Cardiorenal Medicine最新文献

{"title":"Immunosuppressive Therapy-Related Cardiovascular Risk Factors in Renal Transplantation: A Narrative Review.","authors":"Chiara Paccagnella, Stefano Andreola, Alessia Gambaro, Giovanni Gambaro, Chiara Caletti","doi":"10.1159/000542378","DOIUrl":"10.1159/000542378","url":null,"abstract":"<p><strong>Background: </strong>Kidney transplantation is the best treatment for patients with chronic renal failure, capable of improving life expectancy and the risk of death from all causes, which, however, remains higher than in the general population. The leading cause of death in transplant patients is cardiovascular events, burdened by a significant impact brought about by anti-rejection therapy. Experimental and clinical studies to date show that in kidney transplant recipients, traditional cardiovascular risk factors (hypertension, diabetes, dyslipidemia, obesity, tobacco, etc.) may be exacerbated or worsened by the dysmetabolic effects of immunosuppressive drugs, which may also result in additional risk factors such as proteinuria, anemia, and arterial stiffness. The aim of this review was to provide an in-depth evaluation of the effect of immunosuppressive treatments on cardiovascular risk factors.</p><p><strong>Summary: </strong>We have investigated and described the main cardiovascular risk factors related to immunosuppressive drugs. We searched for relevant scientific articles in medicine, transplant, cardiologic, and nephrological journals in major medical science libraries.</p><p><strong>Key messages: </strong>Immunosuppressive drugs allow graft survival and successful bunking of the transplant; however, they are not without significant side effects and should always be prescribed weighing the risk/benefit ratio and the individual patient's therapeutic needs.</p>","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"209-228"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432502","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":"Risk of Hospital Admissions and Death in Patients with Heart Failure and Chronic Kidney Disease: Findings from a Novel Multidisciplinary Clinic.","authors":"Simran Parmar, Tony Lopez, Ronak Shah, Daniel Murphy, Hilary Warrens, Marwa Khairallah, Lisa Anderson, Giuseppe Rosano, Irina Chis Ster, Debasish Banerjee","doi":"10.1159/000541806","DOIUrl":"10.1159/000541806","url":null,"abstract":"<p><strong>Introduction: </strong>Patients with heart failure (HF) and chronic kidney disease (CKD) are often suboptimally treated due to concerns of hyperkalaemia, declining kidney function, and hypotension. They commonly suffer from fluid overload which can lead to frequent hospitalisations and death. This research aims to determine the characteristics associated with hospital admissions and death in patients with CKD and HF.</p><p><strong>Methods: </strong>Consecutive patients with CKD stage 3-5 and HF (regardless of ejection fraction) attending a large, specialised CKD-HF clinic between 12/Sept/2019 and 11/Nov/2021 were identified and data were collected on demographic factors, renal and heart function, medications, hospitalisations, and death. Multinomial and Cox regressions determined the characteristics of patients requiring hospitalisation and their risk of death, respectively.</p><p><strong>Results: </strong>A total of 667 admissions were attributable to 318 patients, 201 admissions were for HF. Men were less likely than women to have been admitted to hospital for HF (risk ratio [RR] 0.43, 95% CI 0.20, 0.94) and non-HF causes (RR 0.21, 95% CI 0.10, 0.47). A serum haemoglobin level greater than 100 g/L was associated with fewer HF and non-HF admissions compared to a serum haemoglobin less than 100 g/L (RR 0.26, 95% CI 0.09, 0.74; RR 0.17, 95% CI 0.06, 0.47). Compared to CKD stage 3, CKD stage 4 was associated with an increased risk of HF and non-HF admissions (RR 4.01, 95% CI 1.04, 15.5; RR 4.33, 95% CI 1.13, 16.5). Having a HF admission (HR 2.41, 95% CI 1.27, 4.60), HFrEF (HR 2.18, 95% CI 1.30, 3.63), CKD stage 4 (HR 1.91, 95% CI 1.16, 3.16), and loop diuretic use (HR 2.24, 95% CI 1.14, 4.40) were associated with a significantly increased risk of death compared to people with no admissions, with HF with reduced preserved ejection fraction, CKD stage 3, and no diuretic use, respectively. The use of RAAS inhibitors halved the risk of death compared to non-prescribed patients (HR 0.44, 95% CI 0.27, 0.72).</p><p><strong>Conclusion: </strong>Hospital admissions among CKD-HF patients were common, particularly in those with lower serum haemoglobin levels and advanced CKD stage. The risk of death was higher in those with HF admissions, the presence of HFrEF, advanced CKD stage, loop diuretic use, and those not prescribed RAAS inhibitors.</p>","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"249-260"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669016","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 Serum Polyamines with Cardiovascular Events and All-Cause Mortality in Chronic Kidney Disease.","authors":"Zijin Chen, Shaobo Wang, Li Liu, Liangyu Yin, Xinli Xu, Jiachuan Xiong, Jinghong Zhao","doi":"10.1159/000545054","DOIUrl":"10.1159/000545054","url":null,"abstract":"<p><strong>Background: </strong>Emerging evidence indicates that serum polyamines, including putrescine, spermidine, and spermine, may serve as potential biomarkers for chronic kidney disease (CKD) and its progression. However, the association between serum polyamine levels, cardiovascular (CV) events, and mortality in CKD patients remains poorly understood.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted, involving 297 adult patients with CKD at stages 1-5 from March 2015 to September 2018, with follow-up until May 2023. Serum polyamine levels were quantified using high-performance liquid chromatography and subsequently categorized into quartiles. The Kaplan-Meier curve was employed to assess the survival probabilities of CV events and overall mortality in relation to serum polyamine levels. The relationship between serum polyamines and the risk of cardiovascular disease (CVD) and overall mortality was explored using univariate and multivariate Cox regression analyses. Furthermore, we conducted a competing-risk analysis to investigate the link between serum polyamines and CV events, with mortality as the competing event.</p><p><strong>Results: </strong>Over a median follow-up of 6.11 years, our findings revealed a negative correlation between putrescine levels and estimated glomerular filtration rate (eGFR), while spermidine and spermine levels were positively correlated with eGFR. The Kaplan-Meier curve demonstrated that serum polyamines were significantly associated with risk of CV events and all-cause mortality. Moreover, Cox regression analyses showed that, in a multivariate Cox model, patients in the highest quartile of putrescine displayed a significantly higher risk of CV events (hazard ratio [HR] 6.972, 95% confidence interval [CI] 2.520-19.294, p < 0.001) compared to those in the lowest quartile. Conversely, higher levels of spermidine were associated with a lower risk of CV events (HR = 0.077, 95% CI 0.022-0.274, p < 0.001), and higher levels of spermine also appeared to reduce the risk of CV events (HR = 0.180, 95% CI 0.061-0.530, p = 0.002). The relationship between serum polyamines and CVD remained robust in the competing risk models. Additionally, in the multivariate model, spermidine and spermine showed a significant protective effect on the risk of overall mortality; however, the protective effect was diminished upon the inclusion of eGFR as a covariate.</p><p><strong>Conclusions: </strong>Our study demonstrates significant disruption in serum polyamine levels among CKD patients, which correlates with eGFR. Altered polyamine levels are linked to an increased risk of CV events and overall mortality. Thus, serum polyamines may be considered valuable prognostic indicators for CKD patients.</p>","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"238-248"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555896","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":"EMCREG-International Multidisciplinary Consensus Panel on Management of Hyperkalemia in Chronic Kidney Disease and Heart Failure.","authors":"Natalie Kreitzer, Nancy M Albert, Alpesh N Amin, Craig J Beavers, Richard C Becker, Gregg Fonarow, W Brian Gibler, Katherine W Kwon, Robert J Mentz, Biff F Palmer, Charles V Pollack, Ileana L Piña","doi":"10.1159/000543385","DOIUrl":"10.1159/000543385","url":null,"abstract":"<p><strong>Background: </strong>Hyperkalemia, generally defined as serum potassium levels greater than 5.0 mEq/L, poses significant clinical risks, including cardiac toxicity and muscle weakness. Its prevalence and severity increase in patients with chronic kidney disease (CKD), diabetes mellitus, and heart failure (HF), particularly when compounded by medications like angiotensin converting inhibitors, angiotensin receptor blockers, and potassium sparing diuretics. Hyperkalemia arises from disruptions in potassium regulation involving intake, excretion, and intracellular-extracellular distribution. In CKD and acute kidney injury, these regulatory mechanisms are impaired, leading to heightened risk. The management of chronic hyperkalemia presents a challenge due to the necessity of balancing effective cardiovascular and renal therapies against the risk of elevated potassium levels.</p><p><strong>Summary: </strong>The emergency department management of acute hyperkalemia focuses on preventing cardiac complications through strategies that stabilize cellular membranes and shift potassium intracellularly. Chronic management often involves dietary interventions and pharmacological treatments. Pharmacological management of acute hyperkalemia includes diuretics, which enhance kaliuresis, and potassium binders such as patiromer and sodium zirconium cyclosilicate, which facilitate fecal excretion of potassium. While diuretics are commonly used, they carry risks of volume contraction and renal function deterioration. The newer potassium binders have shown efficacy in lowering chronically elevated potassium levels in CKD and HF patients, offering an alternative to diuretics and other older agents such as sodium polystyrene sulfonate, which has significant adverse effects and limited evidence for chronic use.</p><p><strong>Key messages: </strong>We convened a consensus panel to describe the optimal management across multiple clinical settings when caring for patients with hyperkalemia. This consensus emphasizes a multidisciplinary approach to managing hyperkalemia, particularly in patients with cardiovascular kidney metabolic syndrome, to avoid fragmentation of care and ensure comprehensive treatment strategies. The primary goal of this manuscript is to describe strategies to maintain cardiovascular benefits of essential medications while effectively managing potassium levels.</p>","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"133-152"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11844669/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142982765","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":"Changes in Antigen Carbohydrate 125 in Patients Receiving Dapagliflozin following an Admission for Acute Heart Failure.","authors":"Gema Miñana, Rafael de la Espriella, Miguel Lorenzo-Hernández, Enrique Rodriguez-Borja, Anna Mollar, Patricia Palau, Agustin Fernández-Cisnal, Ernesto Valero, Arturo Carratalá, Enrique Santas, Vicent Bodi, Juan Sanchis, Antoni Bayés-Genís, Eduardo Nuñez, Julio Nuñez","doi":"10.1159/000543417","DOIUrl":"10.1159/000543417","url":null,"abstract":"<p><strong>Introduction: </strong>Antigen carbohydrate 125 (CA125) has emerged as a proxy of fluid overload and inflammation in acute heart failure (AHF). We aimed to evaluate the influence of dapagliflozin on CA125 levels within the first weeks after discharge and whether CA125 changes were related to 6-month adverse clinical outcomes.</p><p><strong>Methods: </strong>In this retrospective observational study, data from 956 AHF patients discharged from a tertiary hospital were analyzed. CA125 levels were assessed during the index admission (visit 1) and at a median of 26 (15-39) days after discharge (visit 2). The primary endpoint was changes in CA125 and its correlation with the risk of 6-month death and recurrent readmissions (any or AHF-related). Multivariable mixed regression and a two-equation count model regression were used for the analyses.</p><p><strong>Results: </strong>The mean age of the cohort was 73.1 ± 11.1 years, 54.8% were males, 43.5% showed left ventricular ejection fraction ≥50%, and 18.7% of patients received dapagliflozin at discharge. Dapagliflozin treatment was associated with a greater reduction in CA125 levels at follow-up (-24 U/mL) compared to non-dapagliflozin patients (-14 U/mL, p = 0.034). The magnitude of CA125 reduction (per decrease in 10 U/mL) was significantly associated with a lower risk of 6-month death (incidence rate ratio [IRR] = 0.98, 95% CI = 0.96-0.99; p = 0.049), all-cause readmissions (IRR = 0.99, 95% CI = 0.98-0.99; p = 0.003), and HF readmissions (IRR = 0.98, 95% CI = 0.97-0.99; p < 0.001).</p><p><strong>Conclusion: </strong>Dapagliflozin treatment at discharge following an episode of AHF was associated with a greater reduction in CA125 during the first weeks after discharge. The greater CA125 reduction identified patients with a lower risk of 6-month adverse clinical outcomes.</p>","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"122-132"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11844713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142945208","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":"Polishing the Core: Refining VExUS for Venous Congestion Assessment.","authors":"Rogerio da Hora Passos,Pedro Guadix Zulian Teixeira,Carolina de Moraes Pellegrino,Vinicius Barbosa Galindo,Renan Sandoval de Almeida,Thais Dias Midega,Uri Adrian Prync Flato","doi":"10.1159/000541382","DOIUrl":"https://doi.org/10.1159/000541382","url":null,"abstract":"","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":"211 1","pages":"1-4"},"PeriodicalIF":3.8,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142261357","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":"Telomere length is associated with increased risk of cardiovascular events in patients with end-stage kidney disease on hemodialysis.","authors":"Rafaela Vostatek,Philipp Hohensinner,Sabine Schmaldienst,Matthias Lorenz,Renate Klauser-Braun,Ingrid Pabinger,Marcus Säemann,Cihan Ay,Oliver Königsbrügge","doi":"10.1159/000541112","DOIUrl":"https://doi.org/10.1159/000541112","url":null,"abstract":"INTRODUCTIONPatients with chronic kidney disease (CKD), especially those with end-stage kidney disease (ESKD) on hemodialysis (HD), are at increased risk for cardiovascular disease (CVD), including myocardial infarction and ischemic stroke. A shortening in telomere length, as a parameter for accelerated vascular aging, is an established biomarker for CVD in the general population. We aimed to elucidate the role of telomere length in ESKD patient on HD and its association with cardiovascular outcomes.METHODSTelomere length was measured in a prospective population-based cohort study of prevalent HD patients. DNA was isolated from whole blood, sampled at baseline, and analyzed for telomere length via a qPCR-based approach. The risk for the occurrence of the independently adjudicated 3P-MACE outcome (myocardial infarction, ischemic stroke, and cardiovascular death) was statistically analyzed considering the competing risk of non-cardiovascular death.RESULTSIn the cohort of 308 patients with ESKD (115 (37.3%) women, median (25th-75th percentile) age: 67.0 (56.8 - 76.0), the median telomere length was 1.51 kb (25th-75th percentile 0.6-3.2 kb). The 3P-MACE outcome occurred with an incidence rate of 9.4 per 100 patient-years. Patients with longer telomere length more frequently had vascular nephropathy compared to patients with shorter telomere length. Interestingly, patients in the highest quartile of telomere length had a 1.8-fold increased risk for 3P-MACE (95%CI 1.051-3.201, p=0.033), after multivariable adjustment for age, history of stroke, myocardial infarction, venous thromboembolism, presence of heart valve replacement, atrial fibrillation, smoking, anticoagulation, or immunosuppressive use.CONCLUSIONSurprisingly, in this high-risk cohort of patients with ESKD on HD, longer telomere lengths were associated with increased risk of cardiovascular events.","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":"250 1","pages":"1-16"},"PeriodicalIF":3.8,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142207082","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":"Erratum.","authors":"","doi":"10.1159/000539832","DOIUrl":"10.1159/000539832","url":null,"abstract":"","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"1"},"PeriodicalIF":2.4,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11449170/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141859084","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":"Artificial Intelligence in Heart Failure and Acute Kidney Injury: Emerging Concepts and Controversial Dimensions.","authors":"Wisit Cheungpasitporn, Charat Thongprayoon, Kianoush B Kashani","doi":"10.1159/000537751","DOIUrl":"10.1159/000537751","url":null,"abstract":"<p><strong>Background: </strong>The growing complexity of patient data and the intricate relationship between heart failure (HF) and acute kidney injury (AKI) underscore the potential benefits of integrating artificial intelligence (AI) and machine learning into healthcare. These advanced analytical tools aim to improve the understanding of the pathophysiological relationship between kidney and heart, provide optimized, individualized, and timely care, and improve outcomes of HF with AKI patients.</p><p><strong>Summary: </strong>This comprehensive review article examines the transformative potential of AI and machine-learning solutions in addressing the challenges within this domain. The article explores a range of methodologies, including supervised and unsupervised learning, reinforcement learning, and AI-driven tools like chatbots and large language models. We highlight how these technologies can be tailored to tackle the complex issues prevalent among HF patients with AKI. The potential applications identified span predictive modeling, personalized interventions, real-time monitoring, and collaborative treatment planning. Additionally, we emphasize the necessity of thorough validation, the importance of collaborative efforts between cardiologists and nephrologists, and the consideration of ethical aspects. These factors are critical for the effective application of AI in this area.</p><p><strong>Key messages: </strong>As the healthcare field evolves, the synergy of advanced analytical tools and clinical expertise holds significant promise to enhance the care and outcomes of individuals who deal with the combined challenges of HF and AKI.</p>","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"147-159"},"PeriodicalIF":3.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139729083","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":"Evaluation of the Renal and Cardiovascular Effects of Long-Term Tolvaptan Treatment in Autosomal Dominant Polycystic Kidney Disease.","authors":"Alparslan Demiray, Ramazan Ozan, Salih Güntuğ Özaytürk, Hakan İmamoğlu, Gökmen Zararsız, Murat Hayri Sipahioğlu, Bülent Tokgöz, Deniz Elçik, İsmail Koçyiğit","doi":"10.1159/000538098","DOIUrl":"10.1159/000538098","url":null,"abstract":"<p><strong>Introduction: </strong>Cardiovascular diseases constitute a significant cause of morbidity and mortality in individuals with autosomal dominant polycystic kidney disease (ADPKD). This study aimed to assess the long-term effects of tolvaptan on the kidneys and heart in rapidly progressing ADPKD.</p><p><strong>Methods: </strong>Among 354 patients diagnosed with ADPKD, 58 meeting the eligibility criteria for tolvaptan were included in the study. The study comprised two groups with similar demographic and clinical characteristics: 29 patients receiving tolvaptan treatment and 29 in the control group. Several included genetic analysis, magnetic resonance imaging, and echocardiography. Clinical and cardiac changes were recorded in both groups after a 3-year follow-up.</p><p><strong>Results: </strong>Tolvaptan treatment demonstrated a significant reduction in the rate of eGFR decline compared to the control group. Furthermore, it was observed that tolvaptan could prevent the development of cardiac arrhythmias by inhibiting an increase in QTc interval and heart rate.</p><p><strong>Conclusion: </strong>These findings suggest that, in addition to slowing kidney progression in ADPKD management, tolvaptan may potentially benefit in preventing cardiac complications.</p>","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"167-177"},"PeriodicalIF":3.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139995660","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}