scholarly journals Cardiorenal Syndrome Type 5: Clinical Presentation, Pathophysiology and Management Strategies from the Eleventh Consensus Conference of the Acute Dialysis Quality Initiative (ADQI)

Author(s):  
Ravindra L. Mehta ◽  
Hamid Rabb ◽  
Andrew D. Shaw ◽  
Kai Singbartl ◽  
Claudio Ronco ◽  
...  
2011 ◽  
Vol 2011 ◽  
pp. 1-11 ◽  
Author(s):  
Dinna N. Cruz ◽  
Sean M. Bagshaw

Cardiac and kidney diseases are common, increasingly encountered, and often coexist. Recently, the Acute Dialysis Quality Initiative (ADQI) Working Group convened a consensus conference to develop a classification scheme for the CRS and for five discrete subtypes. These CRS subtypes likely share pathophysiologic mechanisms, however, also have distinguishing clinical features, in terms of precipitating events, risk identification, natural history, and outcomes. Knowledge of the epidemiology of heart-kidney interaction stratified by the proposed CRS subtypes is increasingly important for understanding the overall burden of disease for each CRS subtype, along with associated morbidity, mortality, and health resource utilization. Likewise, an understanding of the epidemiology of CRS is necessary for characterizing whether there exists important knowledge gaps and to aid in the design of clinical studies. This paper will provide a summary of the epidemiology of the cardiorenal syndrome and its subtypes.


2010 ◽  
Vol 21 (4) ◽  
pp. 357-364
Author(s):  
Shawn Merhaut ◽  
Robin J. Trupp

Left ventricular dysfunction and renal dysfunction are common chronic conditions that frequently coexist in the same individual, and both are associated with significant morbidity and mortality. Disorders in 1 organ generally lead to dysfunction in the other, and this bidirectional interaction serves as the pathophysiological basis for cardiorenal syndrome (CRS). Until recently, CRS has been neither well defined nor well understood, making its diagnosis and treatment challenging for clinicians. This article presents the pathophysiology of CRS and the new classification for types of CRS, therapeutic interventions targeting CRS, and novel therapies on the basis of the 2010 Acute Dialysis Quality Initiative consensus conference recommendations.


Critical Care ◽  
2014 ◽  
Vol 18 (Suppl 1) ◽  
pp. P364
Author(s):  
W Vandenberghe ◽  
S Gevaert ◽  
H Peperstraete ◽  
I Herck ◽  
J Decruyenaere ◽  
...  

2005 ◽  
Vol 28 (5) ◽  
pp. 441-444 ◽  
Author(s):  
J.A. Kellum ◽  
R. Bellomo ◽  
C. Ronco ◽  
R. Mehta ◽  
W. Clark ◽  
...  

2005 ◽  
Vol 19 (1) ◽  
pp. 15-35 ◽  
Author(s):  
David Armstrong ◽  
John K Marshall ◽  
Naoki Chiba ◽  
Robert Enns ◽  
Carlo A Fallone ◽  
...  

BACKGROUND: Gastroesophageal reflux disease (GERD) is the most prevalent acid-related disorder in Canada and is associated with significant impairment of health-related quality of life. Since the last Canadian Consensus Conference in 1996, GERD management has evolved substantially.OBJECTIVE: To develop up-to-date evidence-based recommendations relevant to the needs of Canadian health care providers for the management of the esophageal manifestations of GERD.CONSENSUS PROCESS: A multidisciplinary group of 23 voting participants developed recommendation statements using a Delphi approach; after presentation of relevant data at the meeting, the quality of the evidence, strength of recommendation and level of consensus were graded by participants according to accepted principles.OUTCOMES: GERD applies to individuals who reflux gastric contents into the esophagus causing symptoms sufficient to reduce quality of life, injury or both; endoscopy-negative reflux disease applies to individuals who have GERD and a normal endoscopy. Uninvestigated heartburn-dominant dyspepsia -- characterised by heartburn or acid regurgitation - includes erosive esophagitis or endoscopy-negative reflux disease, and may be treated empirically as GERD without further investigation provided there are no alarm features. Lifestyle modifications are ineffective for frequent or severe GERD symptoms; over-the-counter antacids or histamine H2-receptor antagonists are effective for some patients with mild or infrequent GERD symptoms. Proton pump inhibitors are more effective for healing and symptom relief than histamine H2-receptor antagonists; their efficacy is proportional to their ability to reduce intragastric acidity. Response to initial therapy - a once-daily proton pump inhibitor unless symptoms are mild and infrequent (fewer than three times per week) - should be assessed at four to eight weeks. Maintenance medical therapy should be at the lowest dose and frequency necessary to maintain symptom relief; antireflux surgery is an alternative for a small proportion of selected patients. Routine testing for Helicobacter pylori infection is unnecessary before starting GERD therapy. GERD is associated with Barrett's epithelium and esophageal adenocarcinoma but the risk of malignancy is very low. Endoscopic screening for Barrett's epithelium may be considered in adults with GERD symptoms for more than 10 years; Barrett's epithelium and low-grade dysplasia generally warrant surveillance; endoscopic or surgical management should be considered for confirmed high-grade dysplasia or malignancy.CONCLUSION: Prospective studies are needed to investigate clinically relevant risk factors for the development of GERD and its complications; GERD progression, on and off therapy; optimal management strategies for typical GERD symptoms in primary care patients; and optimal management strategies for atypical GERD symptoms, Barrett's epithelium and esophageal adenocarcinoma.


Data in Brief ◽  
2018 ◽  
Vol 21 ◽  
pp. 1430-1434
Author(s):  
Giorgio Vescovo ◽  
Chiara Castellani ◽  
Marny Fedrigo ◽  
Grazia Maria Virzì ◽  
Giovanni Maria Vescovo ◽  
...  

Sign in / Sign up

Export Citation Format

Share Document