I always like to remind my cardiology colleagues that some of the most important drugs used in the cardiovascular arsenal, are in fact exerting their benefits through the kidneys. Case is point, drugs that target the renin-angiotensin-aldosterone system….
Cardiorenal syndrome (CRS) is a complex clinical entity that encompasses multiple interactions between the heart and kidney. Ronco and colleagues classified CRS into five types. Below, we’ll focus on CRS type 1, or acute cardiac dysfunction (such as…
This is part 2 of a blog on LVAD for the nephrologist. Part 1 may be found here. Predicting reversibility of renal dysfunction is a difficult task in the setting of heart disease and has a significant effect…
Advanced heart failure is associated with very poor survival rates of about 10 % at one year. Treatment options include cardiac transplantation or cardiac assist devices. A left ventricular assist device (LVAD) is a mechanical circulatory support for…
We have all been called in to see patients who have developed AKI after receiving mechanical ultrafiltration (UF) for acute decompensated heart failure (ADHF). In almost all situations I have experienced, UF was started early, perhaps without optimization…
A randomized controlled trial of loop diuretics was published in NEJM two weeks ago. The trial involved 308 patients, from 26 clinical sites. The details are below: Type: Prospective double-blind randomized controlled trial (intention to treat analysis) Inclusion:…
Renal failure occurring in the setting of acute decompensated heart failure (ADHF) is traditionally believed to be due to renal hypoperfusion from poor “forward flow”. This mechanism has intuitive appeal, and appears to be borne out by our…
Question: Who is the most important medical subspecialist for a patient with CKD to have regular contact with? Is it the nephrologist? A case could be made, relying purely on mortality statistics, that it’s actually the cardiologist. CKD/ESRD…
Any nephrology fellow running the Consult Service will rapidly realize that heart failure and renal failure often go hand in hand, earning the moniker “cardiorenal syndrome.” The thought here is that decreased forward flow from pump failure results…
