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Voigtländer-Buschmann L, Schäfer S, Schmidt-Lauber C, Weimann J, Shenas M, Giraldo Cortes J, Kuta PM, Zeller T, Twerenbold R, Seiffert M, Schofer N, Schneeberger Y, Schäfer A, Schirmer J, Reichenspurner H, Blankenberg S, Conradi L, Schäfer U. Effect of periprocedural furosemide-induced diuresis with matched isotonic intravenous hydration in patients with chronic kidney disease undergoing transcatheter aortic valve implantation. Clin Res Cardiol 2024; 113:801-811. [PMID: 37264143 PMCID: PMC11108912 DOI: 10.1007/s00392-023-02234-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 05/15/2023] [Indexed: 06/03/2023]
Abstract
BACKGROUND Acute kidney injury (AKI) after transcatheter aortic valve implantation (TAVI) is a serious complication which is associated with increased mortality. The RenalGuard system was developed to reduce the risk of AKI after contrast media exposition by furosemide-induced diuresis with matched isotonic intravenous hydration. The aim of this study was to examine the effect of the RenalGuard system on the occurrence of AKI after TAVI in patients with chronic kidney disease. METHODS The present study is a single-center randomized trial including patients with severe aortic valve stenosis undergoing TAVI. Overall, a total of 100 patients treated by TAVI between January 2017 and August 2018 were randomly assigned to a periprocedural treatment with the RenalGuard system or standard treatment by pre- and postprocedural intravenous hydration. Primary endpoint was the occurrence of AKI after TAVI, and secondary endpoints were assessed according to valve academic research consortium 2 criteria. RESULTS Overall, the prevalence of AKI was 18.4% (n = 18). The majority of these patients developed mild AKI according to stage 1. Comparing RenalGuard to standard therapy, no significant differences were observed in the occurrence of AKI (RenalGuard: 21.3%; control group: 15.7%; p = 0.651). In addition, there were no differences between the groups with regard to 30-day and 12-month mortality and procedure-associated complication rates. CONCLUSION In this randomized trial, we did not detect a reduction in AKI after TAVI by using the RenalGuard system. A substantial number of patients with chronic kidney disease developed AKI after TAVI, whereas the majority presented with mild AKI according to stage 1 (ClinicalTrials.gov number NCT04537325).
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Affiliation(s)
| | - Sarina Schäfer
- Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany
| | | | - Jessica Weimann
- Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany
| | - Mina Shenas
- Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany
| | - Julian Giraldo Cortes
- Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany
| | - Piotr Mariusz Kuta
- Institute for Clinical Chemistry and Laboratory Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Tanja Zeller
- Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany
| | - Raphael Twerenbold
- Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany
| | - Moritz Seiffert
- Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany
| | - Niklas Schofer
- Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany
| | - Yvonne Schneeberger
- Department of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, Hamburg, Germany
| | - Andreas Schäfer
- Department of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, Hamburg, Germany
| | - Johannes Schirmer
- Department of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, Hamburg, Germany
| | - Hermann Reichenspurner
- Department of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, Hamburg, Germany
| | - Stefan Blankenberg
- Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany
| | - Lenard Conradi
- Department of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, Hamburg, Germany
| | - Ulrich Schäfer
- Department of Cardiology, Heart and Vessel Center Bad Bevensen, Bad Bevensen, Germany
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2
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Adedokun SD, Sarwar M, Hwang K, Hans A, Baskaran J, Anantha Narayanan M. Outcomes of lower extremity peripheral arterial interventions in patients with and without chronic kidney disease or end-stage renal disease. THE JOURNAL OF CARDIOVASCULAR SURGERY 2023; 64:624-633. [PMID: 38078709 DOI: 10.23736/s0021-9509.23.12798-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/23/2024]
Abstract
INTRODUCTION Peripheral arterial disease (PAD) is a progressive vascular condition characterized by the narrowing or blockage of arteries, primarily attributed to atherosclerosis. PAD's prevalence in the general population is estimated at approximately 5.9%. Notably however, among patients with chronic kidney disease (CKD), PAD's prevalence is substantially higher, ranging from 17% to 48%. This review paper emphasizes the pervasiveness of PAD and its intricate relationship with CKD and end-stage renal disease (ESRD). It demonstrates the importance of early detection, proactive screening, and understanding the formidable challenges associated with treating heavily calcified lesions. EVIDENCE ACQUISITION Comprehensive literature searches encompassed the PubMed/MEDLINE, Cochrane Library, and Embase databases, in order to identify studies involving lower extremity peripheral arterial interventions in patients both with and without CKD or ESRD. The search spanned the timeframe from January 2001 to July 2023. The search strategy included vocabulary terms concerning peripheral artery disease, lower extremities, revascularization, chronic kidney disease, and end-stage renal disease. EVIDENCE SYNTHESIS Initial searches were used to identify articles based on title. Exclusion criteria was then applied, and any redundant articles were removed. The articles abstracts were then reviewed, and relevant articles were selected. Once selected the articles were thoroughly reviewed including the references to find other relevant articles that were missed during the initial search process. In total 28 articles were selected and included for review of clinical data in regard to PAD outcomes in patients with advanced kidney disease. CONCLUSIONS The findings highlight the need for personalized approaches in diagnosing and treating PAD in CKD and ESRD patients. Interdisciplinary collaboration, such as those between nephrologists, vascular surgeons, and interventional radiologists, is vital to optimize outcomes. Further research should focus on innovative, tailored interventions to enhance limb preservation, reduce mortality, prolong patency, and cut healthcare costs.
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Affiliation(s)
| | - Maruf Sarwar
- Section of Internal Medicine, White River Health, Batesville, AR, USA
| | - Keonmin Hwang
- HCA Tristar Skyline Medical Center, Nashville, TN, USA
| | - Aakash Hans
- Section of Internal Medicine, White River Health, Batesville, AR, USA
| | - Janani Baskaran
- Section of Internal Medicine, White River Health, Batesville, AR, USA
| | - Mahesh Anantha Narayanan
- Section of Cardiovascular Diseases, White River Health, Batesville, AR, USA -
- University of Arkansas Medical Sciences, Little Rock, AR, USA
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3
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McDonald JS, McDonald RJ. Risk of Acute Kidney Injury Following IV Iodinated Contrast Media Exposure: 2023 Update, From the AJR Special Series on Contrast Media. AJR Am J Roentgenol 2023. [PMID: 37791729 DOI: 10.2214/ajr.23.30037] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
Iodinated contrast material (ICM) has revolutionized the field of diagnostic radiology through improvements in diagnostic performance and expansion in clinical indications for radiographic and CT examinations. Historically, nephrotoxicity was a feared complication of ICM use, thought to be associated with a significant risk of morbidity and mortality. Such fears often precluded use of ICM in imaging evaluations, commonly at the expense of diagnostic performance and timely diagnosis. Over the past 20 years, the nephrotoxic risk of ICM has become a topic of debate, as more recent evidence from higher-quality studies now suggest that many cases of what was considered contrast-induced acute kidney injury (CI-AKI) were likely cases of mistaken causal attribution; most of these cases represented either acute kidney injury (AKI) caused by any of myriad other known factors that can adversely affect renal function and were coincidentally present at the time of contrast media exposure (contrast-associated AKI (CA-AKI)) or a manifestation of the normal variation in renal function that increases with worsening renal function. This review discusses the current state of knowledge on CI-AKI and CA-AKI including the incidence, risk factors, outcomes, and prophylactic strategies in the identification and management of these clinical conditions.
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Affiliation(s)
- Jennifer S McDonald
- From the Department of Radiology, College of Medicine, Mayo Clinic, Rochester, MN
| | - Robert J McDonald
- From the Department of Radiology, College of Medicine, Mayo Clinic, Rochester, MN
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4
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Occhipinti G, Laudani C, Spagnolo M, Greco A, Capodanno D. Diuresis-matched versus standard hydration in patients undergoing percutaneous cardiovascular procedures: meta-analysis of randomized clinical trials. REVISTA ESPANOLA DE CARDIOLOGIA (ENGLISH ED.) 2023; 76:759-766. [PMID: 36801376 DOI: 10.1016/j.rec.2023.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 02/01/2023] [Indexed: 02/18/2023]
Abstract
INTRODUCTION AND OBJECTIVES Contrast-associated acute kidney injury (CA-AKI) is a potential complication of procedures requiring administration of iodinated contrast medium. RenalGuard, which provides real-time matching of intravenous hydration with furosemide-induced diuresis, is an alternative to standard periprocedural hydration strategies. The evidence on RenalGuard in patients undergoing percutaneous cardiovascular procedures is sparse. We used a Bayesian framework to perform a meta-analysis of RenalGuard as a CA-AKI preventive strategy. METHODS We searched Medline, Cochrane Library and Web of Science for randomized trials of RenalGuard vs standard periprocedural hydration strategies. The primary outcome was CA-AKI. Secondary outcomes were all-cause death, cardiogenic shock, acute pulmonary edema, and renal failure requiring renal replacement therapy. A Bayesian random-effect risk ratio (RR) with corresponding 95% credibility interval (95%CrI) was calculated for each outcome. PROSPERO database number CRD42022378489. RESULTS Six studies were included. RenalGuard was associated with a significant relative reduction in CA-AKI (median RR, 0.54; 95%CrI, 0.31-0.86) and acute pulmonary edema (median RR, 0.35; 95%CrI, 0.12-0.87). No significant differences were observed for the other secondary endpoints [all-cause death (RR, 0.49; 95%CrI, 0.13-1.08), cardiogenic shock (RR, 0.06; 95%CrI, 0.00-1.91), and renal replacement therapy (RR, 0.52; 95%CrI, 0.18-1.18)]. The Bayesian analysis also showed that RenalGuard had a high probability of ranking first for all the secondary outcomes. These results were consistent in multiple sensitivity analyses. CONCLUSIONS In patients undergoing percutaneous cardiovascular procedures, RenalGuard was associated with a reduced risk of CA-AKI and acute pulmonary edema compared with standard periprocedural hydration strategies.
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Affiliation(s)
- Giovanni Occhipinti
- Division of Cardiology, Azienda Ospedaliero-Universitaria Policlinico G. Rodolico-San Marco, University of Catania, Catania, Italy
| | - Claudio Laudani
- Division of Cardiology, Azienda Ospedaliero-Universitaria Policlinico G. Rodolico-San Marco, University of Catania, Catania, Italy
| | - Marco Spagnolo
- Division of Cardiology, Azienda Ospedaliero-Universitaria Policlinico G. Rodolico-San Marco, University of Catania, Catania, Italy
| | - Antonio Greco
- Division of Cardiology, Azienda Ospedaliero-Universitaria Policlinico G. Rodolico-San Marco, University of Catania, Catania, Italy
| | - Davide Capodanno
- Division of Cardiology, Azienda Ospedaliero-Universitaria Policlinico G. Rodolico-San Marco, University of Catania, Catania, Italy.
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5
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Abstract
AKI is a potential complication of intravascular iodinated contrast exposure. Contrast-associated AKI, which typically manifests as small and transient decrements in kidney function that develop within several days of contrast administration, is associated with serious adverse outcomes, including progressive kidney dysfunction and death. However, a causal link between the small increases in serum creatinine that characteristically occur with contrast-associated AKI and serious adverse outcomes remains unproven. This is important given mounting evidence that clinically indicated, potentially lifesaving radiographic procedures are underutilized in patients with CKD. This has been hypothesized to be related to provider concern about precipitating contrast-associated AKI. Intravascular gadolinium-based contrast, an alternative to iodinated contrast that is administered with magnetic resonance imaging, has also been linked with potential serious adverse events, notably the development of nephrogenic systemic fibrosis in patients with severe impairment in kidney function. Patients hospitalized in the intensive care unit frequently have clinical indications for diagnostic and therapeutic procedures that involve the intravascular administration of contrast media. Accordingly, critical care providers and others treating critically ill patients should possess a sound understanding of the risk factors for and incidence of such outcomes, the ability to perform evidence-based risk-benefit assessments regarding intravascular contrast administration, and knowledge of empirical data on the prevention of these iatrogenic complications.
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Affiliation(s)
- Winn Cashion
- Renal-Electrolyte Division, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Steven D Weisbord
- Renal-Electrolyte Division, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania .,Center for Health Equity Research and Promotion, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, Pennsylvania.,Renal Section, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, Pennsylvania
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Mirza AJ, Ali K, Huwez F, Taha AY, Ahmed FJ, Ezzaddin SA, Abdulrahman ZI, Lang CC. Contrast Induced Nephropathy: Efficacy of matched hydration and forced diuresis for prevention in patients with impaired renal function undergoing coronary procedures–CINEMA trial. IJC HEART & VASCULATURE 2022; 39:100959. [PMID: 35146119 PMCID: PMC8818567 DOI: 10.1016/j.ijcha.2022.100959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 01/17/2022] [Indexed: 11/19/2022]
Abstract
Background Matched hydration and forced diuresis (MHFD) using the RenalGuard device has been shown to reduce contrast induced nephropathy (CIN) following coronary interventions. Aim To evaluate the potential benefits of a non-automated MHFD protocol compared to current hydration protocol in prevention of CIN in patients with CKD. Methods A total of 1,205 patients were randomized to either non-automated MHFD group (n = 799) or intravenous hydration control group (n = 406). The MHFD group received 250 ml IV normal saline over 30 min before the coronary procedure followed by 0.5 mg/kg IV furosemide. Hydration infusion rate was manually adjusted to replace the patient's urine output. When urine output rate reached > 300 ml/h, patients underwent coronary procedure. Matched fluid replacement was maintained during the procedure and for 4-hour post-treatment. CIN was defined conventionally as ≥ 25% or ≥ 0.5 mg/dl rise in serum creatinine over baseline. Results CIN occurred in 121 of 1,205 (10.0%) patients in our study. With respect to the primary outcome, 64 (8.01%) of the MHFD patients developed CIN compared with 57 (14.04%) of the control group (p < 0.001). Conclusions A non-automated MHFD protocol is an effective and safe method for the prevention of CIN in patients with CKD.
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Affiliation(s)
- Aram J. Mirza
- Department of Interventional Cardiology, Slemani Cardiac Hospital, Sulaymaniyah, Region of Kurdistan, Iraq
| | - Kashan Ali
- Division of Molecular & Clinical Medicine, School of Medicine, Ninewells Hospital & Medical School, University of Dundee, UK
| | - Farhad Huwez
- Royal London Hospital, Hyper-acute Stroke Unit, Whitechapel, London, UK
| | - Abdulsalam Y. Taha
- Department of Thoracic and Cardiovascular Surgery, College of Medicine, University of Sulaimani, Sulaymaniyah, Region of Kurdistan, Iraq
| | - Farman J. Ahmed
- Department of Interventional Cardiology, Slemani Cardiac Hospital, Sulaymaniyah, Region of Kurdistan, Iraq
| | - Shahow A. Ezzaddin
- Department of Family and Community Medicine, College of Medicine, University of Sulaimani, Sulaymaniyah, Region of Kurdistan, Iraq
| | - Zana I. Abdulrahman
- Shorsh General Hospital, Peshmarga Health Foundation, Ministry of Peshmarga, Region of Kurdistan, Iraq
| | - Chim C. Lang
- Division of Molecular & Clinical Medicine, School of Medicine, Ninewells Hospital & Medical School, University of Dundee, UK
- Corresponding author at: Head, Division of Molecular & Clinical Medicine, School of Medicine, University of Dundee, DD1 9SY, UK.
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7
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Li Y, Shi L, Jia L, Zhang H. [Effect of half-dose fluorescein sodium contrast agent on liver and kidney functions in patients with mild to moderate chronic kidney disease: a retrospective cohort study]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2021; 41:1436-1438. [PMID: 34658362 DOI: 10.12122/j.issn.1673-4254.2021.09.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To observe the effect of half-dose fluorescein sodium (FINa) contrast agent on liver and kidney functions in patients with mild to moderate (stage 1 to 3) chronic kidney disease (CKD) and the incidence of contrast-induced nephropathy (CIN). METHODS Seventy-seven patients (including 50 male and 27 female patients with an mean age of 53.5±9.6 years) with CKD with normal renal function or mild to moderate abnormalities underwent fundus fluorescein angiography (FFG) examination with half-dose FINa. Liver function, blood creatinine (Scr), blood urea nitrogen (BUN), urine β2 microglobulin (β2-MG), and glomerular filtration rate (eGFR) of the patients were measured within 3 days before intravenous injection of the contrast agent and at 1, 3, 7, and 30±1 days after the operation to analyze the effect of the contrast agent on renal function. RESULTS Among the 77 patients, CIN occurred only in one case with an incidence rate of 1.30%. BUN, urine β2- MG, or rapid microalbumin/creatinine did not vary significantly after FFA in these patients. Scr levels showed no significant increments at 1 day and 7 days after FFA, but increased significantly at 3 days (24.6±2.3; P < 0.01) and 30 days (16.0±21.7; P < 0.05). Urine NAG enzymes and urinary osmolality were significantly reduced at 1, 3, 7, and 30 days after FFA (P < 0.01). The eGFR decreased significantly to 10.23±0.62 at 3 days after FAG and became normal at 7 days. Urine albumin level decreased significantly at 1, 3, 7, and 30 days after FFA (P < 0.01). Blood β2-MGFAG level increased significantly at 3 days after FFA (0.314± 0.121; P < 0.01), but decreased to 0.134±0.143 at 7 days (P < 0.05). The level transaminase decreased significantly at 3 and 7 days after FFA (P < 0.01). CONCLUSION Half-dose of FINa has no significant effect on liver function and has only minimal effect on kidney function in patients with mild to moderate CKD, and FFA with half-dose FINa can therefore be safely performed in these patients.
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Affiliation(s)
- Y Li
- Senior Department of Ophthalmology, the Third Medical Center of PLA General Hospital, Beijing 100853, China
| | - L Shi
- Southern Medical Branch of PLA General Hospital, Beijing 100036, China
| | - L Jia
- Senior Department of Ophthalmology, the Third Medical Center of PLA General Hospital, Beijing 100853, China
| | - H Zhang
- Senior Department of Ophthalmology, the Third Medical Center of PLA General Hospital, Beijing 100853, China
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Harfouch B, Prasad A. Implications of Renal Disease in Patients Undergoing Peripheral Arterial Interventions. Interv Cardiol Clin 2020; 9:345-356. [PMID: 32471675 DOI: 10.1016/j.iccl.2020.02.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Since the first peripheral endovascular intervention (PVI) in 1964, the procedure's technical aspects and indications have advanced significantly. Today, endovascular procedures span the spectrum of presentations from acute limb ischemia to critical limb ischemia and symptomatic limiting claudication. Goals of PVI remain restoring limb perfusion, minimizing rates of amputation and mortality, and sparing the need for the high-risk bypass surgery. Unfortunately, there are no large randomized controlled trials that address the optimal approach to peripheral arterial disease revascularization in chronic kidney disease (CKD) patients.
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Affiliation(s)
- Badr Harfouch
- Division of Cardiology, Department of Medicine, UT Health San Antonio, MC 7872, 8300 Floyd Curl Drive, San Antonio, TX 78229-3900, USA
| | - Anand Prasad
- Division of Cardiology, Department of Medicine, UT Health San Antonio, MC 7872, 8300 Floyd Curl Drive, San Antonio, TX 78229-3900, USA.
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9
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Biegus J, Zymlinski R, Siwolowski P, Testani J, Szachniewicz J, Tycińska A, Banasiak W, Halpert A, Levin H, Ponikowski P. Controlled decongestion by Reprieve therapy in acute heart failure: results of the TARGET-1 and TARGET-2 studies. Eur J Heart Fail 2019; 21:1079-1087. [PMID: 31127666 DOI: 10.1002/ejhf.1533] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 05/15/2019] [Accepted: 05/17/2019] [Indexed: 12/19/2022] Open
Abstract
AIMS Safe and effective decongestion is the main goal of therapy in acute heart failure (AHF). In the non-randomized, prospective TARGET-1 and TARGET-2 studies (NCT03897842), we investigated whether adding the Reprieve System® (which continuously monitors urine output and delivers a matched volume of hydration fluid sufficient to maintain the set fluid balance rate) to standard diuretic-based regimen improves decongestion in AHF. METHODS AND RESULTS The population consisted of 19 patients hospitalized with AHF (mean age 67 ± 10 years, 18 male, ejection fraction 34 ± 15%, median N-terminal pro-B-type natriuretic peptide 4492 pg/mL). Patients served as their own controls: each patient underwent 24 h of standard diuretic therapy followed by 24 h of diuretics with Reprieve therapy (with normal saline used for matched volume replacement). The primary efficacy endpoint of actual fluid loss not exceeding the target fluid loss at the end of therapy was met in all 19 (100%) patients. The mean diuresis during Reprieve therapy was 6284 ± 2679 mL (vs. 1966 ± 1057 mL 24 h before therapy) and 2053 ± 888 mL (24 h after therapy) (both P < 0.0001). At the end of therapy, patient global assessment improved from 7.7 ± 1.1 to 3.0 ± 1.3 points (P < 0.001), central venous pressure decreased from 15.5 ± 5.3 mmHg to 12.8 ± 4.8 mmHg (P < 0.05) and the median urine sodium loss was 9.7 [3-13] mmol/h. The Reprieve therapy was safe, systolic blood pressure remained stable, mean creatinine dropped from 1.45 ± 0.4 mg/dL to 1.26 ± 0.4 mg/dL (P < 0.001) and biomarkers of renal injury did not change during treatment. CONCLUSIONS The Reprieve System in conjunction with diuretic therapy supports safe and controlled decongestion in AHF.
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Affiliation(s)
- Jan Biegus
- Department of Heart Diseases, Medical University, Wroclaw, Poland.,Centre for Heart Diseases, Military Hospital, Wroclaw, Poland
| | - Robert Zymlinski
- Department of Heart Diseases, Medical University, Wroclaw, Poland.,Centre for Heart Diseases, Military Hospital, Wroclaw, Poland
| | - Pawel Siwolowski
- Department of Heart Diseases, Medical University, Wroclaw, Poland.,Centre for Heart Diseases, Military Hospital, Wroclaw, Poland
| | | | | | - Agnieszka Tycińska
- Department of Cardiology, Medical University of Bialystok, Bialystok, Poland
| | | | | | | | - Piotr Ponikowski
- Department of Heart Diseases, Medical University, Wroclaw, Poland.,Centre for Heart Diseases, Military Hospital, Wroclaw, Poland
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Aubry P, Demian H. [Management of renal failure in old patients undergoing percutaneous cardiac interventions]. Ann Cardiol Angeiol (Paris) 2018; 67:466-473. [PMID: 30384963 DOI: 10.1016/j.ancard.2018.10.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The elderly benefit from the advances of the interventional cardiology, especially for coronary artery disease and aortic valve stenosis. The prevalence of comorbidities is high in old population, but the benefit-risk balance remains often positive. Chronic kidney disease is frequent and amplifies the risks of contrast-induced nephropathy and acute kidney injury with an impact on clinical course and outcomes, and additional costs. Preventive strategies recognized as efficient to limit renal adverse events must be applied. Future approach may involve research in vulnerable old patients undergoing cardiac interventions.
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Affiliation(s)
- P Aubry
- Département de cardiologie, groupe hospitalier Bichat-Claude-Bernard, Assistance publique des hôpitaux de Paris, 46, rue Henri-Huchard, 75018 Paris, France; Service de cardiologie, centre hospitalier de Gonesse, 95500 Gonesse, France.
| | - H Demian
- Service de cardiologie, centre hospitalier de Gonesse, 95500 Gonesse, France
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11
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Rao G, Sheth S, Grines C. Percutaneous coronary intervention: 2017 in review. J Interv Cardiol 2018; 31:117-128. [DOI: 10.1111/joic.12508] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Accepted: 03/08/2018] [Indexed: 01/09/2023] Open
Affiliation(s)
- Gaurav Rao
- Department of Cardiology; Northwell Health, Donald and Barbara Zucker School of Medicine at Hofstra Northwell; North Shore University Hospital; Manhasset New York
| | - Shikha Sheth
- Department of Cardiology; Northwell Health, Donald and Barbara Zucker School of Medicine at Hofstra Northwell; North Shore University Hospital; Manhasset New York
| | - Cindy Grines
- Department of Cardiology; Northwell Health, Donald and Barbara Zucker School of Medicine at Hofstra Northwell; North Shore University Hospital; Manhasset New York
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12
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Prevention of Contrast and Radiation Injury During Coronary Angiography and Percutaneous Coronary Intervention. CURRENT TREATMENT OPTIONS IN CARDIOVASCULAR MEDICINE 2018; 20:32. [DOI: 10.1007/s11936-018-0621-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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13
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Briguori C, Labalestra N, Condorelli G. Editorial: Contrast-induced acute kidney injury. J Interv Cardiol 2017; 30:488-490. [PMID: 28971538 DOI: 10.1111/joic.12424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2017] [Revised: 07/18/2017] [Accepted: 07/19/2017] [Indexed: 11/30/2022] Open
Affiliation(s)
- Carlo Briguori
- Clinica Mediterranea, Interventional Cardiology Unit, Naples, Italy
| | | | - Gerolama Condorelli
- Department of Molecular Medicine and Medical Biotechnology, "Federico II" University, Naples, Italy
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