A New Era in the Management of Cardiorenal Syndrome: The Importance of Cardiorenal Units
Introduction: Approximately 70% of patients with heart failure (HF) also have kidney disease. Mortality is increased both by cardiorenal syndrome (CRS) and by the exacerbation of other comorbidities. The purpose of this study is to evaluate the clinical performance of patients with CRS wh...
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| Format: | Article |
| Language: | English |
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Karger Publishers
2025-01-01
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| Series: | Cardiorenal Medicine |
| Online Access: | https://karger.com/article/doi/10.1159/000543294 |
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| author | Juan León-Román María Antonieta Azancot Catarina Marouco Marc Patricio-Liebana Jorge Iván Zamora Natalia Ramos Terrades Néstor Toapanta Sara Núñez-Delgado Ana Belen Mendez Fernandez María José Soler |
| author_facet | Juan León-Román María Antonieta Azancot Catarina Marouco Marc Patricio-Liebana Jorge Iván Zamora Natalia Ramos Terrades Néstor Toapanta Sara Núñez-Delgado Ana Belen Mendez Fernandez María José Soler |
| author_sort | Juan León-Román |
| collection | DOAJ |
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Introduction: Approximately 70% of patients with heart failure (HF) also have kidney disease. Mortality is increased both by cardiorenal syndrome (CRS) and by the exacerbation of other comorbidities. The purpose of this study is to evaluate the clinical performance of patients with CRS who are followed up by the Cardiorenal Unit (CRU). Methods: We conducted a retrospective observational study of patients referred to the CRU from April 1, 2022, to April 30, 2023. Demographics, laboratory and ultrasonographic tests, and outcomes were evaluated. Results: Fifty-four patients were seen in the CRU. A total of 45 (83%) and 16 (30%) patients completed follow-up in the CRU at 6 and 12 months, respectively. The mean age was 70 years ± 1.6, and 65% were men. Almost 50% of patients had ischemic heart disease-related HF. The mean cardiac ejection fraction (EF) was 40% ± 1.6, and 61% of patients had HF with reduced EF (HFrEF). NYHA functional classes II and III were the most frequent (60% and 35%, respectively). At 6 months after follow-up, treatment was optimized with sacubitril-valsartan in 33% vs. 49% (p = 0.02) and SGLT2 inhibitors in 48% vs. 72% (p = 0.008), without significant deterioration in renal function (creatinine: p = 0.61; eGFR: p = 0.19). There was also a reduction of more than 50% in the number of hospital admissions (p = 0.002). A total of 22% required peritoneal dialysis, and 20% required hemodialysis. Ten (19%) patients died, five of them due to cardiovascular (CV) events. Conclusions: The CRU is vital for the management of complex patients as it ensures the implementation of medications that reduce CV mortality and decrease the number of hospital admissions in HF. |
| format | Article |
| id | doaj-art-92561eebf0714d14b62e65b57a5c9d4b |
| institution | Kabale University |
| issn | 1664-5502 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Karger Publishers |
| record_format | Article |
| series | Cardiorenal Medicine |
| spelling | doaj-art-92561eebf0714d14b62e65b57a5c9d4b2025-08-20T03:49:41ZengKarger PublishersCardiorenal Medicine1664-55022025-01-0115117418310.1159/000543294A New Era in the Management of Cardiorenal Syndrome: The Importance of Cardiorenal UnitsJuan León-RománMaría Antonieta AzancotCatarina MaroucoMarc Patricio-LiebanaJorge Iván ZamoraNatalia Ramos Terradeshttps://orcid.org/0000-0001-9832-326XNéstor ToapantaSara Núñez-DelgadoAna Belen Mendez FernandezMaría José Soler Introduction: Approximately 70% of patients with heart failure (HF) also have kidney disease. Mortality is increased both by cardiorenal syndrome (CRS) and by the exacerbation of other comorbidities. The purpose of this study is to evaluate the clinical performance of patients with CRS who are followed up by the Cardiorenal Unit (CRU). Methods: We conducted a retrospective observational study of patients referred to the CRU from April 1, 2022, to April 30, 2023. Demographics, laboratory and ultrasonographic tests, and outcomes were evaluated. Results: Fifty-four patients were seen in the CRU. A total of 45 (83%) and 16 (30%) patients completed follow-up in the CRU at 6 and 12 months, respectively. The mean age was 70 years ± 1.6, and 65% were men. Almost 50% of patients had ischemic heart disease-related HF. The mean cardiac ejection fraction (EF) was 40% ± 1.6, and 61% of patients had HF with reduced EF (HFrEF). NYHA functional classes II and III were the most frequent (60% and 35%, respectively). At 6 months after follow-up, treatment was optimized with sacubitril-valsartan in 33% vs. 49% (p = 0.02) and SGLT2 inhibitors in 48% vs. 72% (p = 0.008), without significant deterioration in renal function (creatinine: p = 0.61; eGFR: p = 0.19). There was also a reduction of more than 50% in the number of hospital admissions (p = 0.002). A total of 22% required peritoneal dialysis, and 20% required hemodialysis. Ten (19%) patients died, five of them due to cardiovascular (CV) events. Conclusions: The CRU is vital for the management of complex patients as it ensures the implementation of medications that reduce CV mortality and decrease the number of hospital admissions in HF. https://karger.com/article/doi/10.1159/000543294 |
| spellingShingle | Juan León-Román María Antonieta Azancot Catarina Marouco Marc Patricio-Liebana Jorge Iván Zamora Natalia Ramos Terrades Néstor Toapanta Sara Núñez-Delgado Ana Belen Mendez Fernandez María José Soler A New Era in the Management of Cardiorenal Syndrome: The Importance of Cardiorenal Units Cardiorenal Medicine |
| title | A New Era in the Management of Cardiorenal Syndrome: The Importance of Cardiorenal Units |
| title_full | A New Era in the Management of Cardiorenal Syndrome: The Importance of Cardiorenal Units |
| title_fullStr | A New Era in the Management of Cardiorenal Syndrome: The Importance of Cardiorenal Units |
| title_full_unstemmed | A New Era in the Management of Cardiorenal Syndrome: The Importance of Cardiorenal Units |
| title_short | A New Era in the Management of Cardiorenal Syndrome: The Importance of Cardiorenal Units |
| title_sort | new era in the management of cardiorenal syndrome the importance of cardiorenal units |
| url | https://karger.com/article/doi/10.1159/000543294 |
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