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Intrarenal venous flow in cardiorenal syndrome: a shining light into the darkness

The aim of this case report is to assess the potential role of intrarenal Doppler ultrasonography as a non‐invasive method to evaluate intrarenal venous flow (IRVF) in acute heart failure (AHF) and concomitant renal dysfunction. We report a case of an 81‐year‐old woman with valvular heart disease (p...

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Autores principales: de la Espriella‐Juan, Rafael, Núñez, Eduardo, Miñana, Gema, Sanchis, Juan, Bayés‐Genís, Antoni, González, Jessika, Chorro, Javier, Núñez, Julio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6300820/
https://www.ncbi.nlm.nih.gov/pubmed/30295431
http://dx.doi.org/10.1002/ehf2.12362
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author de la Espriella‐Juan, Rafael
Núñez, Eduardo
Miñana, Gema
Sanchis, Juan
Bayés‐Genís, Antoni
González, Jessika
Chorro, Javier
Núñez, Julio
author_facet de la Espriella‐Juan, Rafael
Núñez, Eduardo
Miñana, Gema
Sanchis, Juan
Bayés‐Genís, Antoni
González, Jessika
Chorro, Javier
Núñez, Julio
author_sort de la Espriella‐Juan, Rafael
collection PubMed
description The aim of this case report is to assess the potential role of intrarenal Doppler ultrasonography as a non‐invasive method to evaluate intrarenal venous flow (IRVF) in acute heart failure (AHF) and concomitant renal dysfunction. We report a case of an 81‐year‐old woman with valvular heart disease (previous mitral valve replacement) that presented with acutely decompensated heart failure and concomitant worsening renal function (WRF). In addition to complete physical examination, laboratory analysis, and echocardiography, IRVF was assessed at baseline and 48 h after the administration of diuretic treatment. At admission, physical examination and echocardiography revealed signs of intravascular congestion (jugular venous distension and severely dilated inferior vena cava). In addition, a significant increase in serum creatinine from 1.23 to 1.81 mg/dL was noted without signs of hypoperfusion at clinical evaluation. At baseline, intrarenal Doppler ultrasonography showed a monophasic IRVF pattern indicating a severely elevated interstitial renal pressure. After aggressive decongestion, a dynamic behaviour was found in IRVF changing from monophasic to biphasic pattern in parallel with an improvement in clinical parameters and renal function (serum creatinine changed from 1.81 to 1.44 mg/dL). In this case of a patient with AHF and WRF, IRVF changed after aggressive decongestion in agreement with clinical evolution. According to these findings, this technique could provide valuable information for identifying patients with a ‘congestion kidney failure’ phenotype. Further studies are needed confirming this observation and evaluating the potential role of this technique for guiding decongestive therapy in patients with AHF and WRF.
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spelling pubmed-63008202018-12-31 Intrarenal venous flow in cardiorenal syndrome: a shining light into the darkness de la Espriella‐Juan, Rafael Núñez, Eduardo Miñana, Gema Sanchis, Juan Bayés‐Genís, Antoni González, Jessika Chorro, Javier Núñez, Julio ESC Heart Fail Case Report The aim of this case report is to assess the potential role of intrarenal Doppler ultrasonography as a non‐invasive method to evaluate intrarenal venous flow (IRVF) in acute heart failure (AHF) and concomitant renal dysfunction. We report a case of an 81‐year‐old woman with valvular heart disease (previous mitral valve replacement) that presented with acutely decompensated heart failure and concomitant worsening renal function (WRF). In addition to complete physical examination, laboratory analysis, and echocardiography, IRVF was assessed at baseline and 48 h after the administration of diuretic treatment. At admission, physical examination and echocardiography revealed signs of intravascular congestion (jugular venous distension and severely dilated inferior vena cava). In addition, a significant increase in serum creatinine from 1.23 to 1.81 mg/dL was noted without signs of hypoperfusion at clinical evaluation. At baseline, intrarenal Doppler ultrasonography showed a monophasic IRVF pattern indicating a severely elevated interstitial renal pressure. After aggressive decongestion, a dynamic behaviour was found in IRVF changing from monophasic to biphasic pattern in parallel with an improvement in clinical parameters and renal function (serum creatinine changed from 1.81 to 1.44 mg/dL). In this case of a patient with AHF and WRF, IRVF changed after aggressive decongestion in agreement with clinical evolution. According to these findings, this technique could provide valuable information for identifying patients with a ‘congestion kidney failure’ phenotype. Further studies are needed confirming this observation and evaluating the potential role of this technique for guiding decongestive therapy in patients with AHF and WRF. John Wiley and Sons Inc. 2018-10-08 /pmc/articles/PMC6300820/ /pubmed/30295431 http://dx.doi.org/10.1002/ehf2.12362 Text en © 2018 The Authors ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Case Report
de la Espriella‐Juan, Rafael
Núñez, Eduardo
Miñana, Gema
Sanchis, Juan
Bayés‐Genís, Antoni
González, Jessika
Chorro, Javier
Núñez, Julio
Intrarenal venous flow in cardiorenal syndrome: a shining light into the darkness
title Intrarenal venous flow in cardiorenal syndrome: a shining light into the darkness
title_full Intrarenal venous flow in cardiorenal syndrome: a shining light into the darkness
title_fullStr Intrarenal venous flow in cardiorenal syndrome: a shining light into the darkness
title_full_unstemmed Intrarenal venous flow in cardiorenal syndrome: a shining light into the darkness
title_short Intrarenal venous flow in cardiorenal syndrome: a shining light into the darkness
title_sort intrarenal venous flow in cardiorenal syndrome: a shining light into the darkness
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6300820/
https://www.ncbi.nlm.nih.gov/pubmed/30295431
http://dx.doi.org/10.1002/ehf2.12362
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