Cardiac Ultrasound for the Nephrologist: Know Thy Heart to Know Thy Kidneys

Goyal, Pankaj; Minardi, Joseph; Sakhuja, Ankit

doi:10.1053/j.ackd.2021.04.001

Cited by 2 publications

(4 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Many CKD-related PE cases initially show no symptoms, even with significant effusion, posing a challenge for early diagnosis [ 31 , 32 ]. Our findings corroborate this, showing that a majority of PE patients did not report chest or epigastric discomfort.…”

Section: Discussionmentioning

confidence: 99%

Pericardial effusion in patients with chronic kidney disease: A two-center study

Eslami,

Mousavi,

Irilouzadian

et al. 2024

PLoS ONE

View full text Add to dashboard Cite

Background and aims Pericardial effusion (PE) is a prevalent form of pericardial involvement in chronic kidney disease (CKD). This study aims to investigate the clinical and laboratory features associated with PE severity in patients with CKD. Methods In this cross-sectional study, we examined the medical records of patients admitted to tertiary hospitals with International Classification of Diseases 10th Revision (ICD-10) codes associated with CKD and PE. We included 112 CKD patients in stage 4 and 5 non-dialysis (ND) with PE for assessing the clinical and laboratory features of severity. Results Patients were divided into two categories based on the severity of PE. Seventy-two patients had mild and 40 had moderate and severe PE. Univariate analysis of demographic and laboratory features on the date of admission demonstrated that chest pain, dyspnea, serum albumin, and neutrophil-to-lymphocyte ratio (NLR) are associated with the severity of PE. The univariate analysis on the date of echocardiography showed significantly higher white blood cell count (WBC), neutrophil count (percentage and absolute count), and NLR, along with significantly lower lymphocyte percentage and serum albumin among patients with moderate and severe PE. In the multivariable analysis of laboratory features, on admission hypoalbuminemia (p-value = 0.014, OR = 4.03, CI: 1.32–12.25) and NLR greater than 5.5 (p-value = 0.015, OR = 4.22, CI: 1.32–13.50) were significantly associated with moderate and severe PE. In a parallel matter, at the time of echocardiography hypoalbuminemia (p-value = 0.004, OR = 5.38, CI: 1.74–16.65) and neutrophilia (p-value = 0.005, OR = 7.94, CI: 1.89–33.44) were significantly associated with moderate and severe PE. Conclusion Despite advancements in the diagnosis and treatment of CKD, PE is still a concerning issue in these patients. This study revealed that hypoalbuminemia, neutrophilia, and NLR greater than 5.5 could be predictive factors of moderate and severe PE in CKD patients with PE. Further prospective study with larger sample size is needed to confirm these results.

show abstract

Section: Discussionmentioning

confidence: 99%

Pericardial effusion in patients with chronic kidney disease: A two-center study

Eslami,

Mousavi,

Irilouzadian

et al. 2024

PLoS ONE

View full text Add to dashboard Cite

show abstract

“…Focused Cardiac Ultrasound (FoCUS) or echocardioscopy performed by the non-cardiologist clinician is an increasingly widespread strategy in nephrology [ 53 ]. The use of echocardiography increases the sensitivity and specificity of auscultation and allows cardiac pathology to be ruled out [ 54 ].…”

Section: Pocus: An Answer In Congestion Assessmentmentioning

confidence: 99%

“…Although the subcostal window is the most appropriate window to assess pericardial effusion, large effusions can also be seen in the posterior region of the LV in PLAX and PSAX planes [ 53 ]. To rule out cardiac tamponade, one of the easiest and most sensitive signs is the distention of the IVC due to altered filling pressures (right atrial collapse in systole and RV collapse in diastole) secondary to extrinsic compression of the heart easily assessed by FoCUS [ 53 , 55 , 61 ].…”

Section: Pocus: An Answer In Congestion Assessmentmentioning

confidence: 99%

“…FoCUS allows adequate assessment of RV morphology and function allowing patients with RV dysfunction who are not candidates for peritoneal dialysis to avoid the creation of proximal AVFs and to decide the best vascular access [ 53 , 60 ]. Furthermore, assessing the AVF flux by PoCUS helps to determine whether blood flow AVF exceeds the cardiac ability to maintain a functional New York Heart Association pattern and can select those patients as candidates for banding or even more, ligation of the AVF.…”

Section: More Pocus Resourcesmentioning

confidence: 99%

See 1 more Smart Citation

PoCUS in nephrology: a new tool to improve our diagnostic skills

Romero‐González

Manrique

Slon-Roblero

et al. 2022

Clinical Kidney Journal

View full text Add to dashboard Cite

Point-of-Care Ultrasonography (PoCUS) aims to include a fifth pillar (insonation) in the classical physical examination in order to obtain images to answer specific questions by the clinician at the patient's bedside, PoCUS allowing rapid identification of structural or functional abnormalities, enabling more accurate volume assessment, supporting diagnosis, as well as guiding procedures. In recent years, PoCUS is becoming a valuable tool in day-to-day clinical practice, adopted by health care professionals from various medical specialties, never replacing physical examination but improving patient and medical care and experience. Renal patients represent a wide range of diseases, which gives PoCUS a special role to work with as a valuable tool in different scenarios, not only for volume-related information but also for the assessment of a wide range of acute and chronic conditions, enhancing the sensitivity of conventional physical examination in nephrology. PoCUS in the hands of a nephrologist is a precision medicine tool.

show abstract

Cardiac Ultrasound for the Nephrologist: Know Thy Heart to Know Thy Kidneys

Cited by 2 publications

References 41 publications

Pericardial effusion in patients with chronic kidney disease: A two-center study

Pericardial effusion in patients with chronic kidney disease: A two-center study

PoCUS in nephrology: a new tool to improve our diagnostic skills

Contact Info

Product

Resources

About