Cardiorenal Medicine最新文献

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Biomarkers for Predicting of Sepsis-Induced Cardiorenal Syndrome in Emergency Settings. 在紧急情况下预测败血症引起的心肾综合征的生物标志物。
IF 2.4 4区 医学
Cardiorenal Medicine Pub Date : 2025-01-01 Epub Date: 2025-02-17 DOI: 10.1159/000543462
Yuanyuan Pei, Liping Guo, Guangping Zhou, Lingjie Cao, Wenfeng Huang, Fengtao Yang, Dilu Li, Cheng Chi, Jihong Zhu
{"title":"Biomarkers for Predicting of Sepsis-Induced Cardiorenal Syndrome in Emergency Settings.","authors":"Yuanyuan Pei, Liping Guo, Guangping Zhou, Lingjie Cao, Wenfeng Huang, Fengtao Yang, Dilu Li, Cheng Chi, Jihong Zhu","doi":"10.1159/000543462","DOIUrl":"10.1159/000543462","url":null,"abstract":"<p><strong>Introduction: </strong>Cardiorenal syndrome (CRS) is a common and critical complication of sepsis, with high morbidity and mortality rates. Studies on biomarkers for the early prediction of septic CRS are sporadic. Classic and novel potential biomarkers were identified to explore their diagnostic performance of in patients with septic CRS.</p><p><strong>Methods: </strong>A total of 138 patients with sepsis from Peking University People's Hospital were enrolled in this prospective observational study, which was conducted between May 2019 and June 2022. The patients were divided into non-CRS (n = 106) and CRS (n = 32) groups. Serum levels of cystatin C, KIM-1, neutrophil gelatinase-associated lipocalin (NGAL), and α-Klotho were detected at admission using enzyme-linked immunosorbent assay. The relationship between the biomarker levels and risk factors of CRS were analyzed, as well as discrimination accuracy comparisons were performed.</p><p><strong>Results: </strong>The incidence of CRS in patients with sepsis was 23.2% (32/138) during hospitalization, with an obvious mortality. Compared with the non-CRS group, serum cystatin C, brain natriuretic peptide (BNP), troponin-I (TNI), KIM-1, and NGAL levels were both significantly elevated at admission in patients with sepsis complicated with CRS. Logistic regression analysis revealed that BNP, TNI, cystatin C, albumin, Lac, D-dimer were risk factors for CRS in sepsis patients. Compared with other biomarkers, serum cystatin C had moderate discriminative power for predicting septic CRS (area under a receiver operating characteristic curve, 0.746; sensitivity, 0.719; specificity, 0.783). BNP combined with cystatin C and D-dimer demonstrated an excellent discrimination performance, for its AUROC was up to 0.878 (sensitivity, 0.844; specificity, 0.759).</p><p><strong>Conclusion: </strong>Serum cystatin C, BNP, TNI, KIM-1, and NGAL levels are elevated in patients with septic CRS. Our study provides reliable evidence that cystatin C in combination with BNP and D-dimer might better predict septic CRS upon admission. Further research on sensitive biomarkers is needed.</p>","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"198-208"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143439630","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}
引用次数: 0
A New Era in the Management of Cardiorenal Syndrome: The Importance of Cardiorenal Units. 心肾综合征管理的新时代:心肾单位的重要性。
IF 2.4 4区 医学
Cardiorenal Medicine Pub Date : 2025-01-01 Epub Date: 2025-01-24 DOI: 10.1159/000543294
Juan León-Román, María Antonieta Azancot, Catarina Marouco, Marc Patricio-Liebana, Jorge Iván Zamora, Natalia Ramos Terrades, Néstor Toapanta, Sara Núñez-Delgado, Ana Belen Mendez Fernandez, María José Soler
{"title":"A New Era in the Management of Cardiorenal Syndrome: The Importance of Cardiorenal Units.","authors":"Juan León-Román, María Antonieta Azancot, Catarina Marouco, Marc Patricio-Liebana, Jorge Iván Zamora, Natalia Ramos Terrades, Néstor Toapanta, Sara Núñez-Delgado, Ana Belen Mendez Fernandez, María José Soler","doi":"10.1159/000543294","DOIUrl":"10.1159/000543294","url":null,"abstract":"<p><strong>Introduction: </strong>Approximately 70% of patients with heart failure (HF) also have kidney disease. Mortality is increased both by cardiorenal syndrome (CRS) and by the exacerbation of other comorbidities. The purpose of this study is to evaluate the clinical performance of patients with CRS who are followed up by the Cardiorenal Unit (CRU).</p><p><strong>Methods: </strong>We conducted a retrospective observational study of patients referred to the CRU from April 1, 2022, to April 30, 2023. Demographics, laboratory and ultrasonographic tests, and outcomes were evaluated.</p><p><strong>Results: </strong>Fifty-four patients were seen in the CRU. A total of 45 (83%) and 16 (30%) patients completed follow-up in the CRU at 6 and 12 months, respectively. The mean age was 70 years ± 1.6, and 65% were men. Almost 50% of patients had ischemic heart disease-related HF. The mean cardiac ejection fraction (EF) was 40% ± 1.6, and 61% of patients had HF with reduced EF (HFrEF). NYHA functional classes II and III were the most frequent (60% and 35%, respectively). At 6 months after follow-up, treatment was optimized with sacubitril-valsartan in 33% vs. 49% (p = 0.02) and SGLT2 inhibitors in 48% vs. 72% (p = 0.008), without significant deterioration in renal function (creatinine: p = 0.61; eGFR: p = 0.19). There was also a reduction of more than 50% in the number of hospital admissions (p = 0.002). A total of 22% required peritoneal dialysis, and 20% required hemodialysis. Ten (19%) patients died, five of them due to cardiovascular (CV) events.</p><p><strong>Conclusions: </strong>The CRU is vital for the management of complex patients as it ensures the implementation of medications that reduce CV mortality and decrease the number of hospital admissions in HF.</p>","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"174-183"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045523","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}
引用次数: 0
Hepatocardiorenal Syndrome: Integrating Pathophysiology with Clinical Decision-Making via Point-Of-Care Ultrasound. 肝心肾综合征:通过POCUS整合病理生理学与临床决策。
IF 2.4 4区 医学
Cardiorenal Medicine Pub Date : 2025-01-01 Epub Date: 2025-02-11 DOI: 10.1159/000543681
Abhilash Koratala, Claudio Ronco, Amir Kazory
{"title":"Hepatocardiorenal Syndrome: Integrating Pathophysiology with Clinical Decision-Making via Point-Of-Care Ultrasound.","authors":"Abhilash Koratala, Claudio Ronco, Amir Kazory","doi":"10.1159/000543681","DOIUrl":"10.1159/000543681","url":null,"abstract":"<p><strong>Background: </strong>Accumulating evidence has challenged the traditional model of the liver-kidney connection in hepatorenal syndrome. Cirrhosis can significantly impact cardiac function, leading to cirrhotic cardiomyopathy. Recent understanding reveals how cardiac dysfunction plays a pivotal role in the development of renal dysfunction in this setting, suggesting that disturbances traditionally categorized under hepatorenal syndrome may actually represent a hepatic form of cardiorenal syndrome - hepatocardiorenal syndrome - where the liver affects the kidney through cardiorenal pathways.</p><p><strong>Summary: </strong>Effective management of hepatocardiorenal syndrome and acute kidney injury in cirrhosis relies on accurately assessing a patient's hemodynamic and volume status. Point-of-care ultrasound, including lung and focused cardiac ultrasound, is a valuable diagnostic tool that provides crucial data on fluid tolerance, subclinical pulmonary congestion, and left ventricular filling pressures. This objective, bedside approach offers a comprehensive assessment that directly influences patient management and therapeutic decisions.</p><p><strong>Key messages: </strong>Point-of-care ultrasound plays an essential role in evaluating and managing hepatocardiorenal syndrome, providing insights into the underlying pathophysiology. By assessing hemodynamic parameters, it helps guide therapy and monitor patient responses, ensuring more accurate and effective treatment of patients with cirrhosis and acute kidney injury.</p>","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"184-197"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143398241","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}
引用次数: 0
Effects of Renal Denervation on Cardiac Remodeling, Cardiac Function, and Cardiovascular Neurohormones in Heart Failure with Reduced Ejection Fraction Patients: A Meta-Analysis and Systematic Review. 肾去神经支配对心力衰竭伴射血分数降低患者心脏重塑、心功能和心血管神经激素的影响:荟萃分析和系统回顾。
IF 2.4 4区 医学
Cardiorenal Medicine Pub Date : 2025-01-01 Epub Date: 2025-03-25 DOI: 10.1159/000545078
Fei Si, Qian Liu, Xin Ma, Jing Yu
{"title":"Effects of Renal Denervation on Cardiac Remodeling, Cardiac Function, and Cardiovascular Neurohormones in Heart Failure with Reduced Ejection Fraction Patients: A Meta-Analysis and Systematic Review.","authors":"Fei Si, Qian Liu, Xin Ma, Jing Yu","doi":"10.1159/000545078","DOIUrl":"10.1159/000545078","url":null,"abstract":"<p><strong>Introduction: </strong>The objective of this study was to evaluate the effects of renal denervation (RDN) on cardiac remodeling, cardiac function, and cardiovascular (CV) neurohormones in heart failure patients with reduced ejection fraction (HFrEF).</p><p><strong>Methods: </strong>We searched PubMed, Embase, Web of Science, and China National Knowledge Infrastructure (CNKI), identifying 6 randomized controlled trials (RCTs) and 9 single-arm studies, totaling 352 participants. Meta-analyses for RCTs and single-arm studies were conducted using STATA 17 software and the metafor package in R, respectively.</p><p><strong>Results: </strong>In RCTs, RDN significantly reduced left ventricular end-diastolic diameter (LVEDD) (weighted mean difference [WMD] = -3.55 mm, 95% CI [-5.51, -1.59], p < 0.01), left ventricular end-systolic diameter (LVESD) (WMD = -4.13 mm, 95% CI [-6.08, -2.18], p < 0.01), and significantly increased left ventricular ejection fraction (LVEF) (WMD = 6.30%, 95% CI [4.64, 7.96], p < 0.01) and 6-min walk test (6MWT) distance (WMD = 51.25 m, 95% CI [8.30, 94.20], p < 0.05). Brain natriuretic peptide (BNP) or N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels were significantly reduced (standardized mean difference = -1.24, 95% CI [-1.57, -0.90], p < 0.01). In single-arm studies, RDN significantly reduced LVEDD (MC = -2.41 mm, 95% CI [-3.74, -1.09], p < 0.01), LVESD (MC = -1.72 mm, 95% CI [-2.77, -0.67], p < 0.01), left atrial diameter (MC = -1.62 mm, 95% CI [-3.16, -0.08], p < 0.01), and interventricular septal thickness (IVST) (MC = -0.76 mm, 95% CI [-1.05, -0.47], p < 0.01). RDN significantly increased LVEF (MC = 29.52%, 95% CI [12.74, 46.31], p < 0.01) and 6MWT distance (MC = 100.49 m, 95% CI [49.12, 151.86], p < 0.05). RDN significantly reduced BNP or NT-proBNP levels (SMC = -0.57, 95% CI [-0.83, -0.31], p < 0.01). Our study also found that RDN had varying degrees of reduction on renin, angiotensin II, aldosterone, and norepinephrine in HFrEF patients. Additionally, we found that RDN had no significant effect on SBP/DBP in HFrEF patients but reduced heart rate (WMD = -7.22 bpm, 95% CI [-9.84, -4.60], p < 0.01).</p><p><strong>Conclusion: </strong>Our meta-analysis demonstrates that RDN can improve cardiac remodeling, enhance cardiac function, reduce CV neurohormones and has no significant effect on blood pressure in patients with HFrEF.</p>","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"261-280"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708721","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}
引用次数: 0
Cardiovascular and Kidney Outcomes of Glucagon-Like Peptide 1 Receptor Agonist Therapy in Type 2 Diabetes Mellitus and Chronic Kidney Disease: A Systematic Review and Meta-Analysis. 胰高血糖素样肽1受体激动剂治疗2型糖尿病和慢性肾病的心血管和肾脏预后:系统综述和荟萃分析
IF 2.4 4区 医学
Cardiorenal Medicine Pub Date : 2025-01-01 Epub Date: 2025-01-02 DOI: 10.1159/000543149
Nicole Felix, Mateus M Gauza, Vinicius Bittar, Alleh Nogueira, Thomaz A Costa, Amanda Godoi, Larissa Araújo de Lucena, Ocílio Ribeiro Gonçalves, Luís Cláudio Santos Pinto, Lucas Tramujas, José A Moura-Neto, Maria Gabriela Guimarães
{"title":"Cardiovascular and Kidney Outcomes of Glucagon-Like Peptide 1 Receptor Agonist Therapy in Type 2 Diabetes Mellitus and Chronic Kidney Disease: A Systematic Review and Meta-Analysis.","authors":"Nicole Felix, Mateus M Gauza, Vinicius Bittar, Alleh Nogueira, Thomaz A Costa, Amanda Godoi, Larissa Araújo de Lucena, Ocílio Ribeiro Gonçalves, Luís Cláudio Santos Pinto, Lucas Tramujas, José A Moura-Neto, Maria Gabriela Guimarães","doi":"10.1159/000543149","DOIUrl":"10.1159/000543149","url":null,"abstract":"<p><strong>Introduction: </strong>The effects of glucagon-like peptide 1 receptor agonists (GLP-1 RA) in patients with diabetes and established chronic kidney disease (CKD) remain unclear.</p><p><strong>Methods: </strong>We systematically searched PubMed, Embase, and Cochrane Library from inception to May 2024 for randomized controlled trials (RCTs) and respective post hoc studies comparing GLP-1 RAs versus placebo in patients with type 2 diabetes mellitus (T2DM) and established CKD (as per study definition or otherwise defined as having an estimated glomerular filtration rate less than 60 mL/min/1.73 m2 and/or urine albumin-to-creatinine ratio more than 30 mg/g). We applied a random-effects model to pool risk ratios (RRs), hazard ratios (HRs), and 95% confidence intervals (CIs).</p><p><strong>Results: </strong>We included 10 RCTs and post hoc analyses comprising 18,042 patients, of whom 9,164 (50.8%) were treated with GLP-1 RAs. There were significantly lower rates of major adverse kidney events (RR 0.82; 95% CI: 0.74-0.90; p < 0.001; high certainty) and a slightly lower incidence of all-cause mortality (HR 0.84; 95% CI: 0.71-1.00; p = 0.046; moderate certainty) with the use of GLP-1 RAs relative to placebo. This kidney protection remained consistent in patients with stage 3b CKD (RR 0.78; 95% CI: 0.65-0.94; p = 0.009; high certainty). No significant differences were observed in major adverse cardiovascular events (HR 0.89; 95% CI: 0.78-1.02; p = 0.090; low certainty) or cardiovascular mortality (HR 0.80; 95% CI: 0.60-1.09; p = 0.155; very low certainty), possibly due to a lack of statistical power.</p><p><strong>Conclusion: </strong>GLP-1 RAs were tied to a lower incidence of all-cause mortality and major adverse kidney events in patients with T2DM and established CKD.</p>","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"98-107"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11844710/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142920893","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}
引用次数: 0
Association of Liver Fibrosis Markers with Mortality Outcomes in Patients with Chronic Kidney Disease and Coronary Artery Disease: Insights from the NHANES 1999-2018 Data. 慢性肾病和冠状动脉疾病患者肝纤维化标志物与死亡率结局的关联:来自NHANES 1999-2018数据的见解
IF 2.4 4区 医学
Cardiorenal Medicine Pub Date : 2025-01-01 Epub Date: 2025-01-21 DOI: 10.1159/000543500
Zixiang Ye, Enmin Xie, Ziyu Guo, Yanxiang Gao, Zhongwei Han, Kefei Dou, Jingang Zheng
{"title":"Association of Liver Fibrosis Markers with Mortality Outcomes in Patients with Chronic Kidney Disease and Coronary Artery Disease: Insights from the NHANES 1999-2018 Data.","authors":"Zixiang Ye, Enmin Xie, Ziyu Guo, Yanxiang Gao, Zhongwei Han, Kefei Dou, Jingang Zheng","doi":"10.1159/000543500","DOIUrl":"10.1159/000543500","url":null,"abstract":"<p><strong>Introduction: </strong>The objective of this research was to explore the possible link between markers of liver fibrosis and survival rates in a group of adults who have been diagnosed with both chronic kidney disease (CKD) and coronary artery disease (CAD).</p><p><strong>Methods: </strong>The National Health and Nutrition Examination Survey (NHANES) data (1999-2018) for participants with both CAD and CKD were analyzed. The fibrosis-4 index (FIB-4), Nonalcoholic Fatty Liver Score (NFS), Forns index, and aspartate aminotransferase/alanine aminotransferase (AST/ALT) ratio were identified as crucial biomarkers. All-cause and cardiovascular disease (CVD) mortality were primary outcomes, assessed using Cox models, Kaplan-Meier curves, and receiver operating characteristic (ROC) analysis.</p><p><strong>Results: </strong>A total of 1,192 CKD and CAD patients were included. The Cox regression analysis revealed substantial correlations between elevated FIB-4, NFS, Forns index, and AST/ALT levels and a heightened risk of all-cause (hazard ratio [HR]: 1.188, 95% confidence interval [CI]: 1.108-1.274; HR: 1.145, 95% CI: 1.069-1.227; HR: 1.142, 95% CI: 1.081-1.201; HR: 1.316, 95% CI: 1.056-1.639, respectively) and CVD mortality (HR: 1.133, 95% CI: 1.007-1.275; HR: 1.155, 95% CI: 1.024-1.303; HR: 1.208, 95% CI: 1.109-1.316 and HR: 1.636, 95% CI: 1.203-2.224, respectively). The ROC analysis indicated comparable predictive accuracy for all three biomarkers, with AST/ALT showing slightly superior performance.</p><p><strong>Conclusion: </strong>Liver fibrosis markers, including AST/ALT, NFS, Forns index and FIB-4, are significant mortality predictors in CAD-CKD patients. The AST/ALT ratio, being easily measurable, may serve as an effective predictive tool for risk stratification in this population.</p>","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"153-163"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11844702/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000647","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}
引用次数: 0
Predicting In-Hospital Mortality in Patients with End-Stage Renal Disease Receiving Extracorporeal Membrane Oxygenation Therapy. 预测接受体外膜氧合治疗的终末期肾病患者的住院死亡率
IF 2.4 4区 医学
Cardiorenal Medicine Pub Date : 2025-01-01 Epub Date: 2025-01-08 DOI: 10.1159/000543434
Tsung-Yu Tsai, Pei-Chun Fan, Cheng-Chia Lee, Shao-Wei Chen, Jia-Jin Chen, Ming-Jen Chan, Ji-Tseng Fang, Yung-Chang Chen, Chih-Hsiang Chang
{"title":"Predicting In-Hospital Mortality in Patients with End-Stage Renal Disease Receiving Extracorporeal Membrane Oxygenation Therapy.","authors":"Tsung-Yu Tsai, Pei-Chun Fan, Cheng-Chia Lee, Shao-Wei Chen, Jia-Jin Chen, Ming-Jen Chan, Ji-Tseng Fang, Yung-Chang Chen, Chih-Hsiang Chang","doi":"10.1159/000543434","DOIUrl":"10.1159/000543434","url":null,"abstract":"<p><strong>Introduction: </strong>Patients on extracorporeal membrane oxygenation (ECMO) often experience worse renal outcomes and higher mortality rates as the severity of kidney injury increases. Nevertheless, the in-hospital mortality risks of patients with end-stage renal disease (ESRD) are poorly understood. This study evaluated several prognostic factors associated with in-hospital mortality in patients with ESRD receiving ECMO therapy.</p><p><strong>Methods: </strong>This study reviewed the medical records of 90 adult patients with ESRD on venoarterial ECMO in intensive care units in Linkou Chang Gung Memorial Hospital between March 2009 and February 2022. Fourteen patients who died within 24 h of receiving ECMO support were excluded; the remaining 76 patients were enrolled. Demographic, clinical, and laboratory variables were retrospectively collected as survival predictors. The primary outcome was in-hospital mortality.</p><p><strong>Results: </strong>The overall in-hospital mortality rate was 69.7%. The most common diagnosis requiring ECMO support was postcardiotomy cardiogenic shock, and the most frequent ECMO-associated complication was infection. Multiple logistic regression analysis revealed that the Acute Physiology and Chronic Health Evaluation II (APACHE II) score on day 1 of ECMO support was an independent risk factor for in-hospital mortality. The APACHE II score demonstrated satisfactory discriminative power (0.788 ± 0.057) in the area under the receiver operating characteristic curve. The cumulative survival rates at the 6-month follow-up differed significantly (p < 0.001) between patients with APACHE II score ≤ 29 versus those with APACHE II score >29.</p><p><strong>Conclusion: </strong>For patients with ESRD on ECMO, the APACHE II score is an excellent predictor of in-hospital mortality.</p>","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"164-173"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11844689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142945212","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}
引用次数: 0
Cardiorenal Syndrome in Heart Failure with Preserved Ejection Fraction: Insights into Pathophysiology and Recent Advances. 保留射血分数的心力衰竭心肾综合征:病理生理学的见解和最新进展。
IF 2.4 4区 医学
Cardiorenal Medicine Pub Date : 2025-01-01 Epub Date: 2025-01-03 DOI: 10.1159/000542633
Harshwardhan Khandait, Sohail Singh Sodhi, Ninad Khandekar, Venugopal Brijmohan Bhattad
{"title":"Cardiorenal Syndrome in Heart Failure with Preserved Ejection Fraction: Insights into Pathophysiology and Recent Advances.","authors":"Harshwardhan Khandait, Sohail Singh Sodhi, Ninad Khandekar, Venugopal Brijmohan Bhattad","doi":"10.1159/000542633","DOIUrl":"10.1159/000542633","url":null,"abstract":"<p><strong>Background: </strong>Cardiorenal syndrome (CRS) refers to the bidirectional interactions between the acutely or chronically dysfunctioning heart and kidney that lead to poor outcomes. Due to the evolving literature on renal impairment and heart failure with preserved ejection fraction (HFpEF), this review aimed to highlight the pathophysiological pathways, diagnosis using imaging and biomarkers, and management of CRS in patients with HFpEF.</p><p><strong>Summary: </strong>The mechanism of CRS in HFpEF can be hypothesized due to the interplay of elevated central venous pressure, renin-angiotensin-aldosterone system (RAAS) activation, oxidative stress, endothelial dysfunction, coronary microvascular dysfunction, and chronotropic incompetence. The correlation between HFpEF and worsening renal function seen in both long-term trials and observational data points to the evidence for these mechanisms. Upcoming biomarkers such as cystatin C, NGAL, NAG, KIM-1, ST-2, and galectin-3, along with conventional ones, are promising for early diagnosis, risk stratification, or response to therapy. Despite the lack of specific treatment for CRS in HFpEF, the management can be discussed with similar medications used in goal-directed medical therapy for heart failure with reduced ejection fraction (HFrEF). Additionally, there is increasing evidence for the role of vasodilators, inotropes, assist devices, and renal denervation, although long-term studies are necessary.</p><p><strong>Key message: </strong>The management of CRS in HFpEF is an evolving field that currently shows promise for using diagnostic and prognostic biomarkers, conventional heart failure medications, and novel therapies such as renal denervation, interatrial shunt, and renal assist devices. Further studies are needed to understand the pathophysiological pathways, validate the use of novel biomarkers, especially for early diagnosis and prognostication, and institute new management strategies for CRS in patients with HFpEF.</p>","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"41-60"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11844688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142930700","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}
引用次数: 0
Point-of-Care Ultrasonography in Chronic Kidney Disease: Addressing Congestion Management. 慢性肾脏疾病的即时超声检查:处理充血管理。
IF 2.4 4区 医学
Cardiorenal Medicine Pub Date : 2025-01-01 Epub Date: 2025-04-03 DOI: 10.1159/000545621
Gregorio Romero-González, Faeq Husain-Syed, Abhilash Koratala, Néstor Rodriguez-Chitiva, María Azancot, Marta Cobo Marcos, Amir Kazory, Claudio Ronco
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引用次数: 0
Global Trends and Hotspots in the Association between Chronic Kidney Disease and Cardiovascular Diseases: A Bibliometric Analysis from 2010 to 2023. 慢性肾脏病与心血管疾病相关的全球趋势和热点:2010 年至 2023 年文献计量分析。
IF 2.4 4区 医学
Cardiorenal Medicine Pub Date : 2025-01-01 Epub Date: 2024-11-23 DOI: 10.1159/000542441
Binghao Chen, Xiangqiu Wang, Dikang Pan, Jingyu Wang
{"title":"Global Trends and Hotspots in the Association between Chronic Kidney Disease and Cardiovascular Diseases: A Bibliometric Analysis from 2010 to 2023.","authors":"Binghao Chen, Xiangqiu Wang, Dikang Pan, Jingyu Wang","doi":"10.1159/000542441","DOIUrl":"10.1159/000542441","url":null,"abstract":"<p><strong>Introduction: </strong>This study endeavors to evaluate the distribution patterns and research frontiers within the international literature on the association between chronic kidney disease and cardiovascular diseases in the medical field, through bibliometric analysis and visualized information.</p><p><strong>Methods: </strong>The Web of Science Core Collection database was selected as the data source from 2010 to 2023, and articles related to the association between chronic kidney disease and cardiovascular diseases were retrieved. The article data were analyzed through CiteSpace for bibliometric mapping, involving the examination of keywords, references, country/region distributions, and institutional contributions to identify and understand the evolving research dynamics and frontiers in this interdisciplinary field.</p><p><strong>Results: </strong>A total of 2,936 publications on the association between chronic kidney disease and cardiovascular diseases were included. The country with the most publications was USA (n = 904), and the institution with the most publications was University of Pennsylvania (n = 116). The most frequent keywords were chronic kidney disease (n = 2,194), cardiovascular disease (n = 1,188), and mortality (n = 604). The top 20 keywords and top 10 references that burst during 2010 to 2023 were listed.</p><p><strong>Conclusion: </strong>The association between chronic kidney disease and cardiovascular diseases has sparked extensive research, particularly in high-prevalence areas. From 2010 to 2023, publications on the association between chronic kidney disease and cardiovascular diseases show a linear increase. Current research hotspots and frontiers are mainly in cardiovascular-kidney-metabolic syndrome; innovative therapies and drug impact; gut microbiome; Mendelian randomization analysis. Overall, our study offers a comprehensive scientometric analysis of the association between chronic kidney disease and cardiovascular diseases, providing valuable insights for both researchers and healthcare professionals in the field.</p>","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"1-20"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11844684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142709268","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}
引用次数: 0
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