The link between cardiovascular & renal disease in chronic critical illness (CCI):

In our review for @MDPIOpenAccess, we define the epidemiology of cardiovascular & renal disease in CCI, summarize pathophysiology, and describe targeted therapies.

https://www.mdpi.com/2077-0383/10/8/1601/htm

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We found that kidney disease independently and substantially increases risk for adverse cardiovascular outcomes, and that cardiovascular disease increases risk for renal disease.

The pathophysiologic mechanisms driving these clinical manifestations are complex.

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Our findings suggest that smoking cessation, physical activity, and dietary modifications are effective, cost-neutral methods for improving clinical outcomes among CCI patients, especially those with chronic kidney disease (CKD).

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Pharmacologic interventions for CCI patients should be targeted to specific cardiovascular and renal disease states.

The pharmacologic treatment options that target blood pressure control have had consistent, positive results in clinical trials.

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Procedural interventions for CCI: Cardiac re-synchronization & renal replacement therapy are beneficial for select patient populations.

In general, behavioral/lifestyle modifications and pharmacologic interventions should be optimized before using procedural interventions.
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Patients who develop acute kidney injury (AKI) during hospital admission face greater risks of renal disease and death.

We propose a model for specialized follow-up care for AKI survivors, focusing on preservation of renal function and preventing further episodes of AKI.

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Given the complex nature of cardiovascular & renal disease in CCI, we need further research to develop targeted therapies.

Authors: @_TylerLoftus, @FilibertoAmanda, @TBaslanti, Saraswathi Gopal, & @AzraBihorac.

Thanks @NIGMS @ncats_nih_gov @NIH for supporting the research!