardiovascular risk in patients with CKD is frequently underestimated and insufficiently treated in routine clinical practice.</p><p><strong>Summary: </strong>In this narrative review, we address ten concise and up-to-date questions focused on cardiovascular risk management in CKD. A panel of ten expert nephrologists provides evidence-based perspectives on key aspects including assessment of the arterial tree, cardiovascular risk estimation, identification of biomarkers for improved risk stratification, and both pharmacological and non-pharmacological interventions proven to reduce cardiovascular risk. Additional topics include blood pressure targets, optimal management of dyslipidemia, and cardiovascular risk management in patients receiving renal replacement therapy. Practical strategies to translate this evidence into everyday clinical care are also discussed.</p><p><strong>Key message: </strong>A comprehensive and structured approach to cardiovascular risk assessment and management are essential in patients with CKD and should be systematically integrated into routine nephrology practice to improve cardiovascular outcomes.</p>","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"113-133"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13046305/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146149255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heart Failure and Comorbidities (Chronic Kidney Disease, Diabetes, Obesity) Management: A Multidisciplinary Approach.","authors":"Dmitry Abramov, Roy O Mathew, Steve V Fordan","doi":"10.1159/000550503","DOIUrl":"10.1159/000550503","url":null,"abstract":"<p><strong>Background: </strong>Heart failure (HF) frequently coexists with chronic kidney disease (CKD), type 2 diabetes (T2D), and obesity, creating a complex clinical landscape that requires integrated, multidisciplinary management. The three main HF phenotypes - HF with reduced ejection fraction (EF ≤40%), mildly reduced ejection fraction (EF 41-49%), and preserved ejection fraction (EF ≥50%) - differ in their underlying pathophysiology and therapeutic approaches. Approximately 20-40% of patients with HF have T2D, 30-40% are obese (body mass index ≥30 kg/m2), and 45-63% have CKD. These comorbidities are interrelated through overlapping mechanisms such as insulin resistance, chronic inflammation, neurohormonal activation, and endothelial dysfunction, which amplify morbidity, mortality, and healthcare costs.</p><p><strong>Summary: </strong>The interplay between HF, CKD, T2D, and obesity extends beyond hemodynamic compromise, influencing other frequent conditions such as anemia, sleep apnea, and atrial fibrillation. Addressing these interconnected comorbidities can yield cumulative benefits by improving both HF-specific and overall health outcomes. Data from recent clinical trials and observational studies indicate how these conditions modify risk, affect therapeutic response, and influence guideline-directed medical therapy. Optimal care involves timely recognition, evidence-based management, and coordination across specialties. Key contributors to care include cardiologists, primary care physicians, endocrinologists, nephrologists, pharmacists, dietitians, and mental health professionals.</p><p><strong>Key messages: </strong>The coexistence of HF with CKD, T2D, and obesity constitutes a major clinical challenge with shared pathogenic pathways. Managing these comorbidities requires an integrated, multidisciplinary strategy to improve outcomes and quality of life. Barriers such as clinical inertia, polypharmacy, and socioeconomic disparities continue to impede effective therapy implementation. Enhanced collaboration and patient-centered care models are essential to optimize management in this high-risk population.</p>","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"95-112"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13106961/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146164063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Periprocedural Oral Hydration Patterns and Early Renal Function after Coronary Angiography and Intervention: A Prospective Real-World Cohort Study.","authors":"Dan Zhu, Lingling Gao, Nanhui Zhuang, Yuan Ma, Lijing Fan, Haiyan Ma, Yimei Zheng","doi":"10.1159/000550260","DOIUrl":"10.1159/000550260","url":null,"abstract":"<p><strong>Introduction: </strong>Guidelines recommend oral hydration (OH) to prevent contrast-associated acute kidney injury (CA-AKI) after coronary angiography or intervention, but quantitative protocols are lacking, and practice varies. Shorter hospital stays limit opportunities for post-procedure creatinine monitoring, and real-world OH patterns and their early renal effects remain poorly described. This study aimed to characterize periprocedural weight-adjusted OH trajectories and to assess whether trajectory membership was associated with a change in serum creatinine within 24 h.</p><p><strong>Methods: </strong>This single-center prospective cohort study enrolled 192 inpatients undergoing coronary angiography or intervention between November 2024 and May 2025. We recorded weight-adjusted oral intake in four windows: pre-12 h, post-0-6 h, 6-12 h, and 12-24 h. We computed partial-overlap dynamic time warping distances and clustered trajectories using partitioning around medoids. Group comparisons used nonparametric tests. The primary outcome was percent change in serum creatinine, and dose-response was assessed with generalized additive models (GAMs) adjusted for baseline creatinine, estimated glomerular filtration rate, comorbidities, procedural indication, contrast volume, and intravenous hydration.</p><p><strong>Results: </strong>After excluding 18 patients for missing periprocedural oral intake or post-procedure creatinine, 174 patients were analyzed (median age 65.0 years, IQR 57.2 to 72.0; 71.8% male). Median weight-adjusted cumulative oral intake was 10.9, 18.6, 23.9, and 33.3 mL/kg for the pre-12 h, post-0-6 h, 0-12 h, and 0-24 h windows. Time-series clustering produced two stable groups (low-OH n = 85, high-OH n = 89; average silhouette = 0.393; bootstrap adjusted Rand index = 0.845). The largest between-group difference occurred in the 0-6 h window (median 4.12 vs. 2.00 mL/kg/h, p < 0.001). No patient met CA-AKI criteria. In adjusted GAMs, the 0-6 h OH rate was not a significant smooth term (edf = 3.79, p = 0.795), and cluster membership was not associated with creatinine change. However, the high-OH cluster had substantially greater 6-h urine output and a larger positive fluid balance (p < 0.001), while serum potassium was similar between clusters.</p><p><strong>Conclusion: </strong>Periprocedural OH was generally ample and formed two reproducible patterns. Concentrating oral intake in the first 6 h increased early urine output and positive fluid balance but did not show a significant dose-response association with early serum creatinine change. This null result should be interpreted cautiously because the cohort was generally low-risk, follow-up was short, and the study had limited power. Future studies should validate whether early concentrated OH protects renal function using earlier sensitive biomarkers and by targeting high-risk patients.</p>","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"25-36"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12872192/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145877687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Indexed Neutrophil Gelatinase-Associated Lipocalin: Improving Prediction and Ruling Out of Contrast-Induced Nephropathy.","authors":"Shafik Khoury, Shir Frydman, Moran Gvili Perlman, Shmuel Banai, Haytham Abu Katash, Yacov Shacham","doi":"10.1159/000550837","DOIUrl":"10.1159/000550837","url":null,"abstract":"<p><strong>Background: </strong>The risk for contrast-induced acute kidney injury (CI-AKI) following cardiac procedures involving contrast administration is particularly high among chronic kidney disease (CKD) patients. Neutrophil gelatinase-associated lipocalin (NGAL) has been widely studied as an early marker for renal injury. However, CKD could impact NGAL levels and alter their predictive performance. This study aimed to evaluate a novel baseline \"indexed NGAL\" (I-NGAL), calculated by adjusting NGAL to the estimated glomerular filtration rate (eGFR), for the prediction of CI-AKI in CKD patients undergoing elective transcatheter aortic valve replacement (TAVR).</p><p><strong>Methods: </strong>A total of 134 CKD patients undergoing elective TAVR were included. Serum NGAL levels were drawn at hospital admission. Patients were followed for the occurrence of CI-AKI. Receiver-operator characteristic methods were used to identify optimal sensitivity and specificity for I-NGAL. Univariate and multivariate binary logistic regression models were used to assess I-NGAL predictive performance.</p><p><strong>Results: </strong>Overall, 35/134 patients (26%) developed CI-AKI following TAVR; both NGAL and I-NGAL were significantly higher among patients having CI-AKI. I-NGAL results had a higher predictive ability than unindexed NGAL results (AUC of 0.83 vs. 0.78, p < 0.001). The optimal I-NGAL cutoff for prediction of CI-AKI was 4, with a sensitivity of 71%, a specificity of 77%, and a negative predictive value of 88%. In a multivariate logistic regression model, I-NGAL was independently associated with CI-AKI (OR 1.22, 95% CI: 1.05-1.41; p = 0.007). I-NGAL level >4 was also independently associated with CI-AKI (OR 8.13, 95% CI 3-21.8, p < 0.001).</p><p><strong>Conclusion: </strong>Among CKD patients undergoing elective TAVR, adjusting baseline NGAL values according to eGFR yields an I-NGAL that serves as an improved tool for predicting and ruling out CI-AKI, regardless of baseline renal function.</p>","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"80-86"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13008385/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146112012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting Stroke Incidence Using Estimated Glucose Disposal Rate Index in the Population with Cardiovascular-Kidney-Metabolic Syndrome Stage 0-3 in the Chinese Middle-Aged and Elderly Population.","authors":"Qian Lu, Jiaxin Shao, Jijie Jin, Fei Wang, Zhenyang Cao, Qianrong Zheng, Shengzhang Chen, Jianghua Zhou, Hao Zhou, Changxi Chen","doi":"10.1159/000549744","DOIUrl":"10.1159/000549744","url":null,"abstract":"<p><strong>Background: </strong>Stroke remains a leading cause of death and disability worldwide. Although individuals in cardiovascular-kidney-metabolic (CKM) syndrome stages 0-3 have not yet experienced overt clinical events such as stroke, mounting evidence suggests that these stages often involve subclinical metabolic and vascular injury. Insulin resistance (IR), a hallmark of CKM syndrome, contributes to cerebrovascular injury via mechanisms such as inflammation, oxidative stress, and endothelial dysfunction. The estimated glucose disposal rate (eGDR), a noninvasive index of IR, has shown cardiovascular prognostic value, yet its utility in predicting stroke across early CKM stages remains unclear.</p><p><strong>Methods: </strong>This study analyzed 4,065 participants from the China Health and Retirement Longitudinal Study (CHARLS) classified as CKM stages 0-3. The eGDR was computed using waist circumference, HbA1c, and hypertension status. K-means clustering identified four longitudinal eGDR changes. Restricted cubic spline (RCS) models were used to determine stage-specific eGDR thresholds for stroke prediction. Cox regression assessed associations between baseline, cumulative, and dynamic eGDR with stroke incidence, while subgroup analyses also employed.</p><p><strong>Results: </strong>During follow-up, 383 incident stroke cases were observed. Lower baseline and cumulative eGDR levels were independently associated with higher stroke risk. Participants with persistently low or sharply declining eGDR group exhibited more than double the stroke risk compared to those with stable high eGDR. The RCS analysis confirmed a linear inverse association between cumulative eGDR and stroke in CKM stages 2-3 and identified optimal thresholds that maximized sensitivity and specificity. Notably, stage 2 presented the lowest threshold (7.41), potentially reflecting a critical tipping point where metabolic burden exceeds vascular compensation.</p><p><strong>Conclusion: </strong>eGDR is a clinically relevant predictor of stroke in asymptomatic individuals with CKM syndrome. The application of stage-specific thresholds enhances the precision of early risk stratification and highlights the need for tailored surveillance strategies. These findings suggest the potential value of eGDR monitoring as a practical tool for early risk stratification in metabolically at-risk populations.</p>","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"1-13"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12810968/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145647322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Inflammation and High-Sensitivity C-Reactive Protein in Atherosclerotic Cardiovascular Disease and Chronic Kidney Disease: The FLAME-ASCVD Survey among Nephrologists.","authors":"Vlado Perkovic, David Cherney, Edmundo Erazo-Tapia, Sofia Gerward, Sandra Waechter, Manisha Sahay, Nikolaus Marx","doi":"10.1159/000550094","DOIUrl":"10.1159/000550094","url":null,"abstract":"<p><strong>Background: </strong>Systemic inflammation (SI) contributes to increased cardiovascular risk in patients with atherosclerotic cardiovascular disease (ASCVD) and chronic kidney disease (CKD). We assessed clinical perceptions toward SI and usage of high-sensitivity C-reactive protein (hsCRP) among nephrologists.</p><p><strong>Methods: </strong>FLAME-ASCVD Nephro was an online survey of nephrologists from 10 countries who treat ≥20 patients with ASCVD and CKD a month and were practicing for ≥3 years. Results were analyzed using descriptive statistics.</p><p><strong>Results: </strong>Of 513 nephrologists who responded, 300 completed and were included in the survey; the mean age was 46 years and the mean time in practice was 16 years. Hypertension (89%), overweight/obesity (81%), and CKD (80%) were the ASCVD risk factors most often discussed with patients (SI was ninth). The most common unmet needs (ranked 1-3) for patients with ASCVD and CKD were \"lack of effective SI treatment options\" (44%), \"limited awareness of the role of SI in ASCVD\" (35%), and \"higher risk of CV events\" (33%). Seventy-four percent of nephrologists wanted to learn more about the role of SI in ASCVD and 71% test for and use SI results when determining management approaches. Seventy percent of nephrologists considered hsCRP testing in patients with ASCVD and CKD (aided), and proven clinical efficacy of hsCRP was the top reason (37%); out-of-pocket cost (30%) was the most common reason for not considering hsCRP testing.</p><p><strong>Conclusion: </strong>Lack of effective treatment options for SI remains the most common unmet need for patients with ASCVD and CKD. Further medical education is needed to raise awareness among nephrologists about the role of SI and hsCRP testing.</p>","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"14-24"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12863726/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145773550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}