Mapping Progress in Reducing Cardiovascular Risk with Kidney Disease

Shafi, Tariq; Güallar, Eliseo

doi:10.2215/cjn.02760218

Cited by 6 publications

(4 citation statements)

References 9 publications

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“…Efforts to improve ICM adoption among dialysis patients could be aided by a “Cardiorenal” curriculum that includes procedural skills for monitor implantation and arrhythmia identification and management. [ 8 ] Implementing such a curriculum for trainees could help prepare future nephrologists in addressing patients’ concerns and knowledge gaps about arrhythmia/SCD.…”

Section: Resultsmentioning

confidence: 99%

“…[ 1 ] Arrhythmia detection by miniaturized implantable cardiac monitors (ICMs)[ 2 – 7 ] may help individualize care by promoting the use of established management strategies for arrhythmias. [ 8 ] Few nephrologists and patients, however, are aware of these devices. We report the results of a qualitative study assessing patients’ and family members’ knowledge gaps.…”

Section: Introductionmentioning

confidence: 99%

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Patients’ and family members’ perspectives on arrhythmias and sudden death in dialysis: the HeartLink focus groups pilot study

Boyer

Jaar

et al. 2021

BMC Nephrol

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Background Patients receiving dialysis face a high risk of cardiovascular disease, arrhythmia and sudden cardiac death. Few patients, however, are aware of this risk. Implantable cardiac monitors are currently available for clinical use and can continuously monitor cardiac rhythms without the need for transvenous leads. Our goal was to gauge patients’ and family members’ perceptions of these risks and to identify their concerns about cardiac monitors. Methods Two 90-minute focus groups were conducted: one with patients receiving in-center hemodialysis and one with their family members. Trained moderators assessed: (1) knowledge of cardiovascular disease; (2) cardiovascular disease risk in dialysis; (3) risk of death due to cardiovascular disease; (4) best ways to convey this risk to patients/families; and (5) concerns about cardiac monitors. The sessions were audiotaped, transcribed, and independently analyzed by two reviewers to identify core themes. Emblematic quotations were chosen to illustrate the final themes. Results Nine adult patients and three family members participated. Patients felt education was inadequate and had little knowledge of arrhythmias. Patients’/families’ concerns regarding cardiac monitors were related to adverse effects, the notification process, and cosmetic effects. Patients/families felt that nephrologists, not dialysis staff, would be the best source for education. Conclusions The preliminary data from this small study population suggest that patients/families are not well aware of the high risk of arrhythmia and sudden cardiac death in dialysis. Further investigation is required to gauge this awareness among patients/families and to assess their impressions of implantable cardiac monitors for arrhythmia detection and management.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Patients’ and family members’ perspectives on arrhythmias and sudden death in dialysis: the HeartLink focus groups pilot study

Boyer

Jaar

et al. 2021

BMC Nephrol

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“…Finally, to optimize care of hemodialysis patients, personalized monitoring that incorporates the interdialytic period utilizing ihealth trackers may allow event prediction and timely intervention. 189 Progress in achieving the goals discussed in the article will help to develop hemodialysis from a vital but poorly tolerated therapy to one that is personalized and aims to minimize organ damage, reduce adverse clinical outcomes, in particular cardiovascular mortality and morbidity as well as optimize health-related quality of life and patient-reported outcomes. In addition, the use of embarked monitoring tools, such as a sodium balancing module, will support caregivers and dietitians to guide more precisely patient's diet.…”

Section: A Personalized Medicine Approachmentioning

confidence: 99%

Dialysis-Induced Cardiovascular and Multiorgan Morbidity

Canaud

Kooman

Selby

et al. 2020

Kidney International Reports

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Hemodialysis has saved many lives, albeit with significant residual mortality. Although poor outcomes may reflect advanced age and comorbid conditions, hemodialysis per se may harm patients, contributing to morbidity and perhaps mortality. Systemic circulatory "stress" resulting from hemodialysis treatment schedule may act as a disease modifier, resulting in a multiorgan injury superimposed on preexistent comorbidities. New functional intradialytic imaging (i.e., echocardiography, cardiac magnetic resonance imaging [MRI]) and kinetic of specific cardiac biomarkers (i.e., Troponin I) have clearly documented this additional source of end-organ damage. In this context, several factors resulting from patienthemodialysis interaction and/or patient management have been identified. Intradialytic hypovolemia, hypotensive episodes, hypoxemia, solutes, and electrolyte fluxes as well as cardiac arrhythmias are among the contributing factors to systemic circulatory stress that are induced by hemodialysis. Additionally, these factors contribute to patients' symptom burden, impair cognitive function, and finally have a negative impact on patients' perception and quality of life. In this review, we summarize the adverse systemic effects of current intermittent hemodialysis therapy, their pathophysiologic consequences, review the evidence for interventions that are cardioprotective, and explore new approaches that may further reduce the systemic burden of hemodialysis. These include improved biocompatible materials, smart dialysis machines that automatically may control the fluxes of solutes and electrolytes, volume and hemodynamic control, health trackers, and potentially disruptive technologies facilitating a more personalized medicine approach.

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“…We should establish a cardiorenal curriculum among nephrologists or dialysis nurses (4). Focused training on heart failure, volume management, rhythm control, electrolyte management, and device handling is required.…”

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confidence: 99%

The ABCs in the Mapping Progress in Reducing Cardiovascular Risk with Kidney Disease

Wanner

2018

CJASN

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Mapping Progress in Reducing Cardiovascular Risk with Kidney Disease

Cited by 6 publications

References 9 publications

Patients’ and family members’ perspectives on arrhythmias and sudden death in dialysis: the HeartLink focus groups pilot study

Patients’ and family members’ perspectives on arrhythmias and sudden death in dialysis: the HeartLink focus groups pilot study

Dialysis-Induced Cardiovascular and Multiorgan Morbidity

The ABCs in the Mapping Progress in Reducing Cardiovascular Risk with Kidney Disease

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