Review
Physiology
Diana Rodriguez-Espinosa, Joan Guzman-Bofarull, Juan Carlos de la Fuente-Mancera, Francisco Maduell, Jose Jesus Broseta, Marta Farrero
Summary: This paper reviews the common occurrence of refractory congestion in acute and chronic heart failure and its significant impact on functional class, renal function, hospital admissions, and survival. It proposes an integrated multimodal diagnostic algorithm and discusses various treatment strategies and alternative approaches.
FRONTIERS IN PHYSIOLOGY
(2022)
Review
Cardiac & Cardiovascular Systems
Ilana Forado-Benatar, Pedro Caravaca-Perez, Diana Rodriguez-Espinosa, Joan Guzman-Bofarull, Elena Cuadrado-Payan, Yasbanoo Moayedi, Jose Jesus Broseta, Marta Farrero
Summary: There is a growing interest in the evaluation of tricuspid regurgitation due to its increasing prevalence and detrimental impact. The development of percutaneous treatment techniques has provided new opportunities for management. However, a comprehensive exploration of the pathophysiological mechanisms is essential to establish clear indications and optimal timing for medical and percutaneous intervention.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2023)
Article
Cardiac & Cardiovascular Systems
Nhat Giang Minh, Hai Nguyen Hoang, Daichi Maeda, Yuya Matsue
Summary: This study aims to demonstrate the effectiveness of early tolvaptan add-on therapy in patients with acute heart failure and renal dysfunction, and to provide clinical evidence of loop diuretic resistance.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2022)
Review
Urology & Nephrology
Zachary L. Cox, Veena S. Rao, Jeffrey M. Testani
Summary: Despite incomplete understanding of the causes and mechanisms of cardiorenal syndrome, renal sodium retention plays a significant role in driving congestive heart failure and determining the response to diuretic therapy. Recent studies have challenged classical diuretic resistance mechanisms and proposed new categorizations for therapeutic strategies in cardiorenal syndrome.
Review
Biochemistry & Molecular Biology
John A. D'Elia, George P. Bayliss, Larry A. Weinrauch
Summary: Cardiorenal syndrome, the end-stage of heart failure and kidney disease combination, is a serious condition that is influenced by factors such as diabetes, hyperlipidemia, obesity, hypertension, and renal impairment. Current therapy focuses on improving hemodynamic factors destructive to both the heart and kidney, but there have been limited advances in this area.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2022)
Review
Cardiac & Cardiovascular Systems
Patrick Kennelly, Rajju Sapkota, Maimoona Azhar, Faisal Habib Cheema, Claire Conway, Aamir Hameed
Summary: Diuretics play a significant role in managing congestive heart failure by relieving congestive symptoms, but their appropriate use is challenging due to complications such as electrolyte abnormalities, worsening renal function, and diuretic resistance. Therefore, finding safer and more effective alternatives is necessary for successful management of fluid overload in heart failure patients.
Article
Cardiac & Cardiovascular Systems
Watanyu Parapiboon, Tanit Kingjun, Laddaporn Wongluechai, Waraporn Leawnoraset
Summary: The study demonstrated that peritoneal dialysis is a viable option for critically ill patients with cardiorenal syndrome type 1, especially in resource-limited settings, saving up to 27% of lives among these patients.
CARDIORENAL MEDICINE
(2021)
Article
Pharmacology & Pharmacy
Cankun Zheng, Wanling Xuan, Zhenhuan Chen, Rui Zhang, Xiaoxia Huang, Yingqi Zhu, Siyuan Ma, Kaitong Chen, Lu Chen, Mingyuan He, Hairuo Lin, Wangjun Liao, Jianping Bin, Yulin Liao
Summary: Diabetes-induced cardiorenal dysfunction has a poor prognosis and its pathogenesis is not fully understood. This study reveals that CX3CL1 protein levels are increased in the heart and kidneys of diabetic mice, and hyperglycemia leads to persistent expression of CX3CL1 even after insulin control. Inhibition of CX3CL1 or its receptor CX3CR1 improves cardiorenal dysfunction in diabetic mice. Additionally, treatment with a sodium glucose cotransporter 2 inhibitor reduces CX3CL1 expression and improves cardiorenal dysfunction.
FRONTIERS IN PHARMACOLOGY
(2022)
Review
Medicine, General & Internal
Giovanni Goffredo, Roberta Barone, Vito Di Terlizzi, Michele Correale, Natale Daniele Brunetti, Massimo Iacoviello
Summary: Cardiorenal syndrome is a clinical manifestation of the bidirectional interaction between heart and kidney diseases. Multiple biomarkers have been studied over recent years to better assess renal function and identify patients at risk of chronic or acute worsening of kidney function. This review aims to discuss the potential clinical utility of the latest biomarkers in the context of cardiorenal syndrome.
JOURNAL OF CLINICAL MEDICINE
(2021)
Article
Critical Care Medicine
Zaccaria Ricci, Stefano Romagnoli, Claudio Ronco
Summary: Cardiorenal syndrome is common in patients with initial severe forms of heart or kidney failure, with a tight bidirectional link between these two organs. Critically ill patients may develop cardiorenal syndrome in the context of multiple organ failure, and prolonged artificial organ support in end-stage failure can lead to a novel form of the syndrome. Pediatric cardiorenal syndrome is typical after cardiac surgery, but a new classification reveals its frequent occurrence in frail patients.
CRITICAL CARE CLINICS
(2021)
Review
Biochemistry & Molecular Biology
Piotr Lagosz, Jan Biegus, Szymon Urban, Robert Zymlinski
Summary: Cardiorenal syndrome (CRS) is a complex and heterogeneous spectrum of symptoms that has posed challenges for cardiologists for many years. The coexistence of heart failure (HF) and deteriorated renal function adds to these challenges and is a strong predictor of poor outcomes. However, with the development of new renal assessment methods, we now have the opportunity to treat CRS more effectively than ever before. This review focuses on explaining the pathophysiology, recent advances, and current practices of monitoring renal function in patients with acute CRS, aiming to improve patient care and guide treatment strategies.
Article
Biochemistry & Molecular Biology
Guido Gembillo, Luca Visconti, Maria Ausilia Giusti, Rossella Siligato, Alessia Gallo, Domenico Santoro, Alessandro Mattina
Summary: Cardiorenal syndrome is a multi-organ disease involving complex interactions between the heart and kidney, with the use of specific biomarkers aiding in diagnosis, risk assessment, and prognosis determination.
Review
Cardiac & Cardiovascular Systems
Sung Yoon Lim, Sejoong Kim
Summary: Heart and kidney dysfunction can affect other organs, with venous congestion playing a key role in renal and cardiac diseases. Decongestive therapy can alleviate symptoms in CRS patients, but its impact on kidney function and mortality is still uncertain, highlighting the need for accurate assessment of volume status. Future objective measures of renal venous congestion may help guide therapeutic decisions.
KOREAN CIRCULATION JOURNAL
(2021)
Article
Urology & Nephrology
Wendy McCallum, Mark J. Sarnak
Summary: The cardiorenal syndrome involves dysfunction in both the heart and kidney and is characterized by mechanisms such as venous congestion, arterial underfilling, neurohormonal activation, inflammation, and endothelial dysfunction. It is important to rule out intrinsic kidney disease and confirm the diagnosis of the cardiorenal syndrome through medical history, kidney function tests, and imaging. Treatment strategies involve diuretics with varying pharmacological targets, invasive methods of decongestion, and strategies for increasing forward perfusion.
CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY
(2023)
Editorial Material
Biochemistry & Molecular Biology
Luca Sgarabotto, Verdiana Ravarotto, Lucia Federica Stefanelli, Martina Cacciapuoti, Paul A. Davis, Federico Nalesso, Lorenzo A. Calo
Summary: Two genetic tubulopathies, Bartter's (BS) and Gitelman's (GS) syndromes, exhibit activation of the angiotensin system (RAS) despite normo/hypotension and absent cardiac remodeling. Investigating BSGS patients reveals that BSGS is the opposite of hypertension. This understanding allows BSGS to be used as a human model to study RAS system pathways and oxidative stress in cardiovascular and renal remodeling and pathophysiology.
Letter
Rheumatology
Maria De Santis, Antonio Voza, Victor Savevski, Salvatore Badalamenti, Maurizio Cecconi, Alberto Mantovani, Carlo Selmi
ANNALS OF THE RHEUMATIC DISEASES
(2023)
Review
Transplantation
Manuel Alfredo Podesta, David Cucchiari, Paola Ciceri, Piergiorgio Messa, Jose-Vicente Torregrosa, Mario Cozzolino
Summary: Vascular and valvular calcifications are common in kidney transplant recipients and associated with increased risk of cardiovascular events. Despite resolution of uremia-related metabolic derangements, recipients are still exposed to pro-calcifying stimuli, highlighting the need for strategies to correct or minimize their effects.
NEPHROLOGY DIALYSIS TRANSPLANTATION
(2022)
Meeting Abstract
Cardiac & Cardiovascular Systems
F. Pugno Vanoni, M. Biroli, F. Cannata, B. Pagliaro, M. Pellegrino, A. Villaschi, G. Gasparini, L. Ardino, E. Vrinceanu, F. Loiacono, D. Pini
EUROPEAN HEART JOURNAL SUPPLEMENTS
(2022)
Meeting Abstract
Cardiac & Cardiovascular Systems
M. Pellegrino, G. Gasparini, D. Ghianda, A. Villaschi, A. Oliva, F. Loiacono, B. Pagliaro, N. Natali Testona, M. Atuncar, D. Pini
EUROPEAN HEART JOURNAL SUPPLEMENTS
(2022)
Article
Cardiac & Cardiovascular Systems
Matteo Pagnesi, Carlo Mario Lombardi, Mauro Chiarito, Davide Stolfo, Luca Baldetti, Ferdinando Loiacono, Chiara Tedino, Luca Arrigoni, Daniele Ghiraldin, Daniela Tomasoni, Riccardo Maria Inciardi, Marta Maccallini, Alessandro Villaschi, Gaia Gasparini, Marco Montella, Stefano Contessi, Daniele Cocianni, Maria Perotto, Giuseppe Barone, Marco Merlo, Alberto Maria Cappelletti, Gianfranco Sinagra, Daniela Pini, Marco Metra
Summary: The study evaluated the prognostic impact of the advanced heart failure definition proposed by the Heart Failure Association of the European Society of Cardiology in patients with heart failure, showing that patients meeting this definition had a higher rate of the primary endpoint at 1 year.
EUROPEAN JOURNAL OF HEART FAILURE
(2022)
Article
Biochemistry & Molecular Biology
Maria Lisa Garavaglia, Daniela Giustarini, Graziano Colombo, Francesco Reggiani, Silvia Finazzi, Marta Calatroni, Lucia Landoni, Nicola Marcello Portinaro, Aldo Milzani, Salvatore Badalamenti, Ranieri Rossi, Isabella Dalle-Donne
Summary: This review explores the relationship between abnormal levels of thiols and chronic kidney disease, and introduces the potential of thiols, S-thiolated proteins, and the protein thiolation index as biomarkers of oxidative stress. This minimally invasive analysis provides valuable information on the redox status of less-easily accessible tissues and organs, as well as the whole organism.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2022)
Review
Cardiac & Cardiovascular Systems
Pier Pasquale Leone, Mauro Chiarito, Damiano Regazzoli, Marta Pellegrino, Lorenzo Monti, Beniamino Pagliaro, Ferdinando Loiacono, Giulio Stefanini, Daniela Pini, Bernhard Reimers, Antonio Colombo, Azeem Latib, Antonio Mangieri
Summary: Tricuspid regurgitation (TR) is prevalent in the overall population and its impact on patient outcomes is negative, even when the severity is mild. Recent advances in diagnosis and risk stratification have provided new treatment options for patients who might benefit from intervention.
REVIEWS IN CARDIOVASCULAR MEDICINE
(2022)
Article
Immunology
Elena Azzolini, Lorenzo Maria Canziani, Antonio Voza, Antonio Desai, Jack Pepys, Maria De Santis, Angela Ceribelli, Chiara Pozzi, Massimo Turato, Salvatore Badalamenti, Luca Germagnoli, Alberto Mantovani, Maria Rescigno, Carlo Selmi
Summary: Adverse events following BNT162b2 vaccination are common and may be associated with IgG response. Female sex, younger age, receiving the second dose of the vaccine, and previous COVID-19 infection are independently associated with adverse events. Subjects with adverse events demonstrate a significantly higher IgG response, particularly those experiencing myalgia, fever, and lymphadenopathy.
Article
Immunology
Emanuele Nappi, Maria De Santis, Giovanni Paoletti, Corrado Pelaia, Fabrizia Terenghi, Daniela Pini, Michele Ciccarelli, Carlo Francesco Selmi, Francesca Puggioni, Giorgio Walter Canonica, Enrico Heffler
Summary: Anti-SARS-CoV-2 vaccines are safe and effective, but there are reports suggesting that they may trigger or exacerbate immune-mediated diseases in predisposed individuals. We describe a case of a 63-year-old man who experienced symptoms of eosinophilic granulomatosis with polyangiitis (EGPA) after receiving the booster dose of the mRNA-1273 vaccine. The patient also had worsening asthma after previous vaccine shots. Our report suggests caution in administering additional vaccine doses to individuals who experienced an increase in disease severity following previous shots.
Article
Rheumatology
Manuel Alfredo Podesta, Federica Mescia, Anna Ricchiuto, Rona Smith, Martina Tedesco, Matthias Arnaldo Cassia, Julia Holle, Renato Alberto Sinico, Annette Bruchfeld, Iva Gunnarsson, Sophie Ohlsson, Bo Baslund, Zdenka Hruskova, Vladimir Tesar, Gianmarco Sabiu, Maurizio Gallieni, Maria C. Cid, Augusto Vaglio, Lorraine Harper, Mario Cozzolino, Francesco Scolari, David Jayne, Federico Alberici
Summary: This study aims to assess factors associated with hypogammaglobulinemia in AAV patients treated with rituximab, and the results showed that hypogammaglobulinemia is common in AAV patients treated with rituximab, and lower IgG levels are associated with severe infections. Age and higher glucocorticoid doses increase the risk of hypogammaglobulinemia in these patients.
Article
Immunology
Hengcheng Zhang, Cecilia B. Cavazzoni, Benjamin L. Hanson, Elsa D. Bechu, Manuel A. Podesta, Jamil Azzi, Bruce R. Blazar, Anita S. Chong, Daniel Kreisel, Alessandro Alessandrini, Peter T. Sage
Summary: After allogeneic kidney transplantation, the formation of donor-specific antibodies and antibody-mediated rejection contribute to graft loss. B cells infiltrate into kidney grafts during this rejection process, however, their origins, repertoires, and functions are still unknown.
Review
Biochemistry & Molecular Biology
Manuel Alfredo Podesta, Gianmarco Sabiu, Andrea Galassi, Paola Ciceri, Mario Cozzolino
Summary: Results from recent trials have shown that SGLT2 inhibitors have brought a paradigm shift in the treatment of type 2 diabetes mellitus. These drugs not only improve metabolic control, but also independently protect patients from cardiovascular events and slow the progression of chronic kidney disease (CKD). The observed nephroprotective effect of SGLT2 inhibitors may make them the most impactful drug class for diabetic patients with CKD. Furthermore, these inhibitors have also been shown to slow CKD progression in non-diabetic individuals with proteinuria, suggesting a broader involvement of SGLT2 in the pathogenesis of CKD.
Article
Urology & Nephrology
Sofia Bin, Kelly Budge, Micaela Gentile, Manuel Alfredo Podesta, Yaseen Khan, Jamil R. Azzi, Luis Sanchez Russo, Gaetano La Manna, Paolo Cravedi
Summary: Genetically induced decay-accelerating factor (DAF) overexpression prevents adriamycin (ADR)-induced focal segmental glomerulosclerosis (FSGS) in mice. Pharmacologic inhibition of DAF cleavage reduces complement activation in the glomeruli and albuminuria in murine ADR-induced FSGS. Inhibition of complement activation represents a valuable therapeutic strategy for FSGS and, potentially, other glomerular diseases.
Article
Biochemistry & Molecular Biology
Federica Casiraghi, Marta Todeschini, Manuel Alfredo Podesta, Marilena Mister, Barbara Ruggiero, Matias Trillini, Camillo Carrara, Olimpia Diadei, Alessandro Villa, Ariela Benigni, Giuseppe Remuzzi
Summary: Immune dysregulation plays a key role in the pathogenesis of steroid-dependent/frequently relapsing nephrotic syndrome (SDNS/FRNS). However, no major B- or T-cell alterations have been described for adults, unlike in pediatric cases. This study found that patients with SDNS/FRNS have expansion of memory B cells and reduced memory Tregs. The levels of CD45RO(+) Tregs at baseline may help predict which patients will achieve sustained remission following rituximab infusion.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2023)
Meeting Abstract
Surgery
H. Zhang, C. Cavazzoni, E. Bechu, B. Hanson, M. A. Podesta, D. Kreisel, A. Alessandrini, P. Sage
AMERICAN JOURNAL OF TRANSPLANTATION
(2022)