Reposted by Raphael
🔥🫀ARNI showed superior cardioprotective effects.
May have renoprotective effects as per their molecular mechanism, but the evidence to date applies only to heart failure.
Future studies in CKD are needed, perhaps? 🤔
May have renoprotective effects as per their molecular mechanism, but the evidence to date applies only to heart failure.
Future studies in CKD are needed, perhaps? 🤔
June 26, 2025 at 6:41 PM
🔥🫀ARNI showed superior cardioprotective effects.
May have renoprotective effects as per their molecular mechanism, but the evidence to date applies only to heart failure.
Future studies in CKD are needed, perhaps? 🤔
May have renoprotective effects as per their molecular mechanism, but the evidence to date applies only to heart failure.
Future studies in CKD are needed, perhaps? 🤔
Reposted by Raphael
🔥SGLT2 Inhibitors: Game-changers!
They reduce HF hospitalisations, preserve GFR, slow CKD progression and improve outcomes in CRS.
🔹 Trials: DAPA-HF, EMPA-KIDNEY show mortality & renal benefits.
Do check out the link for the new SGLT2i toolkit there: theisn.org/initiatives/...
They reduce HF hospitalisations, preserve GFR, slow CKD progression and improve outcomes in CRS.
🔹 Trials: DAPA-HF, EMPA-KIDNEY show mortality & renal benefits.
Do check out the link for the new SGLT2i toolkit there: theisn.org/initiatives/...
June 26, 2025 at 6:41 PM
🔥SGLT2 Inhibitors: Game-changers!
They reduce HF hospitalisations, preserve GFR, slow CKD progression and improve outcomes in CRS.
🔹 Trials: DAPA-HF, EMPA-KIDNEY show mortality & renal benefits.
Do check out the link for the new SGLT2i toolkit there: theisn.org/initiatives/...
They reduce HF hospitalisations, preserve GFR, slow CKD progression and improve outcomes in CRS.
🔹 Trials: DAPA-HF, EMPA-KIDNEY show mortality & renal benefits.
Do check out the link for the new SGLT2i toolkit there: theisn.org/initiatives/...
Reposted by Raphael
See here an Evidence Table of RCTs Comparing Pharmacological Therapy for Fluid Overload and UF in Pts With Acute Decompensated HF
doi.org/10.1161/CIRC...
doi.org/10.1161/CIRC...
June 26, 2025 at 6:41 PM
See here an Evidence Table of RCTs Comparing Pharmacological Therapy for Fluid Overload and UF in Pts With Acute Decompensated HF
doi.org/10.1161/CIRC...
doi.org/10.1161/CIRC...
Reposted by Raphael
Decongestion Therapy
🔹 Loop diuretics = cornerstone
🔹 Use high doses for diuretic resistance; consider thiazides for synergy.
🔹 UF for refractory cases, but monitor renal function closely.
🔹 Aggressive diuresis improves outcomes even with transient ↑ creatinine.
🔹 Loop diuretics = cornerstone
🔹 Use high doses for diuretic resistance; consider thiazides for synergy.
🔹 UF for refractory cases, but monitor renal function closely.
🔹 Aggressive diuresis improves outcomes even with transient ↑ creatinine.
June 26, 2025 at 6:41 PM
Decongestion Therapy
🔹 Loop diuretics = cornerstone
🔹 Use high doses for diuretic resistance; consider thiazides for synergy.
🔹 UF for refractory cases, but monitor renal function closely.
🔹 Aggressive diuresis improves outcomes even with transient ↑ creatinine.
🔹 Loop diuretics = cornerstone
🔹 Use high doses for diuretic resistance; consider thiazides for synergy.
🔹 UF for refractory cases, but monitor renal function closely.
🔹 Aggressive diuresis improves outcomes even with transient ↑ creatinine.
Reposted by Raphael
Key Principles in Rx
1️⃣ Decongestion (diuretics/ultrafiltration).
2️⃣ Neurohormonal modulation (RAASI, SGLT2i).
3️⃣ Volume assessment (CVP, intrarenal Doppler).
4️⃣ Treat underlying systemic disease (e.g., sepsis).
5️⃣ Multidisciplinary care
doi.org/10.3390/hear...
1️⃣ Decongestion (diuretics/ultrafiltration).
2️⃣ Neurohormonal modulation (RAASI, SGLT2i).
3️⃣ Volume assessment (CVP, intrarenal Doppler).
4️⃣ Treat underlying systemic disease (e.g., sepsis).
5️⃣ Multidisciplinary care
doi.org/10.3390/hear...
June 26, 2025 at 6:41 PM
Key Principles in Rx
1️⃣ Decongestion (diuretics/ultrafiltration).
2️⃣ Neurohormonal modulation (RAASI, SGLT2i).
3️⃣ Volume assessment (CVP, intrarenal Doppler).
4️⃣ Treat underlying systemic disease (e.g., sepsis).
5️⃣ Multidisciplinary care
doi.org/10.3390/hear...
1️⃣ Decongestion (diuretics/ultrafiltration).
2️⃣ Neurohormonal modulation (RAASI, SGLT2i).
3️⃣ Volume assessment (CVP, intrarenal Doppler).
4️⃣ Treat underlying systemic disease (e.g., sepsis).
5️⃣ Multidisciplinary care
doi.org/10.3390/hear...
Reposted by Raphael
What about management?
CRS management is about balance. It’s a tightrope walk between relieving congestion & preserving renal function. Let’s talk strategies.
Here is the strategy for acute cases, doi.org/10.3390/hear...
CRS management is about balance. It’s a tightrope walk between relieving congestion & preserving renal function. Let’s talk strategies.
Here is the strategy for acute cases, doi.org/10.3390/hear...
June 26, 2025 at 6:41 PM
What about management?
CRS management is about balance. It’s a tightrope walk between relieving congestion & preserving renal function. Let’s talk strategies.
Here is the strategy for acute cases, doi.org/10.3390/hear...
CRS management is about balance. It’s a tightrope walk between relieving congestion & preserving renal function. Let’s talk strategies.
Here is the strategy for acute cases, doi.org/10.3390/hear...
Reposted by Raphael
Different imaging tech can also provide an overview of tissue damage and the overall function of the heart and kidneys
doi.org/10.3390/jpm1...
doi.org/10.3390/jpm1...
June 26, 2025 at 6:41 PM
Different imaging tech can also provide an overview of tissue damage and the overall function of the heart and kidneys
doi.org/10.3390/jpm1...
doi.org/10.3390/jpm1...
Reposted by Raphael
🔬 Biomarkers of cardiac and kidney injury may provide important information when and can serve to indicate early cardiac or renal injury, the repair process, and long-term sequelae doi.org/10.1161/CIR....
Here is a list
Here is a list
June 26, 2025 at 6:41 PM
🔬 Biomarkers of cardiac and kidney injury may provide important information when and can serve to indicate early cardiac or renal injury, the repair process, and long-term sequelae doi.org/10.1161/CIR....
Here is a list
Here is a list
Reposted by Raphael
How do we diagnose it? doi.org/10.1161/CIRC...
We look at:
Biomarkers: NT-proBNP, cystatin C, NGAL, KIM-1
Imaging: Echo (CVP, LVEF), renal US (exclude obstruction)
Volume status: Clinical exam + POCUS
We look at:
Biomarkers: NT-proBNP, cystatin C, NGAL, KIM-1
Imaging: Echo (CVP, LVEF), renal US (exclude obstruction)
Volume status: Clinical exam + POCUS
June 26, 2025 at 6:41 PM
How do we diagnose it? doi.org/10.1161/CIRC...
We look at:
Biomarkers: NT-proBNP, cystatin C, NGAL, KIM-1
Imaging: Echo (CVP, LVEF), renal US (exclude obstruction)
Volume status: Clinical exam + POCUS
We look at:
Biomarkers: NT-proBNP, cystatin C, NGAL, KIM-1
Imaging: Echo (CVP, LVEF), renal US (exclude obstruction)
Volume status: Clinical exam + POCUS
Reposted by Raphael
Congestion vs Perfusion
For years, we thought hypoperfusion drove CRS.
🔥Turns out, congestion is the bigger villain. High venous pressure, intra-abdominal pressure (IAP), and renal compression all hurt GFR.
doi.org/10.3389/fphy...
For years, we thought hypoperfusion drove CRS.
🔥Turns out, congestion is the bigger villain. High venous pressure, intra-abdominal pressure (IAP), and renal compression all hurt GFR.
doi.org/10.3389/fphy...
June 26, 2025 at 6:41 PM
Congestion vs Perfusion
For years, we thought hypoperfusion drove CRS.
🔥Turns out, congestion is the bigger villain. High venous pressure, intra-abdominal pressure (IAP), and renal compression all hurt GFR.
doi.org/10.3389/fphy...
For years, we thought hypoperfusion drove CRS.
🔥Turns out, congestion is the bigger villain. High venous pressure, intra-abdominal pressure (IAP), and renal compression all hurt GFR.
doi.org/10.3389/fphy...
Reposted by Raphael
🫀🔥Now, the million-dollar question: Why does this happen?
—it’s a cocktail of mechanisms: 🩺
Central players:
Congestion → ↓ Renal perfusion
RAAS & SNS activation → Maladaptive changes
Inflammation & oxidative stress → Organ damage
doi.org/10.1161/CIR....
—it’s a cocktail of mechanisms: 🩺
Central players:
Congestion → ↓ Renal perfusion
RAAS & SNS activation → Maladaptive changes
Inflammation & oxidative stress → Organ damage
doi.org/10.1161/CIR....
Cardiorenal Syndrome: Classification, Pathophysiology, Diagnosis, and Treatment Strategies: A Scientific Statement From the American Heart Association | Circulation
Cardiorenal syndrome encompasses a spectrum of disorders involving both the heart
and kidneys in which acute or chronic dysfunction in 1 organ may induce acute or chronic
dysfunction in the other orga...
doi.org
June 26, 2025 at 6:41 PM
🫀🔥Now, the million-dollar question: Why does this happen?
—it’s a cocktail of mechanisms: 🩺
Central players:
Congestion → ↓ Renal perfusion
RAAS & SNS activation → Maladaptive changes
Inflammation & oxidative stress → Organ damage
doi.org/10.1161/CIR....
—it’s a cocktail of mechanisms: 🩺
Central players:
Congestion → ↓ Renal perfusion
RAAS & SNS activation → Maladaptive changes
Inflammation & oxidative stress → Organ damage
doi.org/10.1161/CIR....
Reposted by Raphael
🔑What is CRS?
nature.com/articles/nrn...
Types of CRS:
1️⃣ Type I: Acute HF → AKI
2️⃣ Type II: Chronic HF → CKD
3️⃣ Type III: AKI → Acute HF
4️⃣ Type IV: CKD → Chronic HF
5️⃣ Type V: Systemic diseases (e.g., sepsis) → Combined dysfunction
nature.com/articles/nrn...
Types of CRS:
1️⃣ Type I: Acute HF → AKI
2️⃣ Type II: Chronic HF → CKD
3️⃣ Type III: AKI → Acute HF
4️⃣ Type IV: CKD → Chronic HF
5️⃣ Type V: Systemic diseases (e.g., sepsis) → Combined dysfunction
June 26, 2025 at 6:41 PM
🔑What is CRS?
nature.com/articles/nrn...
Types of CRS:
1️⃣ Type I: Acute HF → AKI
2️⃣ Type II: Chronic HF → CKD
3️⃣ Type III: AKI → Acute HF
4️⃣ Type IV: CKD → Chronic HF
5️⃣ Type V: Systemic diseases (e.g., sepsis) → Combined dysfunction
nature.com/articles/nrn...
Types of CRS:
1️⃣ Type I: Acute HF → AKI
2️⃣ Type II: Chronic HF → CKD
3️⃣ Type III: AKI → Acute HF
4️⃣ Type IV: CKD → Chronic HF
5️⃣ Type V: Systemic diseases (e.g., sepsis) → Combined dysfunction