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

FEATURED GUEST EDITOR

ISSUE INTRO

The Scourge of Cardiogenic Shock

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RECOGNITIONS

Arvind Bhimaraj, MD, MPH, Guides Issue on Cardiogenic Shock

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REVIEW ARTICLES See More

Pathophysiology and Advanced Hemodynamic Assessment of Cardiogenic Shock

Cardiogenic Shock in the Setting of Acute Myocardial Infarction

Cardiogenic Shock in Patients with Advanced Chronic Heart Failure

Acute Mechanical Circulatory Support for Cardiogenic Shock

Management of Cardiogenic Shock in a Cardiac Intensive Care Unit

Physiological Concepts of Cardiogenic Shock Using Pressure-Volume Loop Simulations: A Case-Based Review

Systems of Care in Cardiogenic Shock

Cardiogenic Shock in Perioperative and Intraoperative Settings: A Team Approach

CASE REPORTS See More

COVID-19: A Potential Risk Factor for Acute Pulmonary Embolism

Repair of Extent III Thoracoabdominal Aneurysm in the Presence of Aortoiliac Occlusion

Williams-Beuren Syndrome: The Role of Cardiac CT in Diagnosis

A Rare Case of Pancreatitis-Induced Thrombosis of the Aorta and Superior Mesenteric Artery

MUSEUM OF HMH MULTIMODALITY IMAGING CENTER See More

A T2-Weighty Discovery: Aortitis on Cardiac MRI with Histopathologic Correlation

CLINICAL PERSPECTIVES See More

POINTS TO REMEMBER

Acute Kidney Injury in Cardiogenic Shock

EXCERPTA

Cardio-Oncology, Then and Now: An Interview with Barry Trachtenberg

POINTS TO REMEMBER

Onconephrology: An Evolving Field

POINTS TO REMEMBER

Herbal Nephropathy

EDITORIALS

Letter to the Editor in Response to “Cardiac Autonomic Neuropathy in Diabetes Mellitus”