Multidisciplinary approach to patients with heart failure and kidney disease : preliminary experience of an integrated cardiorenal unit
© The Author(s) 2023. Published by Oxford University Press on behalf of the ERA..
Background: Cardiorenal programs have emerged to improve the management of cardiorenal disease (CRD). Evidence about the benefits of these programs is still scarce. This work aims to evaluate the performance of a novel cardiorenal program and describe the clinical profile and outcomes of patients with CRD.
Methods: We conducted a retrospective observational study of patients with CRD attended in a cardiorenal unit (CRU) from February 2021 to February 2022. Demographics and laboratory tests were collected and events (all-cause death and cardiovascular hospitalizations) were evaluated. Optimization of comorbidities and protective therapies was also assessed.
Results: Eighty-two patients were included, with a mean age of 76.8 years [standard deviation (SD) 8.5] and 72% were men. A total of 58.5% (n = 47) had left ventricular ejection fraction <50%. The mean follow-up was 11 months (SD 4.0). Almost 54% of the patients (n = 44) required hospitalization, 30.5% for heart failure (HF) decompensation. Total hospitalizations significantly decreased after CRU inclusion: 0.70 versus 0.45 admissions/year (P < .02). Global mortality was 17.1% (n = 14). The percentage of patients with HF with reduced ejection fraction on quadruple therapy increased by 20%, and up to 60% of the patients were on three drugs. A total of 39% of the patients with HF and preserved ejection fraction started treatment with sodium-glucose co-transporter inhibitors. Hyperkalaemia required the use of potassium binders in 12.2% of the patients and treatment of secondary hyperparathyroidism was started in 42.7% and renal anaemia in 23.2%. Renal replacement therapy was initiated in 10% of the patients (n = 8).
Conclusion: CRD confers a considerable risk of adverse outcomes. Cardiorenal programs may improve cardiorenal syndrome management by optimizing therapies, treating comorbidities and reducing hospitalizations.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:16 |
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| Enthalten in: |
Clinical kidney journal - 16(2023), 11 vom: 14. Nov., Seite 2100-2107 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Marques, María [VerfasserIn] |
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| Links: |
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| Themen: |
Cardiorenal syndrome |
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| Anmerkungen: |
Date Revised 03.11.2023 published: Electronic-eCollection Citation Status PubMed-not-MEDLINE |
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| doi: |
10.1093/ckj/sfad169 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM364078162 |
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| 100 | 1 | |a Marques, María |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Multidisciplinary approach to patients with heart failure and kidney disease |b preliminary experience of an integrated cardiorenal unit |
| 264 | 1 | |c 2023 | |
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| 500 | |a Date Revised 03.11.2023 | ||
| 500 | |a published: Electronic-eCollection | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a © The Author(s) 2023. Published by Oxford University Press on behalf of the ERA. | ||
| 520 | |a Background: Cardiorenal programs have emerged to improve the management of cardiorenal disease (CRD). Evidence about the benefits of these programs is still scarce. This work aims to evaluate the performance of a novel cardiorenal program and describe the clinical profile and outcomes of patients with CRD | ||
| 520 | |a Methods: We conducted a retrospective observational study of patients with CRD attended in a cardiorenal unit (CRU) from February 2021 to February 2022. Demographics and laboratory tests were collected and events (all-cause death and cardiovascular hospitalizations) were evaluated. Optimization of comorbidities and protective therapies was also assessed | ||
| 520 | |a Results: Eighty-two patients were included, with a mean age of 76.8 years [standard deviation (SD) 8.5] and 72% were men. A total of 58.5% (n = 47) had left ventricular ejection fraction <50%. The mean follow-up was 11 months (SD 4.0). Almost 54% of the patients (n = 44) required hospitalization, 30.5% for heart failure (HF) decompensation. Total hospitalizations significantly decreased after CRU inclusion: 0.70 versus 0.45 admissions/year (P < .02). Global mortality was 17.1% (n = 14). The percentage of patients with HF with reduced ejection fraction on quadruple therapy increased by 20%, and up to 60% of the patients were on three drugs. A total of 39% of the patients with HF and preserved ejection fraction started treatment with sodium-glucose co-transporter inhibitors. Hyperkalaemia required the use of potassium binders in 12.2% of the patients and treatment of secondary hyperparathyroidism was started in 42.7% and renal anaemia in 23.2%. Renal replacement therapy was initiated in 10% of the patients (n = 8) | ||
| 520 | |a Conclusion: CRD confers a considerable risk of adverse outcomes. Cardiorenal programs may improve cardiorenal syndrome management by optimizing therapies, treating comorbidities and reducing hospitalizations | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a cardiorenal syndrome | |
| 650 | 4 | |a cardiorenal units | |
| 650 | 4 | |a chronic kidney disease | |
| 650 | 4 | |a heart failure | |
| 650 | 4 | |a therapy optimization | |
| 700 | 1 | |a Cobo, Marta |e verfasserin |4 aut | |
| 700 | 1 | |a López-Sánchez, Paula |e verfasserin |4 aut | |
| 700 | 1 | |a García-Magallón, Belén |e verfasserin |4 aut | |
| 700 | 1 | |a Salazar, María Luisa Serrano |e verfasserin |4 aut | |
| 700 | 1 | |a López-Ibor, Jorge V |e verfasserin |4 aut | |
| 700 | 1 | |a Janeiro, Darío |e verfasserin |4 aut | |
| 700 | 1 | |a García, Estefanya |e verfasserin |4 aut | |
| 700 | 1 | |a Briales, Paula Sánchez |e verfasserin |4 aut | |
| 700 | 1 | |a Montero, Esther |e verfasserin |4 aut | |
| 700 | 1 | |a Illazquez, María Victoria López |e verfasserin |4 aut | |
| 700 | 1 | |a Gómez, Teresa Soria |e verfasserin |4 aut | |
| 700 | 1 | |a Citores, Yolanda Martínez |e verfasserin |4 aut | |
| 700 | 1 | |a Peral, Ana Martínez |e verfasserin |4 aut | |
| 700 | 1 | |a Segovia, Javier |e verfasserin |4 aut | |
| 700 | 1 | |a Portolés, José |e verfasserin |4 aut | |
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