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This comprehensive manual reviews the management of cardiorenal syndrome in heart failure. Chapters are structured in a practically applicable and easy-to-follow format with realistic case vignettes and key clinical management questions and answers, followed by a brief discussion of underlying pathophysiological mechanisms of a patient with cardiorenal syndrome. Building from this case, key questions are posed that are relevant to the clinical management and then potential evidence-based treatment strategies are proposed. Topics covered include loop diuretic resistance in acute and chronic heart failure, abdominal congestion, low output failure and potential diuretic complications due to hyponatremia. Cardiorenal Syndrome in Heart Failure thoroughly reviews cardiorenal syndrome from the perspective of both the cardiologist and nephrologist. Its case-based approach makes it an ideal resource for both practising and trainee cardiology and nephrology practitioners.
Associated with both acute kidney injury (AKI) and cardio-renal syndromes (CRS), new biomarkers represent both a popular area of investigation and a new opportunity for advancement of therapy. This book contains the resolutions of the most recent ADQI conferences on biomarkers in AKI (Dublin) and on cardio-renal syndromes (Venice). The first part answers specific questions about new biomarkers and their use and utility in AKI: What are the most suitable candidate molecules and physiologic measures, how solid and evidence based is the discovery phase? How can we incorporate the new biomarkers in the AKI conceptual model describing the evolution from susceptibility to insult, decreased GFR and organ death? Even if we have a positive biomarker pattern and we can identify patients at risk or patients with early or even subclinical AKI, how is this information affecting our clinical behavior and practice? The second part is dedicated to the appraisal of the current knowledge about the pathophysiological mechanisms involved in different forms of CRS: it contains contributions on the state-of-the-art knowledge and practice of CRS, particularly focusing on the pathophysiology of the five subtypes. Acute and chronic mechanisms of damage are explored in depth, with particular attention to the primacy of organ involvement and the subsequent pathways of organ crosstalk.Presenting the most recent research in the field of biomarkers, AKI and CRS, this publication is an important educational tool for advanced investigators and clinical experts, but also for students and fellows.
This textbook provides a practical and board-driven resource to describe and define the emerging field of cardiorenal medicine. Covering all aspects of the topic with depth and relevance, this groundbreaking reference brings together experts at the nexus between cardiovascular and renal medicine to provide an exception reference to educate in this critical area of modern medicine. It describes how the heart and kidneys are inextricably linked via hemodynamic, neural, hormonal and cellular signaling systems and, concentrating on disease-based coverage, goes on to review emerging concepts in epidemiology, pathogenesis, screening, diagnosis and the management of cardiorenal syndromes, all extensively illustrated and containing features to support scholarship in the field. Textbook of Cardiorenal Medicine provides consistent chapter organization, clear design and engaging text to define the diagnosis, treatment, intervention and surgical aspects of the full range of conditions encountered within this area of medicine. It is therefore an essential resource to all involved in the management of cardiorenal disease.
Chronic kidney disease with a worldwide prevalence of 10% in the general population is emerging as a major public health priority. Renal dysfunction is associated with a high risk for cardiovascular complications. The relationship between renal insufficiency and cardiovascular disease, termed the cardiorenal syndrome exists whether impairment of renal function is a consequence of primary renal parenchymal disease or primary heart disease. Several pathophysiologic mechanisms have been postulated to explain the relationship between renal dysfunction and cardiovascular disease. Recent studies indicate an integrated response of the vascular smooth muscles and glomerular mesangial cells to traditional and uremia related cardiovascular risk factors. Traditional risk factors can incite renal impairment and cardiac damage. As renal function deteriorates, uremia-related risk factors play an increasing role both in reduction in glomerular filtration rate and cardiovascular damage. Several uremia related factors such as uncontrolled hypertension, disturbed glucose insulin metabolism, microalbuminuria, phosphate retention, secondary hyperparathyroidism, myocardial and vascular calcification, hypertensive-uremic cardiomyopathy, inflammation, oxidant injury, and neurohormonal dysregulation have been implicated in the pathogenesis of the cardiorenal syndrome. Recent data suggest that management of the cardiorenal syndrome requires aggressive control of traditional risk factors as well novel approaches to prevent or reverse uremia –related processes. This book provides a comprehensive update analysis of our current understanding of the cardiorenal syndrome including epidemiology, pathophysiologic mechanisms, and therapeutic approaches.
Extending from the outpatient management of cardiovascular and kidney disease, to hospital-based decision making in patients with cardio-renal disease and complex interfaces such as hemodialysis in patients with ventricular assist device support, this book serves as a single reference point for cardiology and nephrology clinicians and researchers dealing with the significant overlap areas between these two specialties. Chapters cover the physiology, biomarkers, therapeutic agents and full spectrum of these comorbidities and feature separate sections on cardiovascular and CKD evaluations, stratification of kidney transplant patients, lipid management in CKD, interventional strategies and hypertension. Leaders in cardiology, nephrology, hypertension and lipidology bring together the latest evidence with their collective clinical experience into this invaluable resource.This textbook is an essential resource for physicians and allied professionals practicing cardiology, nephrology, students and physician trainees, to deepen their understanding of this crucial field.
The treatment of hypertension has become the most important intervention in the management of all forms of chronic kidney disease. Chronic Kidney Disease and Hypertension is a current, concise, and practical guide to the identification, treatment and management of hypertension in patients with chronic kidney disease. In depth chapters discuss many relevant clinical questions and the future of treatment through medications and or novel new devices. Written by expert authors, Chronic Kidney Disease and Hypertension provides an up-to-date perspective on management and treatment and how it may re-shape practice approaches tomorrow.
Cardiorenal syndrome - the presence of significant renal insufficiency and heart failure simultaneously - constitutes one of the most vexing and difficult challenges facing clinicians and researchers today. Given the fundamental role of the kidneys in maintaining fluid and electrolyte balance within the body, it comes as no surprise that renal abnormalities are inextricably linked with congestive heart failure. What is surprising is that recent data have indicated that renal dysfunction is a more critical determinant of mortality than heart failure itself. In The Cardiorenal Syndrome: A Clinician's Guide to Pathophysiology and Management, experts from around the world clearly outline the current issues associated with this increasingly prevalent condition, provide invaluable insight into its pathophysiology, and highlight the risks, benefits, and rationales for both practical and promising prevention and treatment strategies, including: DiureticsRole of ACE inhibitors/ angiotensin receptor blockers in renal dysfunctionNew "designer" peptides for heart failureInotropes and neurohormonal blockadeDialysis and ultrafiltrationRenal cell therapyLeft ventricular assist device implantationRenal and/or heart transplantation While recognition of the role of renal dysfunction in the progression of heart failure is a pivotal advance, many questions about the scope and impact of this condition remain. This book serves as a touchstone for cardiovascular specialists and internists as they encounter the diverse varieties of cardiorenal syndrome and attempt to navigate the radically different and evolving therapeutic options in their quest to provide optimal individualized care for their patients.
For many years, there has been a great deal of work done on chronic congestive heart failure while acute heart failure has been considered a difficult to handle and hopeless syndrome. However, in recent years acute heart failure has become a growing area of study and this is the first book to cover extensively the diagnosis and management of this complex condition. The book reflects the considerable amounts of new data reported and many new concepts which have been proposed in the last 3-4 years looking at the epidemiology, diagnostic and treatment of acute heart failure.
Using a multidisciplinary, team-oriented approach, this unique title expertly covers all the latest approaches to the assessment, diagnosis, and treatment of patients with critical cardiac illness. Led by Dr David L. Brown, a stellar team of authoritative writers guides you through cardiac pathophysiology, disease states presenting in the CICU, and state-of-the-art advanced diagnosis and therapeutic techniques. A visually appealing format, new chapters, and thorough updates ensure that you stay on the cutting edge of this rapidly advancing field. Discusses recent changes in cardiac intensive care, including new care paradigms, new mechanical support modalities, and new therapies and interventions. Contains 11 new chapters: Palliative Care, Temporary Pacemaker Insertion, Pericardiocentesis, Distributive Shock, Electrical Storm, Cardiopulmonary Cerebral Resuscitation after Cardiac Arrest, Temporary Mechanical Circulatory Support Devices, Cardiorenal Syndrome, Fulminant Myocarditis, Stress-Induced Cardiomyopathy, Diagnosis and Treatment of Unstable Supraventricular Tachycardia. Concisely yet thoroughly covers acute and severe heart failure, chronic pulmonary hypertension, life-threatening dysrhythmias, aortic dissection, and other cardiac conditions as they relate to intensive care. Explains drug therapy for key cardiac drugs, such as inotropes, vasodilators, anti-arrhythmics, diuretics, anticoagulants, and anti-platelets, and discusses important drug interactions. Ideal for all healthcare professionals involved in cardiac intensive care, including intensivists, cardiologists, cardiac surgeons, residents, fellows, cardiac nurses, respiratory therapists, physical therapists, and nutritionists.
If you understand heart failure, you understand cardiology This book applies practical clinical concepts to the latest four-stage model of heart failure from preclinical risk and early asymptomatic disease to classic symptomatic heart failure and finally advanced heart failure. This framework emphasizes a tailored approach to ongoing heart failure assessment to guide therapy and improve outcomes. Features: Illustrated with over 250 full-color figuresSpecific recommendations backed by clinical trial dataPractical algorithms for diagnosis and therapy Topics include: Prevention of heart failureIdentification and treatment of structural heart disease prior to heart failureHow to combine lifestyle changes, medications, and devices to improve outcomesReversing decompensated heart failureKey indicators of advanced heart failure and appropriate treatment optionsEmerging new therapies “This book will be valuable to all training and practicing clinicians. He writes as if you and he are both completing patient rounds together. Brian E. Jaski is to be commended for capturing the essence of treating this formidable clinical challenge and demystifying the stages of heart failure.” --From the foreword by Sidney C. Smith, Jr. MD FACC, FAHA, FESC, FACP Professor of Medicine, University of North Carolina at Chapel Hill Past President, American Heart Association Past President, World Heart Federation “The culmination of Dr. Jaski’s 25 years of teaching experience and clinical acumen is now available in one highly readable text designed to highlight key information and stimulate the learning process.” --Dylan E. Wessman, MD, FACC, FACP Program Director, Cardiovascular Disease Fellowship Naval Medical Center San Diego San Diego, California