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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.
Critical care nephrology is an emerging multidisciplinary science in which the competences of different specialists are merged to provide a unified diagnostic and therapeutic approach to the critically ill patient. The volume at hand places great emphasis on cardiorenal syndromes and the multidisciplinary collaboration between cardiology and nephrology. Several contributions describe the cardiorenal syndrome in its different varieties and subtypes and report the results from the most recent Acute Dialysis Quality Initiative Consensus Conference, as well as proposing new diagnostic approaches based on early biomarkers of AKI. Other papers discuss advances in technology for renal replacement therapy and multiple organ support therapy. Moreover, special emphasis is placed on the potential role of extracorporeal therapies in patients affected by H1N1 influenza, and a summary of the most recent trials in the field is included. Containing the proceedings of the 2010 International Vicenza Course on Critical Care Nephrology, this publication is a state-of-the-art appraisal of today's technology and current issues related to cardiorenal syndromes.
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.
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.
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.
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.
Fluid overload is often observed in patients with heart failure and secondary oliguric states. A thorough assessment of the fluid status of the patient may help guide the therapy and prevent complications induced by inappropriate therapeutic strategies.The present publication is divided into four parts: Definition and Classification, Pathophysiology, Diagnosis and Therapy. In the first section, the authors present new definitions for heart failure, acute kidney injury and cardiorenal syndromes to facilitate the process of understanding the complex link between the heart and the kidney. Subsequently, different conditions leading to fluid overload are described, followed by an account of emerging diagnostic tools, therapies and technologies devoted to the treatment of patients with severe fluid-related disorders. Clearly structured and written, the present book is a practical tool for physicians and professionals involved in the management and care of patients with combined heart and kidney disorders. Moreover, it also serves as a reference textbook for medical students, residents and fellows dealing in everyday practice with fluid overloaded and oliguric patients.
The ESC Textbook of Intensive and Acute Cardiovascular Care is the official textbook of the Acute Cardiovascular Care Association (ACVC) of the ESC. Cardiovascular diseases (CVDs) are a major cause of premature death worldwide and a cause of loss of disability-adjusted life years. For most types of CVD early diagnosis and intervention are independent drivers of patient outcome. Clinicians must be properly trained and centres appropriately equipped in order to deal with these critically ill cardiac patients. This new updated edition of the textbook continues to comprehensively approach all the different issues relating to intensive and acute cardiovascular care and addresses all those involved in intensive and acute cardiac care, not only cardiologists but also critical care specialists, emergency physicians and healthcare professionals. The chapters cover the various acute cardiovascular diseases that need high quality intensive treatment as well as organisational issues, cooperation among professionals, and interaction with other specialities in medicine. SECTION 1 focusses on the definition, structure, organisation and function of ICCU's, ethical issues and quality of care. SECTION 2 addresses the pre-hospital and immediate in-hospital (ED) emergency cardiac care. SECTIONS 3-5 discuss patient monitoring, diagnosis and specific procedures. Acute coronary syndromes (ACS), acute decompensated heart failure (ADHF), and serious arrhythmias form SECTIONS 6-8. The main other cardiovascular acute conditions are grouped in SECTION 9. Finally SECTION 10 is dedicated to the many concomitant acute non-cardiovascular conditions that contribute to the patients' case mix in ICCU. This edition includes new chapters such as low cardiac output states and cardiogenic shock, and pacemaker and ICDs: troubleshooting and chapters have been extensively revised. Purchasers of the print edition will also receive an access code to access the online version of the textbook which includes additional figures, tables, and videos to better to better illustrate diagnostic and therapeutic techniques and procedures in IACC. The third edition of the ESC Textbook of Intensive and Acute Cardiovascular Care will establish a common basis of knowledge and a uniform and improved quality of care across the field.
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. - Online access features heart sounds and murmurs to accompany the chapter on history and physical examination, videos of clinical images and key procedures, frequently updated information on late-breaking clinical trials, reviews of new research publications, and more. - 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. - Expert ConsultTM eBook version included with purchase. This enhanced eBook experience allows you to search all of the text, figures, and references from the book on a variety of devices and contains an up to date collection of all relevant ACC/AHA and ESC guidelines.