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

Adult Congenital Heart Update

Vol 15, Issue 2 (2019)


FEATURED GUEST EDITOR

ISSUE INTRO

The Growing Number of Adults Surviving with Congenital Heart Disease

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RECOGNITIONS

Drs. MacGillivray and Lin Take the Lead in Adult Congenital Heart Disease

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REVIEW ARTICLES See More

Advanced Cardiac Imaging for Complex Adult Congenital Heart Diseases

149 Fontan Conversions

Anomalous Aortic Origin of a Coronary Artery

Pulmonary Valve Replacement for Tetralogy of Fallot

Management of the Adult with Arterial Switch

Ebstein’s Anomaly

Heart Transplantation in Adults with Congenital Heart Disease

Cholesterol: Can’t Live With It, Can’t Live Without It

CASE REPORTS See More

Simultaneous Transfemoral Mitral and Tricuspid Valve in Ring Implantation: First Case Report with Edwards Sapien 3 Valve

Uneventful Follow-Up 2 Years after Endovascular Treatment of a High Flow Iatrogenic Aortocaval Fistula Causing Pulmonary Hypertension and Right Heart Failure

Device-Related Thrombus: A Reason for Concern?

Retained Coronary Balloon Requiring Emergent Open Surgical Retrieval: An Uncommon Complication Requiring Individualized Management Strategies

MUSEUM OF HMH MULTIMODALITY IMAGING CENTER See More

Do I Look Fat in This? Multimodality Imaging Findings of a Cardiac Lipoma

CLINICAL PERSPECTIVES See More

POINTS TO REMEMBER

The Kidney in Congenital Cyanotic Heart Disease

EXCERPTA

Talking Statins with Antonio Gotto

POINTS TO REMEMBER

Lipids and Renal Disease

EXCERPTA

Addressing the Feedback Loop Between Depression, Diabetes, and Cardiovascular Disease

EDITORIALS

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