Congestive Nephropathy

D’Marco, Luis

doi:10.3390/ijerph19052499

Cited by 5 publications

(3 citation statements)

References 27 publications

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“…As the kidney receives 20% of the cardiac output, it is vulnerable to global hypoperfusion, and circulatory shock is one potential factor responsible for renal injury (2, 32). Furthermore, general anesthesia, fluid therapy, surgical trauma, blood loss, and repositioning of the stomach leads to congestive nephropathy, IRI, damage induced by pro-inflammatory cytokines, and oxidative stress in dogs with GDV (1,3,33). Renal ischemic injury causes damage to the glomerulus, renal tubular cells, and renal vasculature (32).…”

Section: Discussionmentioning

confidence: 99%

Concentrations and kinetics of renal biomarkers in dogs with gastric dilatation-volvulus with and without 24-h intravenous lidocaine

et al. 2023

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BackgroundGastric dilatation volvulus (GDV) can lead to organ failure including acute kidney injury (AKI). Due to its cytoprotective, antioxidant and anti-inflammatory effects, lidocaine has a potential to prevent AKI in dogs with GDV.Design and settingProspective, observational cohort study in client-owned dogs with GDV.ObjectiveTo determine concentrations of renal biomarkers for AKI in dogs with GDV with and without intravenous (IV) lidocaine therapy.MethodsThirty-two dogs were randomized to receive either IV lidocaine (2 mg/kg, followed by a lidocaine constant rate infusion at a dose of 50 μg/kg/min over 24 h; n = 17) or no lidocaine (n = 15). Blood and urine samples were taken at admission (T0) (only blood), during or immediately after surgery (T1), and 24 (T24) and 48 (T48) h after surgery. Plasma creatinine (pCr), plasma neutrophil gelatinase-associated lipocalin (pNGAL), urinary NGAL (uNGAL), uNGAL to creatinine ratio (UNCR), and urinary gamma-glutamyl transferase to creatinine ratio (uGGT/uCr) were evaluated. Biomarker concentrations were compared between dogs with and without IV lidocaine and the course of each marker was determined in comparison to its admission value.ResultsIn the entire population, a significantly higher pCr at T0 (median, 95 μmol/L, interquartile range, 82–105) compared with T1 (69 μmol/L, 60–78), T24 (63 μmol/L, 52–78), and T48 (78 μmol/L, 65–87) (P < 0.001) was found. Plasma NGAL increased significantly between T0 (5.66 ng/mL, 3.58–7.43) and T24 (7.50 ng/mL, 4.01–11.89) (P = 0.006) and T48 (9.86 ng/mL, 5.52–13.92) (P < 0.001), respectively. Urinary NGAL increased significantly between T1 (0.61 ng/mL, 0.30–2.59) and T24 (2.62 ng/mL, 1.86–10.92) (P = 0.001) and T48 (4.79 ng/mL, 1.96–34.97 (P < 0.001), respectively. UNCR increased significantly between T1 (0.15 μg/mmol, 0.09–0.54) and T24 (1.14 μg/mmol, 0.41–3.58) (P = 0.0015) and T48 (1.34 μg/mmol, 0.30–7.42) (P < 0.001), respectively. Concentrations of uGGT/uCr increased significantly from T0 highest at T24 (6.20 U/mmol, 3.90–9.90) and significantly decreased at T48 (3.76 U/mmol, 2.84–6.22) (P < 0.001). No significant differences in any renal biomarker concentration were found between dogs with and without IV lidocaine therapy.Conclusion and clinical relevancePlasma NGAL, uNGAL and UNCR remained increased up to 48 h post-surgery. No evidence of lidocaine-associated renoprotection was found.

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Section: Discussionmentioning

confidence: 99%

Concentrations and kinetics of renal biomarkers in dogs with gastric dilatation-volvulus with and without 24-h intravenous lidocaine

et al. 2023

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“…In individuals experiencing systemic congestion, the elevation in central venous pressure induces renal venous congestion, precipitating an augmentation in renal interstitial hydrostatic pressure due to the limited expansibility of the encapsulated kidney. Consequently, there ensues a simultaneous rise in the glomerular transcapillary hydrostatic pressure gradient, initiating glomerular hyperfiltration initially but potentially compromising both glomerular filtration rate (GFR) and renal blood flow subsequently Figure 1 [ 18 , 19 ]. The kidneys endeavor to sustain pressures by augmenting lymphatic outflow, yet a persistent increase in central venous pressure ultimately diminishes lymphatic outflow[ 20 ].…”

Section: Congestive Nephropathymentioning

confidence: 99%

Point-of-care ultrasonography spotlight: Could venous excess ultrasound serve as a shared language for internists and intensivists?

Khan,

Saeed,

Haque

et al. 2024

World J Crit Care Med

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Point-of-care ultrasonography (POCUS), particularly venous excess ultrasound (VExUS) is emerging as a valuable bedside tool to gain real-time hemodynamic insights. This modality, derived from hepatic vein, portal vein, and intrarenal vessel Doppler patterns, offers a scoring system for dynamic venous congestion assessment. Such an assessment can be crucial in effective management of patients with heart failure exacerbation. It facilitates diagnosis, quantification of congestion, prognostication, and monitoring the efficacy of decongestive therapy. As such, it can effectively help to manage cardiorenal syndromes in various clinical settings. Extended or eVExUS explores additional veins, potentially broadening its applications. While VExUS demonstrates promising outcomes, challenges persist, particularly in cases involving renal and liver parenchymal disease, arrhythmias, and situations of pressure and volume overload overlap. Proficiency in utilizing spectral Doppler is pivotal for clinicians to effectively employ this tool. Hence, the integration of POCUS, especially advanced applications like VExUS, into routine clinical practice necessitates enhanced training across medical specialties.

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“…In addition, end-organ effects of fluid overload are being increasingly recognized, which brings us to the topic of congestive nephropathy. Congestive nephropathy is defined as renal dysfunction that occurs due to venous congestion leading to impaired organ perfusion[ 7 ]. While this term was recently coined[ 8 ], several studies have previously shown that elevated central venous pressure (CVP) is associated with worsening renal function despite preserved cardiac index[ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Point-of-care ultrasound in diagnosis and management of congestive nephropathy

Turk¹,

Robertson²,

Koratala³

2023

World J Crit Care Med

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Congestive nephropathy is kidney dysfunction caused by the impact of elevated venous pressures on renal hemodynamics. As a part of cardiorenal syndrome, the diagnosis is usually made based on history and physical examination, with findings such as jugular venous distension, a third heart sound, and vital signs as supporting findings. More recently, however, these once though objective measures have come under scrutiny for their accuracy. At the same time, bedside ultrasound has increased in popularity and is routinely being used by clinicians to take some of the guess work out of making the diagnosis of volume overload and venous congestion. In this mini-review, we will discuss some of the traditional methods used to measure venous congestion, describe the role of point-of-care ultrasound and how it can ameliorate a clinician’s evaluation, and offer a description of venous excess ultrasound score, a relatively novel scoring technique used to objectively quantify congestion. While there is a paucity of published large scale clinical trials evaluating the potential benefit of ultrasonography in venous congestion compared to gold standard invasive measurements, more study is underway to solidify the role of this objective measure in daily clinical practice.

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Congestive Nephropathy

Cited by 5 publications

References 27 publications

Concentrations and kinetics of renal biomarkers in dogs with gastric dilatation-volvulus with and without 24-h intravenous lidocaine

Concentrations and kinetics of renal biomarkers in dogs with gastric dilatation-volvulus with and without 24-h intravenous lidocaine

Point-of-care ultrasonography spotlight: Could venous excess ultrasound serve as a shared language for internists and intensivists?

Point-of-care ultrasound in diagnosis and management of congestive nephropathy

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