Chronic kidney disease is frequently associated with cardiovascular disease, particularly among elderly patients, and this combination complicates the management of severe congestive heart failure (CHF).1,2 Even with adequate renal function, end-stage cardiomyopathy of any etiology can at times result in severe hemodynamic alterations leading to volume overload that is unresponsive to conventional diuretic therapy.7 Moreover, aggressive diuretic programs inevitably lead to acid/base and electrolyte-metabolic imbalance that further compounds the clinical scenario. Simultaneous correction of intractable fluid overload and metabolic disarray in these patients can be achieved by using different ultrafiltration modalities, including continuous venovenous hemofiltration/dialysis, sustained low-efficiency dialysis, sustained continuous ultrafiltration and continuous cyclic peritoneal dialysis. While the duration of these therapies varies, patients who do not have a favorable response within 30 days usually have a poor prognosis.3
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Chronic kidney disease is frequently associated with cardiovascular disease, particularly among elderly patients, and this combination complicates the management of severe congestive heart failure (CHF).1,2 Even with adequate renal function, end-stage cardiomyopathy of any etiology can at times result in severe hemodynamic alterations leading to volume overload that is unresponsive to conventional diuretic therapy.7 Moreover, aggressive diuretic programs inevitably lead to acid/base and electrolyte-metabolic imbalance that further compounds the clinical scenario. Simultaneous correction of intractable fluid overload and metabolic disarray in these patients can be achieved by using different ultrafiltration modalities, including continuous venovenous hemofiltration/dialysis, sustained low-efficiency dialysis, sustained continuous ultrafiltration and continuous cyclic peritoneal dialysis. While the duration of these therapies varies, patients who do not have a favorable response within 30 days usually have a poor prognosis.3
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Methodist Journal

IN THIS ISSUE

Diabetes and the Heart

Vol 14, Issue 4 (2019)


FEATURED GUEST EDITOR

ISSUE INTRO

The Intersection of Diabetes and Cardiovascular Disease

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RECOGNITIONS

Guest Editors Steven Petak and Archana Sadhu Guide Issue on Diabetes and the Heart

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REVIEW ARTICLES See More

Cardiac Autonomic Neuropathy in Diabetes Mellitus

Stage-Based Management of Type 2 Diabetes Mellitus with Heart Failure

Imaging to Stratify Coronary Artery Disease Risk in Asymptomatic Patients with Diabetes

Update on Management of Type 2 Diabetes for Cardiologists

New Therapeutic Strategies for Type 2 Diabetes

Prediabetes: Why Should We Care?

Central Venous Pathologies: Treatments and Economic Impact

Venous Thrombosis and Post-Thrombotic Syndrome: From Novel Biomarkers to Biology

CASE REPORTS See More

Loperamide Mimicking Brugada Pattern

Reversed Pulsus Paradoxus in Right Ventricular Failure

Mycobacterium Chimaera Mimicking Sarcoidosis

Immune Checkpoint Inhibitor Related Cardiotoxicity

MUSEUM OF HMH MULTIMODALITY IMAGING CENTER See More

A Right Ventricular Mass

CLINICAL PERSPECTIVES See More

POINTS TO REMEMBER

The Kidney as an Endocrine Organ

EXCERPTA

The Other Side of the Prescription

EXCERPTA

Telemedicine Shakes Up the ICU Experience

POINTS TO REMEMBER

Venous Thrombosis in Nephrotic Syndrome

EDITORIALS

Letter to the Editor in response to “Role of Subcutaneous Leadless Implantable Cardioverter Defibrillator in Young Patients