Cardiorenal Medicine最新文献

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Comparative Prognostic Assessment of European Kidney Function Consortium Equations for Mortality Prediction: A Population-Based Cohort Study. 死亡率预测EKFC方程的比较预后评估:一项基于人群的队列研究。
IF 3.2 4区 医学
Cardiorenal Medicine Pub Date : 2026-01-01 Epub Date: 2026-06-09 DOI: 10.1159/000552852
Sitong Chen, Jinjing Shi, Iokfai Cheang, Gengmin Liang, Qiang Qu, Ziqi Chen, Huaxin Yuan, Yiyang Fu, Shengen Liao, Xinli Li
{"title":"Comparative Prognostic Assessment of European Kidney Function Consortium Equations for Mortality Prediction: A Population-Based Cohort Study.","authors":"Sitong Chen, Jinjing Shi, Iokfai Cheang, Gengmin Liang, Qiang Qu, Ziqi Chen, Huaxin Yuan, Yiyang Fu, Shengen Liao, Xinli Li","doi":"10.1159/000552852","DOIUrl":"10.1159/000552852","url":null,"abstract":"<p><strong>Introduction: </strong>The European Kidney Function Consortium (EKFC) has introduced equations for estimated glomerular filtration rate (eGFR) using serum creatinine (Cr) and cystatin C (Cys). While their diagnostic accuracy is established, their comparative prognostic value for long-term mortality in the general population is not well defined. This study compared the prognostic performance of three EKFC equations - creatinine-based (EKFC-eGFRcr), Cys-based (EKFC-eGFRcys), and the combined (EKFC-eGFRcrcys) model - for predicting all-cause and cardiovascular (CV) mortality.</p><p><strong>Methods: </strong>We analyzed a population-based cohort of 4,519 participants from the National Health and Nutrition Examination Survey (NHANES) 1999-2002. eGFR was calculated using all three EKFC variations (EKFC-eGFRcr, EKFC-eGFRcys, and EKFC-eGFRcrcys). The primary and secondary endpoints were all-cause and CV mortality, respectively, through December 31, 2019. Predictive improvements were evaluated using integrated discrimination improvement (IDI), net reclassification improvement (NRI), and number needed to measure (NNM).</p><p><strong>Results: </strong>The eGFR value calculated by the EKFC-eGFRcys, EKFC-eGFRcr, and EKFC-eGFRcrcys was 78.92 ± 22.98, 84.45 ± 23.21, and 81.68 ± 22.13 mL/min/1.73 m2, respectively. Over a median follow-up of 211 months, all three eGFR models were independent predictors of mortality (all p < 0.001). Restricted cubic spline regression revealed significant non-linear, inverse associations between all eGFR measures and adjusted mortality risks (all p for non-linearity < 0.001). Compared to EKFC-eGFRcr, EKFC-eGFRcys significantly improved risk reclassification for all-cause mortality (categorical NRI = 15.9%; 95% CI: 14.1-17.8%; NNM = 7). The combined EKFC-eGFRcrcys also outperformed the Cr-only model (NRI = 8.9%; NNM = 12). However, EKFC-eGFRcys demonstrated modestly better performance than the combined equation (NRI = 7.0%; NNM = 15), suggesting limited incremental value in adding Cr to Cys. The superiority of EKFC-eGFRcys was primarily driven by improved classification of non-events.</p><p><strong>Conclusion: </strong>The EKFC-eGFRcys equation provides superior prognostic value for all-cause and CV mortality compared to both Cr-based and combined EKFC equations. Notably, the combined model offered no prognostic advantage over Cys alone. These findings highlight the clinical importance of Cys-based eGFR for accurate risk stratification in the general population.</p>","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"393-408"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13432935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148210081","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
Inclisiran in Chronic Kidney Disease Patients: A Real-World Experience. 慢性肾脏病患者的Inclisiran:一个真实世界的经验。
IF 3.2 4区 医学
Cardiorenal Medicine Pub Date : 2026-01-01 Epub Date: 2026-02-04 DOI: 10.1159/000549898
Andrea Dello Strologo, Aldo Franculli, Pasquale Saporito, Natascia Miani, Antonio Bellasi, Paolo Lido, Luca Di Lullo, Claudio Ronco, Paola Peverini
{"title":"Inclisiran in Chronic Kidney Disease Patients: A Real-World Experience.","authors":"Andrea Dello Strologo, Aldo Franculli, Pasquale Saporito, Natascia Miani, Antonio Bellasi, Paolo Lido, Luca Di Lullo, Claudio Ronco, Paola Peverini","doi":"10.1159/000549898","DOIUrl":"10.1159/000549898","url":null,"abstract":"<p><strong>Introduction: </strong>Patients with chronic kidney disease (CKD) have a high incidence of morbidity and mortality from cardiovascular causes. Among the most significant cardiovascular risk factors is undoubtedly hypercholesterolemia, especially elevated cholesterol LDL levels. The first-line therapy for the management of hypercholesterolemia, including in patients with CKD, is represented by statins even in combination with ezetimibe. In patients with CKD, statin therapy is often poorly tolerated with high incidence of rhabdomyolysis. An alternative treatment is represented by small interfering RNA inclisiran, which has been shown to be effective in double yearly administration.</p><p><strong>Methods: </strong>Thirty-two patients (19 males and 13 females) with a mean age of 60.2 years, basal total cholesterol values of 225 mg/dL and LDL cholesterol values of 138 mg/dL were enrolled in our observational study. The mean eGFR value at baseline was 36.93 mL/min/m2. All patients had a diagnosis of chronic ischemic heart disease (CAD), and 4 patients also had type 2 diabetes mellitus. The patients received therapy with inclisiran 284 mg at time zero, then repeated at 3 months and then at 6 months.</p><p><strong>Results: </strong>After 12 months of treatment, there was almost 50% reduction in both total and LDL cholesterol values with no significant change in eGFR values. Only one patient presented with an episode of myocardial infarction 11 months after treatment was started, and no drug-related side effects were reported.</p><p><strong>Conclusion: </strong>Inclisiran should be considered as a viable therapeutic alternative for the management of pure hypercholesterolemia in patients with CKD who are intolerant to statin treatment because it achieves the optimal LDL cholesterol targets required by actual guidelines without side effects.</p>","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"87-94"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13008394/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146117896","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
The Neuroendocrine-Cardiovascular Axis in Chronic Kidney Disease: The Role of Prolactin and Gonadal Dysfunction. 慢性肾脏疾病的神经内分泌-心血管轴:催乳素和性腺功能障碍的作用。
IF 3.2 4区 医学
Cardiorenal Medicine Pub Date : 2026-01-01 Epub Date: 2026-09-08 DOI: 10.1159/crm/abtag009
Vincenzo Barbera, Luca Di Lullo, Antonio Bellasi, Lorenzo D'Elia, Annalisa Villani, Paola Peverini, Aldo Franculli
{"title":"The Neuroendocrine-Cardiovascular Axis in Chronic Kidney Disease: The Role of Prolactin and Gonadal Dysfunction.","authors":"Vincenzo Barbera, Luca Di Lullo, Antonio Bellasi, Lorenzo D'Elia, Annalisa Villani, Paola Peverini, Aldo Franculli","doi":"10.1159/crm/abtag009","DOIUrl":"10.1159/crm/abtag009","url":null,"abstract":"<p><strong>Background: </strong>Chronic kidney disease (CKD) is accompanied by endocrine disturbances, including elevated prolactin and disruption of the hypothalamic-pituitary-gonadal axis. Their reproductive consequences are well recognized, whereas their cardiovascular relevance remains uncertain.</p><p><strong>Summary: </strong>Reduced renal metabolism, altered dopaminergic regulation, the uremic milieu, inflammation, and comorbidity may increase prolactin and suppress gonadal function. In men, testosterone deficiency becomes more common as kidney function declines. In women, the dominant phenotype is loss of cyclicity, menstrual disturbance, anovulation, and a shortened reproductive lifespan; a single low estradiol value does not adequately characterize this heterogeneous state. Experimental studies identify candidate endothelial, nitric-oxide, inflammatory, thrombotic, and body-composition pathways. Clinical evidence, however, is predominantly observational, is more extensive in men than women, and is inconsistent for prolactin. Non-dialysis CKD and dialysis cohorts are therefore considered separately. Hormone measurement also requires attention to assay method, biological variability, acute illness, medication exposure, menstrual status, and timing relative to dialysis.</p><p><strong>Key messages: </strong>Prolactin and gonadal dysfunction are best viewed as components of a hypothesis-generating neuroendocrine-cardiovascular framework rather than established causal cardiovascular risk factors. No evidence supports routine dopamine-agonist treatment of asymptomatic CKD-related hyperprolactinemia or hormone therapy for cardiovascular prevention. Symptom-directed endocrine evaluation, rigorous diagnosis, and CKD-specific prospective and interventional studies are needed.</p>","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"525-540"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13682702/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148911068","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
The Heart of the Matter: Cardiac PoCUS and the Hemodynamic Logic of Vascular Access. 问题的核心:心脏PoCUS和血管通路的血流动力学逻辑。
IF 2.9 4区 医学
Cardiorenal Medicine Pub Date : 2026-01-01 Epub Date: 2026-01-19 DOI: 10.1159/000550535
Jordi Soler-Majoral, Nestor Rodriguez-Chitiva, Marina Urrutia-Jou, Lucia Martínez Carnovales, Manuela Rodríguez Domínguez, Mohamed Nassiri, Stephanie Cáceres-Díaz, Victor Martínez Valiente, Jordi Bover, Jordi Ara, Faeq Husain-Syed, Eduardo R Argaiz, Abhilash Koratala, Aleksandar N Neskovic, Fredzzia Graterol Torres, Gregorio Romero-González
{"title":"The Heart of the Matter: Cardiac PoCUS and the Hemodynamic Logic of Vascular Access.","authors":"Jordi Soler-Majoral, Nestor Rodriguez-Chitiva, Marina Urrutia-Jou, Lucia Martínez Carnovales, Manuela Rodríguez Domínguez, Mohamed Nassiri, Stephanie Cáceres-Díaz, Victor Martínez Valiente, Jordi Bover, Jordi Ara, Faeq Husain-Syed, Eduardo R Argaiz, Abhilash Koratala, Aleksandar N Neskovic, Fredzzia Graterol Torres, Gregorio Romero-González","doi":"10.1159/000550535","DOIUrl":"10.1159/000550535","url":null,"abstract":"","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"37-43"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12908948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146002870","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
Lipoprotein(a) and Cardiovascular Risk: Emerging Therapeutic Perspectives with Implications for Chronic Kidney Disease. 脂蛋白(a)和心血管风险:慢性肾脏疾病的新治疗观点
IF 3.2 4区 医学
Cardiorenal Medicine Pub Date : 2026-01-01 Epub Date: 2026-07-10 DOI: 10.1159/000553534
Luca Di Lullo, Paola Peverini, Antonio Bellasi, Andre Dello Strologo, Claudio Ronco, Pasquale Saporito, Aldo Franculli
{"title":"Lipoprotein(a) and Cardiovascular Risk: Emerging Therapeutic Perspectives with Implications for Chronic Kidney Disease.","authors":"Luca Di Lullo, Paola Peverini, Antonio Bellasi, Andre Dello Strologo, Claudio Ronco, Pasquale Saporito, Aldo Franculli","doi":"10.1159/000553534","DOIUrl":"10.1159/000553534","url":null,"abstract":"<p><strong>Background: </strong>Lipoprotein(a) (Lp(a)) is an low-density lipoprotein (LDL)-like particle containing apolipoprotein B100 covalently bound to apolipoprotein(a). Elevated Lp(a) is now recognized as a genetically determined, independent, and likely causal risk factor for atherosclerotic cardiovascular disease, calcific aortic valve stenosis, and residual cardiovascular risk despite optimal LDL cholesterol control. Current European and North American recommendations support measuring Lp(a) at least once in adulthood, particularly for cardiovascular risk refinement. Lp(a) levels are predominantly inherited and are only modestly influenced by lifestyle or conventional lipid-lowering therapies.</p><p><strong>Summary: </strong>Chronic kidney disease (CKD) represents a clinically relevant setting in which Lp(a) levels may rise as renal function declines, contributing to the excess cardiovascular burden and residual risk (including severe vascular calcification) left unaddressed by historical statin trials in the end-stage renal disease population. However, the causal role of Lp(a) in CKD-related cardiovascular disease remains incompletely defined.</p><p><strong>Key messages: </strong>Novel RNA-based and small molecule therapies, including pelacarsen, olpasiran, lepodisiran, zerlasiran, and muvalaplin, have shown marked Lp(a)-lowering effects, but definitive cardiovascular outcome data are still missing.</p>","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"449-460"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13472591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148419159","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
Erratum. 勘误表。
IF 3.2 4区 医学
Cardiorenal Medicine Pub Date : 2026-01-01 Epub Date: 2026-09-21 DOI: 10.1159/crm/abtag005
{"title":"Erratum.","authors":"","doi":"10.1159/crm/abtag005","DOIUrl":"https://doi.org/10.1159/crm/abtag005","url":null,"abstract":"<p><p>This is a correction to: Luca Di Lullo, Paola Peverini, Antonio Bellasi, Andre Dello Strologo, Claudio Ronco, Pasquale Saporito, Aldo Franculli; Lipoprotein(a) and Cardiovascular Risk: Emerging Therapeutic Perspectives with Implications for Chronic Kidney Disease. Cardiorenal Med. 2026;1(1):449-460. https://doi.org/10.1159/000553534.The name of the 4th co-author has been corrected in the article to read: \"Andrea Dello Strologo\".</p>","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":"16 1","pages":"499"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149015788","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
Comparative Prognostic Value of Four Urinary Biomarkers for Cardiovascular and Renal Outcomes after Transcatheter Aortic Valve Implantation. 四种尿液生物标志物对经导管主动脉瓣植入术后心血管和肾脏预后的比较价值。
IF 3.2 4区 医学
Cardiorenal Medicine Pub Date : 2026-01-01 Epub Date: 2026-01-19 DOI: 10.1159/000550414
Hidetoshi Yasuda, Hiroshi Iwata, Shinichiro Doi, Takuma Koike, Soshi Moriya, Yuichi Chikata, Takehiro Funamizu, Norihito Takahashi, Ryota Nishio, Seiji Koga, Hirohisa Endo, Iwao Okai, Shinya Okazaki, Tohru Minamino
{"title":"Comparative Prognostic Value of Four Urinary Biomarkers for Cardiovascular and Renal Outcomes after Transcatheter Aortic Valve Implantation.","authors":"Hidetoshi Yasuda, Hiroshi Iwata, Shinichiro Doi, Takuma Koike, Soshi Moriya, Yuichi Chikata, Takehiro Funamizu, Norihito Takahashi, Ryota Nishio, Seiji Koga, Hirohisa Endo, Iwao Okai, Shinya Okazaki, Tohru Minamino","doi":"10.1159/000550414","DOIUrl":"10.1159/000550414","url":null,"abstract":"<p><strong>Introduction: </strong>Renal risk stratification after transcatheter aortic valve implantation (TAVI) remains anchored to filtration metrics such as serum creatinine and estimated glomerular filtration rate (eGFR). These indices may not capture early tubular injury, which is clinically relevant in older TAVI populations. We therefore investigated whether four urinary biomarkers - N-acetyl-β-<sc>d</sc>-glucosaminidase (NAG), liver-type fatty acid-binding protein (L-FABP), β<sub>2</sub>-microglobulin, and α<sub>1</sub>-microglobulin - measured the day after TAVI are associated with subsequent cardiorenal outcomes.</p><p><strong>Methods: </strong>We enrolled 191 consecutive patients undergoing TAVI in a single-center cohort within the LAPLACE-TAVI registry (February 2016 to December 2019). Spot urine collected 12-18 h post-procedure was assayed for four urinary markers. The primary endpoint was a 24-month composite of all-cause death or first heart failure hospitalization; a renal composite used contemporary surrogate criteria. Multivariable Cox models adjusted for clinical covariates including eGFR. Biomarkers were examined using cohort medians as prespecified cut points.</p><p><strong>Results: </strong>Median follow-up was 1.8 years (interquartile range [IQR] 1.1-2.0); the primary endpoint occurred in 27/191 (14.1%) patients. NAG showed no correlation with eGFR (r = -0.03, p = 0.68), whereas β<sub>2</sub>-microglobulin and α<sub>1</sub>-microglobulin correlated inversely with eGFR (r = -0.27, p = 0.002; r = -0.34, p < 0.001); L-FABP was not correlated (r = -0.09, p = 0.21). Patients above the cohort median for NAG (6.8 IU/L) experienced higher 2-year event rates, with early separation of Kaplan-Meier curves (log-rank p = 0.02). In adjusted models, both high-NAG (hazard ratio [HR] 2.63, 95% confidence interval (CI): 1.17-6.46; p = 0.02), and high L-FABP (HR 2.48, 95% CI: 1.08-6.16; p = 0.03) remained independently associated with the primary endpoint, whereas β<sub>2</sub>-microglobulin and α<sub>1</sub>-microglobulin were not. Creatinine and eGFR were comparable across NAG strata; renal composite events were higher in the high-NAG group but did not reach statistical significance.</p><p><strong>Conclusion: </strong>A single urinary NAG and L-FABP measurement within 24 h post-TAVI identified increased 2-year risk of death or heart failure hospitalization despite preserved filtration indices. Although limited by sample size and single-center design, these pilot data support external validation and the evaluation of biomarker-guided surveillance and renoprotective strategies following TAVI.</p>","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"68-79"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12975143/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146002841","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
Estimated Plasma Volume Status May Modify the Association between Estimated Glomerular Filtration Rate and Atrial Fibrillation in Heart Failure with Preserved Ejection Fraction: A post hoc Analysis of the TOPCAT Trial. 估计血浆容量状态可能改变HFpEF患者肾小球滤过率和房颤之间的关系:TOPCAT试验的事后分析
IF 3.2 4区 医学
Cardiorenal Medicine Pub Date : 2026-01-01 Epub Date: 2026-06-05 DOI: 10.1159/000552893
Jialing Zhang, Qing Wang
{"title":"Estimated Plasma Volume Status May Modify the Association between Estimated Glomerular Filtration Rate and Atrial Fibrillation in Heart Failure with Preserved Ejection Fraction: A post hoc Analysis of the TOPCAT Trial.","authors":"Jialing Zhang, Qing Wang","doi":"10.1159/000552893","DOIUrl":"10.1159/000552893","url":null,"abstract":"<p><strong>Introduction: </strong>This post hoc analysis of the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist (TOPCAT) trial examined whether estimated plasma volume status (ePVS) modifies the association between estimated glomerular filtration rate (eGFR) and incident atrial fibrillation (AF) in patients with heart failure with preserved ejection fraction (HFpEF).</p><p><strong>Methods: </strong>A total of 2,202 HFpEF patients without baseline AF were included. ePVS was calculated using the Duarte formula, and participants were stratified into low and high ePVS groups based on the cohort median. Multivariable Cox proportional hazards models were used to assess the association between eGFR and incident AF, with stratified analyses by spironolactone treatment.</p><p><strong>Results: </strong>During follow-up, 4.9% of patients developed incident AF. No significant association between eGFR and AF was observed in the low ePVS group. In contrast, among patients with high ePVS, higher eGFR was associated with a reduced risk of incident AF after multivariable adjustment, with a significant nonlinear relationship (p for nonlinearity <0.001) and a statistically significant eGFR × ePVS interaction (p for interaction = 0.010). The association was consistent regardless of spironolactone use.</p><p><strong>Conclusion: </strong>This exploratory post hoc analysis suggested that ePVS may modify the association between eGFR and incident AF in HFpEF, with lower eGFR linked to higher AF risk primarily in patients with elevated ePVS. These hypothesis-generating findings should be interpreted cautiously given the limited number of events. Prospective studies are warranted to validate this potential interaction and its clinical implications.</p>","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"367-373"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13412220/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148175671","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
Short-Term Peri-Procedural Dapagliflozin for Prevention of Contrast-Induced Acute Kidney Injury in Diabetic Patients Undergoing Coronary Computed Tomographic Angiography: A Prospective Randomized Double-Blind Placebo-Controlled Study. 短期围手术期达格列净预防行冠状动脉计算机断层造影的糖尿病患者造影剂引起的急性肾损伤:一项前瞻性随机双盲安慰剂对照研究。
IF 3.2 4区 医学
Cardiorenal Medicine Pub Date : 2026-01-01 Epub Date: 2026-08-20 DOI: 10.1159/crm/abtag003
Tian Zheng, Lifeng Zhang, Jianxin Hu, Xiaoshu Cheng, Yuxuan Zhong, Xiao Huang, Lianggeng Gong, Biming Zhan
{"title":"Short-Term Peri-Procedural Dapagliflozin for Prevention of Contrast-Induced Acute Kidney Injury in Diabetic Patients Undergoing Coronary Computed Tomographic Angiography: A Prospective Randomized Double-Blind Placebo-Controlled Study.","authors":"Tian Zheng, Lifeng Zhang, Jianxin Hu, Xiaoshu Cheng, Yuxuan Zhong, Xiao Huang, Lianggeng Gong, Biming Zhan","doi":"10.1159/crm/abtag003","DOIUrl":"10.1159/crm/abtag003","url":null,"abstract":"<p><strong>Introduction: </strong>Sodium-glucose cotransporter 2 (SGLT2) inhibitors have established long-term cardiorenal benefits in patients with type 2 diabetes mellitus. However, their short-term peri-procedural role in preventing contrast-induced acute kidney injury (CI-AKI) after coronary computed tomographic angiography (CCTA) remains uncertain, and their acute effects on renal oxygenation may be complex.</p><p><strong>Methods: </strong>This prospective, randomized, double-blind, placebo-controlled single-center study screened 352 diabetic patients scheduled for CCTA. A total of 335 patients were randomized, and 322 patients with complete baseline and post-CCTA creatinine assessment were included in the modified intention-to-treat analysis. Participants received dapagliflozin 10 mg once daily or matched placebo beginning 3 days before CCTA and continuing through the 72-h post-CCTA follow-up. CI-AKI was defined according to prespecified serum creatinine-based criteria within 72 h after contrast exposure. Serial renal indices and exploratory biomarker variables were summarized at available time points, and logistic regression was restricted to a parsimonious covariate set because of the limited number of events.</p><p><strong>Results: </strong>The modified intention-to-treat analysis included 322 patients, with 161 patients assigned to each group. CI-AKI occurred in 29 patients overall (9.0%), with a significantly lower incidence in the dapagliflozin group than in the placebo group (6/161 [3.7%] vs. 23/161 [14.3%]; odds ratio, 0.23; 95% confidence interval, 0.09-0.59; p = 0.001 by Fisher's exact test). Baseline renal indices, including serum creatinine, estimated glomerular filtration rate, blood urea nitrogen, neutrophil gelatinase-associated lipocalin, and baseline eGFR category distribution, were comparable between groups. At 72 h after CCTA, the dapagliflozin group had lower serum creatinine and higher eGFR than the placebo group. KDIGO creatinine-based AKI stage distribution did not differ significantly between groups (p = 0.064), and no patient required new dialysis or kidney replacement therapy during the 72-h follow-up. Exploratory secondary biomarker analyses showed lower blood urea nitrogen and neutrophil gelatinase-associated lipocalin levels at 72 h in the dapagliflozin group.</p><p><strong>Conclusion: </strong>In diabetic patients undergoing CCTA, short-term peri-procedural dapagliflozin was associated with a lower incidence of creatinine-defined CI-AKI and improved early post-contrast renal function profiles. By focusing on a noninvasive CCTA population, this study expands the potential application of SGLT2 inhibition from invasive coronary procedures to intravenous contrast-enhanced cardiac CT, suggesting a novel adjunctive approach for renal risk reduction in selected diabetic patients. Larger multicenter trials are needed to validate these findings and define the patients most likely to benefit.</p>","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"500-512"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13688672/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148788437","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
Advances in Cardiorenal Medicine: The Year 2024 in Review. 心肾医学进展;回顾2024年。
IF 2.4 4区 医学
Cardiorenal Medicine Pub Date : 2025-01-01 Epub Date: 2025-02-20 DOI: 10.1159/000544817
Amir Kazory, Claudio Ronco
{"title":"Advances in Cardiorenal Medicine: The Year 2024 in Review.","authors":"Amir Kazory, Claudio Ronco","doi":"10.1159/000544817","DOIUrl":"10.1159/000544817","url":null,"abstract":"","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"229-237"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143466647","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
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