scholarly journals Management of Acute Admissions of Heart Failure Patients with Kidney Disease

2019 ◽  
Vol 18 (2) ◽  
pp. 96-104
Author(s):  
Joey Junarta ◽  
◽  
Anita Banerjee ◽  
Racquel Lowe-Jones ◽  
Debasish Banerjee ◽  
...  
Keyword(s):  
Heart Failure ◽  
Kidney Disease ◽  
Length Of Stay ◽  
Diuretic Therapy ◽  
High Dose ◽  
Chronic Renal Impairment ◽  
Assessment Unit ◽  
Poor Outcomes ◽  
Acute Admissions

Acute heart failure (HF) admissions are common. They are often associated with prolonged hospitalisations and poor outcomes. One-third of chronic HF patients also suffer from chronic kidney disease (CKD). Hence, acute admissions of HF with CKD are common and are associated with longer length of stay and increased mortality. Hyperkalaemia and acute on chronic renal impairment are important challenges in the management of these cases. Cautious introduction of high-dose diuretic therapy, followed by the re-commencement of renin-angiotensin-aldosterone (RAAS) inhibitors, improves length of stay, quality of life, and prognosis. During an admission on to the medical assessment unit careful monitoring and management of the patient’s clinical condition and biochemistry is essential.

scholarly journals Effect of Short Call Admission on Length of Stay and Quality of Care for Acute Decompensated Heart Failure

Circulation ◽  
2008 ◽  
Vol 117 (20) ◽  
pp. 2637-2644 ◽  
Author(s):  
Jennifer L. Schuberth ◽  
Tom A. Elasy ◽  
Javed Butler ◽  
Robert Greevy ◽  
Theodore Speroff ◽  
...  
Keyword(s):  
Heart Failure ◽  
Quality Of Care ◽  
Length Of Stay ◽  
Acute Decompensated Heart Failure ◽  
Decompensated Heart Failure ◽  
Call Admission ◽  
Short Call

What impact do specialist and advanced-level nurses have on people living with heart failure compared to physician-led care? A literature review

2020 ◽  
pp. 174498712094679
Author(s):  
Dean A Anderson ◽  
Victoria Clemett
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Length Of Stay ◽  
Literature Review ◽  
Hospital Admissions ◽  
Self Care ◽  
Self Assessment ◽  
Advanced Level ◽  
The Impact

Background The inclusion of specialist nurses in multi-disciplinary teams is the current gold standard for care of people with heart failure (HF) in the UK; however, they remain underutilised in practice. Though existing systematic reviews favourably compare advanced nursing roles to physician-led care, none has focused solely on HF. Aim To investigate the impact of specialist and advanced nurse-led care on the clinical outcomes, quality of life and satisfaction of people with HF compared to physician-led care. Methods Literature review and narrative synthesis. Results This review included 12 studies and categorised their measured outcomes into five domains: mortality; hospital admissions and length of stay; HF diagnosis and management; quality of life and patient satisfaction; and finally, self-assessment and self-care. Five studies appraised as medium or low risk of bias suggest the impact of specialist and advanced-level nurses on people with HF to be broadly equivalent to physicians regarding mortality, hospital admissions and length of stay, while superior in terms of self-assessment and self-care behaviours. Conclusions There were too few studies of sufficient methodological quality to draw definitive conclusions. However, no evidence was found to suggest that nurse-led services are any less effective or safe than physician-led services.

scholarly journals Helping people to live well with chronic kidney disease

2020 ◽  
Vol 81 (6) ◽  
pp. 1-10 ◽  
Author(s):  
Simon Fraser ◽  
Maarten Taal
Keyword(s):  
Quality Of Life ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Treatment Burden ◽  
Pharmacological Interventions ◽  
Increased Risk ◽  
Future Risk ◽  
Poor Outcomes

Reduced glomerular filtration rate and presence of albuminuria are both associated with increased risk of several poor outcomes. People with chronic kidney disease also commonly suffer from lower quality of life than their age-matched peers. The experiences reported by patients with chronic kidney disease include being shocked by the diagnosis, being uncertain about the cause and worrying about progression and future treatment. Issues such as depression, pain and fatigue are common in people with chronic kidney disease. Helping people to live well with a long-term condition like chronic kidney disease should include efforts to reduce the risk of adverse events occurring in the future, and consider what can be done to enhance quality of life now. Clinicians can help by being aware of the patient perspective, communicating clearly and recommending interventions that reduce future risk as well as recognising and treating symptoms. Assessing overall treatment burden is an important component of management and non-pharmacological interventions that may improve mobility, strength and pain should be considered.

scholarly journals Response to Letter Regarding Article, “Effect of Short Call Admissions on Length of Stay and Quality of Care for Acute Decompensated Heart Failure”

Circulation ◽  
2009 ◽  
Vol 119 (1) ◽  
Author(s):  
Christianne L. Roumie ◽  
Robert Greevy ◽  
Jennifer L. Schuberth ◽  
Tom A. Elasy ◽  
Theodore Speroff ◽  
...  
Keyword(s):  
Heart Failure ◽  
Quality Of Care ◽  
Length Of Stay ◽  
Acute Decompensated Heart Failure ◽  
Decompensated Heart Failure ◽  
Short Call

scholarly journals Kidney disease and hemodialysis: identification of blood biomarkers to detect heart failure and kidney failure

2020 ◽  
Vol 7 (2) ◽  
Author(s):  
Barbara Mayer ◽  
Pollyana Thays Lameira da Costa ◽  
Maria Elena Echevarría-Guanilo ◽  
Silvana Silveira Kempfer ◽  
Kleber Maciel Da Silva Pieri
Keyword(s):  
Heart Failure ◽  
Kidney Disease ◽  
Kidney Failure ◽  
Clinical Management ◽  
Web Of Science ◽  
Blood Biomarkers ◽  
Qualitative Synthesis ◽  
Risk Of Mortality ◽  
Final Sample

Objectives: to identify valid blood biomarkers to detect heart failure and kidney failure associated with kidney disease and hemodialysis. Methods: systematic literature review conducted in August 2018 in the following: Web Of Science, PubMed, Scopus, Cinahal, Cochrane, Science Direct and Lilacs. The guiding question was: “What are the blood biomarkers used to detect heart failure and kidney failure?” A total of 537 publications were found, 94 of these appeared more than once, 383 were excluded after reading titles and abstracts, 32 were excluded after reading the full texts, and 10 were excluded in the quantitative and qualitative synthesis.   Results: 18 papers compose the final sample and report laboratory and imaging tests, instruments to assess the risk of kidney and heart failure, and also clinical management of the progression of kidney and heart failure. All the studies correlated risk of mortality and mortality. Conclusion: laboratory tests are important to identifying kidney and heart failure and need to be used to improve clinical management of the hemodialysis treatment of people with chronic kidney disease in order to improve quality of life and life expectancy.

scholarly journals Chronic Hyperkalemia in Cardiorenal Patients: Risk Factors, Diagnosis, and New Treatment Options

2018 ◽  
Vol 9 (1) ◽  
pp. 8-21 ◽  
Author(s):  
Luca Di Lullo ◽  
Claudio Ronco ◽  
Antonio Granata ◽  
Ernesto Paoletti ◽  
Vincenzo Barbera ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Medical Condition ◽  
Treatment Options ◽  
Correct Diagnosis ◽  
New Treatment ◽  
Poor Outcomes ◽  
Careful Management

Chronic hyperkalemia (HK) is a serious medical condition that often manifests in patients with chronic kidney disease (CKD) and heart failure (HF) leading to poor outcomes and necessitating careful management by cardionephrologists. CKD, HF, diabetes, and renin-angiotensin-aldosterone system inhibitors use is known to induce HK. Current therapeutic options are not optimal, as pointed out by a large number of CKD and HF patients with HK. The following review will focus on the main risk factors for developing HK and also aims to provide a guide for a correct diagnosis and present new approaches to therapy.

scholarly journals A Single-Center Retrospective Study on the Initiation of Peritoneal Dialysis in Patients With Cardiorenal Syndrome and Subsequent Hospitalizations

2020 ◽  
Vol 7 ◽  
pp. 205435812097923
Author(s):  
Bourne L. Auguste ◽  
Arnav Agarwal ◽  
Ali Z. Ibrahim ◽  
Michael Y. Girsberger ◽  
Zita Abreu ◽  
...  
Keyword(s):  
Heart Failure ◽  
Peritoneal Dialysis ◽  
Length Of Stay ◽  
American Literature ◽  
Diuretic Therapy ◽  
Cardiorenal Syndrome ◽  
Catheter Insertion ◽  
Health Network ◽  
Number Of Patients ◽  
Before And After

Background: Inotropic dependence and diuretic resistance in patients with cardiorenal syndrome (CRS) lead to frequent hospitalizations and are associated with high mortality. Starting peritoneal dialysis (PD) acutely (within 2 weeks of a heart failure hospitalization) offers effective volume removal without hemodynamic compromise in this population. There is little data on this approach in the North American literature. Objective: To determine whether volume-overloaded patients with CRS on maximal doses of diuretic therapy had reduced hospitalization for heart failure following PD initiation. Design: Retrospective cohort study. Setting: Academic hospital network (University Health Network, Toronto, Ontario). Patients: Patients with CRS receiving a bedside catheter and starting PD within 2 weeks of insertion at the University Health Network from January 1, 2013, to December 31, 2018. Methods and measurements: Data for heart failure–related hospitalizations and length of stay 6 months before and after PD initiation were collected. Patients who died, switched to hemodialysis, or were transferred to another facility within 6 months of starting PD were excluded from the analysis. Results: We identified 31 patients with CRS who had a bedside PD catheter inserted. The average age of patients was 66.0 ± 13.0 years. There were 7 (22.6%) deaths and 4 (12.9%) transfers to other programs or hemodialysis within 6 months of catheter insertion. After exclusion, we analyzed hospitalization and length of stay data for 20 patients. The hospitalization rate 6 months before PD initiation was 6.9 admissions per 1000 patient-days. This decreased to 2.5 admissions per 1000 patient-days after PD initiation. In addition, there was also a significant reduction in the average length of stay per hospitalization (24.1-3.9 days; P = .001). Limitations: Our study did not assess the severity of heart failure symptoms using a standardized functional classification system. We did not assess quality of life and illness intrusiveness scores before and after starting dialysis, nor did we capture non–heart-failure-related hospitalizations or external admissions at other hospital sites. We limited eligibility to clinically stable patients with no prior major abdominal surgical history in a single Canadian PD program using bedside ultrasound approach for catheter insertions by experienced nephrologists and included a small number of patients. Conclusions: Volume-overloaded patients with CRS receiving maximal diuretic therapy have lower hospitalization rates and shorter stays after initiation of PD. The development of a bedside PD catheter insertion program and close collaboration between nephrology and cardiology services may facilitate acute start dialysis in this population.

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