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1

Teerlink, John R., and Barry M. Massie. "Nesiritide and Worsening of Renal Function." Circulation 111, no. 12 (2005): 1459–61. http://dx.doi.org/10.1161/01.cir.0000160874.48045.54.

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2

Testani, Jeffrey, Martin St. John Sutton, and James Kirkpatrick. "Venous Congestion and Worsening Renal Function." Journal of the American College of Cardiology 54, no. 7 (2009): 661. http://dx.doi.org/10.1016/j.jacc.2009.03.074.

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3

van Kimmenade, Roland R. J., Tim J. ten Cate, and Hans-Peter Brunner-La Rocca. "Worsening Renal Function in Heart Failure." Journal of the American College of Cardiology 69, no. 1 (2017): 70–72. http://dx.doi.org/10.1016/j.jacc.2016.11.016.

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4

&NA;. "Worsening renal function with longer nesiritide infusions." Reactions Weekly &NA;, no. 1148 (2007): 5. http://dx.doi.org/10.2165/00128415-200711480-00017.

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5

&NA;. "Worsening renal function with longer nesiritide infusions." Inpharma Weekly &NA;, no. 1584 (2007): 25. http://dx.doi.org/10.2165/00128413-200715840-00074.

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6

Tsay, Julie, Daniel Pinkhas, Bryan C. Lee, et al. "Worsening Renal Function in Cardiac Mechanical Support." Heart, Lung and Circulation 29, no. 8 (2020): 1247–55. http://dx.doi.org/10.1016/j.hlc.2019.11.011.

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7

Warraich, Haider J., and Anju Nohria. "Is worsening renal function relevant without clinical context?" European Journal of Heart Failure 24, no. 2 (2022): 375–77. http://dx.doi.org/10.1002/ejhf.2416.

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8

Maqsood, Farhan, and Harold M. Szerlip. "Relationship of Venous Congestion to Worsening Renal Function." Journal of the American College of Cardiology 54, no. 7 (2009): 661–62. http://dx.doi.org/10.1016/j.jacc.2009.03.073.

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9

Núñez, Julio, Eduardo Núñez, Gema Miñana, Antoni Bayés-Genis, and Juan Sanchis. "Worsening Renal Function in Acute Decompensated Heart Failure." JACC: Heart Failure 4, no. 3 (2016): 232–33. http://dx.doi.org/10.1016/j.jchf.2015.10.013.

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10

Tan, M. H., S. K. Glendon Lau, W. H. Han, N. T. Ross, R. Visvanathan, and Y. Y. Ngau. "072 WORSENING RENAL FUNCTION IN HEART FAILURE PATIENTS." Kidney International Reports 2, no. 4 (2017): S35. http://dx.doi.org/10.1016/j.ekir.2017.06.112.

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11

Momomura, Shin-ichi. "Tolvaptan, Is It a Trump to Worsening Renal Function?" Circulation Journal 81, no. 5 (2017): 642–44. http://dx.doi.org/10.1253/circj.cj-17-0311.

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12

Murai, Ryosuke, Seiji Habara, Takeshi Tada, et al. "WORSENING RENAL FUNCTION AFTER ACUTE TYPE B AORTIC DISSECTION." Journal of the American College of Cardiology 71, no. 11 (2018): A2065. http://dx.doi.org/10.1016/s0735-1097(18)32606-8.

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13

Tanaka, Yoshihiro, Hayato Tada, Kenshi Hayashi, Olle Melander, and Masa-Aki Kawashiri. "ATRIAL FIBRILLATION AS A CAUSE OF WORSENING RENAL FUNCTION." Journal of the American College of Cardiology 73, no. 9 (2019): 1798. http://dx.doi.org/10.1016/s0735-1097(19)32404-0.

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14

Chughtai, Haroon L., Muzammil Musani, Muhammed Janjua, et al. "Predictors of Worsening Renal Function After Open Heart Surgery." Chest 138, no. 4 (2010): 500A. http://dx.doi.org/10.1378/chest.11070.

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15

Lanfear, David, Ali Shafiq, Edward Peterson, Karen Wells, Yong Hu, and L. Keoki Williams. "Race and Worsening Renal Function after Solid Organ Transplantation." Journal of Cardiac Failure 19, no. 8 (2013): S19. http://dx.doi.org/10.1016/j.cardfail.2013.06.067.

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16

Barone, R., G. Goffredo, V. Di Terlizzi, et al. "P237 WORSENING OF RENAL FUNCTION AND INCREASE IN RENAL RESISTANCE INDEX AFTER CARDIAC SURGERY." European Heart Journal Supplements 25, Supplement_D (2023): D132. http://dx.doi.org/10.1093/eurheartjsupp/suad111.312.

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Abstract Worsening of renal function (WRF) is frequently observed after cardiac surgery and it is associated with both short– and long–term worse outcome. Among the pathophysiological conditions favoring the occurrence of WRF, the abnormalities in renal blood flow could play a key role. The aim of this study was to evaluate the changes in renal resistance index (RRI), a parameter reflecting renal parenchymal and hemodynamic parameters, after cardiac surgery. Methods Thirty–one patients were enrolled (age 65±12 years, 29% males, mean left ventricular ejection fraction 55±5%, mean creatinine serum levels 0.89±0.18 mg/dl, mean eGFR 89±28 ml/min*1.73 m2). All patients underwent cardiac surgery. Before cardiac surgery, after 3 days and before discharge, RRI was evaluated according to Peurcelot’s formula by renal interlobular arteries pulsed Doppler. Worsening of renal function was defined as an increase in serum creatinine of > 0.3 mg/dl associated with a change > 25% or the need of renal replacement therapy due to severe acute kidney injury. Results As shown in the table 1, after cardiac surgery a significant increase in RRI was observed at 3 days after cardiac surgery but not before discharge. The significant increase in RRI was observed both in patients with and without WRF. However, in patients with WRF significant higher values of RRI were observed before as well as after cardiac surgery. Conclusions Among patients undergoing cardiac surgery a significant increase in RRI values is observed after surgery. Among patients with WRF a significant greater values of RRI are observed before as well as cardiac surgery thus suggesting that a critical increase in renal resistance could play a role in the cardiorenal syndrome worsening.
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17

Tobe, Akihiro, Akihito Tanaka, Yoshiyuki Tokuda, et al. "Albuminuria predicts worsening renal function after transcatheter aortic valve replacement." Journal of Cardiology 79, no. 5 (2022): 648–54. http://dx.doi.org/10.1016/j.jjcc.2021.11.014.

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18

&NA;. "Risk of worsening renal function with nesiritide in HF patients." Inpharma Weekly &NA;, no. 1482 (2005): 24. http://dx.doi.org/10.2165/00128413-200514820-00077.

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19

Kristeller, Judith Lyn, Haley Papps, and Russell F. Stahl. "Risk of worsening renal function with nesiritide following cardiac surgery." American Journal of Health-System Pharmacy 63, no. 23 (2006): 2351–53. http://dx.doi.org/10.2146/ajhp060250.

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20

&NA;. "CCA/loop diuretics: worsening renal function in heart failure patients." Reactions Weekly &NA;, no. 996-997 (2004): 5. http://dx.doi.org/10.2165/00128415-200409960-00012.

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21

&NA;. "Risk of worsening renal function with nesiritide in HF patients." Reactions Weekly &NA;, no. 1046 (2005): 5. http://dx.doi.org/10.2165/00128415-200510460-00017.

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22

Damman, Kevin, and John J. V. McMurray. "Why and when should we worry about worsening renal function?" European Journal of Heart Failure 16, no. 1 (2013): 4–5. http://dx.doi.org/10.1111/ejhf.17.

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23

Lanfear, David E., Oluchi Uju-Eke, Oday L. Rabadi, et al. "Persistence of Worsening Renal Function during Acute Heart Failure Hospitalization." Journal of Cardiac Failure 15, no. 6 (2009): S88. http://dx.doi.org/10.1016/j.cardfail.2009.06.076.

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24

Heinlen, Jonathan E., Bradley P. Kropp, and Dominic C. Frimberger. "PROGRESSION OF HYDRONEPHROSIS CORRELATES WITH WORSENING RENAL FUNCTION IN CHILDREN." Journal of Urology 181, no. 4S (2009): 443. http://dx.doi.org/10.1016/s0022-5347(09)61257-x.

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25

Damman, Kevin, Serge Masson, Hans L. Hillege, et al. "Tubular Damage and Worsening Renal Function in Chronic Heart Failure." JACC: Heart Failure 1, no. 5 (2013): 417–24. http://dx.doi.org/10.1016/j.jchf.2013.05.007.

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26

Sato, Chisato, Kohei Wakabayashi, Hiroki Yamaguchi, and Kaoru Tanno. "Worsening renal failure due to renal steal by aortoiliac bypass." BMJ Case Reports 12, no. 3 (2019): e227775. http://dx.doi.org/10.1136/bcr-2018-227775.

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Aortoiliac bypass surgery is the gold standard strategy for removing persistent ischaemia resulting from bilateral aortoiliac occlusive disease, a condition known as Leriche syndrome. However, the impact of aortoiliac bypass surgery on the blood flow of the renal artery is not fully understood. Here, we report a case of worsening renal failure caused by renal steal immediately after aortoiliac bypass for Leriche syndrome. The revascularisation of bilateral renal arteries dramatically improved the patient’s renal function and allowed us to discontinue both haemodialysis and diuretics. This case demonstrates that in rare instances, haemodynamic change induced by aortoiliac bypass surgery affects the arteries feeding other organs. Careful preoperative evaluation for the corresponding branches of the aorta is indispensable. Optimal revascularisation should be performed to avoid serious complications after aortoiliac bypass if the patient is at risk of developing critical ischaemia.
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27

Bangolo, Ayrton, Mahabuba Akhter, Amer Jarri, et al. "A Case Report of Premalignant Plasma Cell Dyscrasia-Induced Renal Failure in a 31-Year-Old Female." Case Reports in Hematology 2022 (June 7, 2022): 1–4. http://dx.doi.org/10.1155/2022/2497380.

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Monoclonal gammopathy of renal significance (MGRS) is a rare disorder in which monoclonal immunoglobulin secreted by nonmalignant B cell or plasma cell clone causes kidney damage. Although MGRS is a premalignant condition, it can cause severe kidney disease and end-stage renal disease (ESRD) at any age. Herein, we present a 31-year-old female with past medical history of lupus nephritis who presented with signs of volume overload and worsening renal function despite adequate immunosuppressive therapy. Renal biopsy revealed heavy and light chain deposition consistent with MGRS. This case report demonstrates the importance of including MGRS in the differential diagnosis of worsening renal function despite adequate treatment, raising awareness of this premalignant yet morbid condition.
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28

Joshi, Abhishek, Keelin O'Donoghue, Uzma Mahmood, Debasish Banerjee, and Anita Banerjee. "Pregnancy outcomes in a patient with Sjögren's disease with renal involvement." Obstetric Medicine 6, no. 4 (2013): 175–78. http://dx.doi.org/10.1177/1753495x13487323.

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Background: Maternal and fetal outcome in pregnancy with renal failure is unpredictable, where each condition can adversely affect the other. We present a case of steroid sensitive Sjögren's nephritis worsened by pregnancy, demonstrated over the course of multiple pregnancies and investigated the aetiology. Case: A 28-year-old nullipara with a diagnosis of primary Sjögren's syndrome presented with a deterioration of renal function. A diagnosis of secondary tubulo-interstitial nephritis was made on renal biopsy. Her first pregnancy ended in the second trimester with a decision to deliver a female infant at 27 weeks due to worsening maternal renal function. Renal function improved immediately. A second pregnancy ended in a first trimester miscarriage. The third and fourth pregnancies delivered male infants at 35 and 34 weeks, with worsening renal function in each pregnancy, reaching end stage. Repeat biopsy showed extensive glomerulosclerosis and male cells were identified. Conclusions: This case of Sjögren's syndrome with renal disease demonstrated the increased risk of fetal and maternal adverse pregnancy outcomes. Renal function worsened in each pregnancy and progressed to end-stage renal disease. Fetal microchimerism offers an interesting mechanism for our patient's renal failure and its apparent relationship to her pregnancies.
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29

Landau, Daniel, Muhammad H. Assadi, Rawan Abu Hilal, Yu Chen, Ralph Rabkin, and Yael Segev. "SOCS2 Silencing Improves Somatic Growth without Worsening Kidney Function in CKD." American Journal of Nephrology 51, no. 7 (2020): 520–26. http://dx.doi.org/10.1159/000508224.

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Background: Growth hormone (GH) resistance in CKD is partly due to increased expression of SOCS2, a GH signaling negative regulator. In SOCS2 absence, body growth is exaggerated. However, GH overexpression in mice causes glomerulosclerosis. Accordingly, we tested whether lack of SOCS2 improves body growth, but accelerates kidney damage in CKD. Methods: Eight-week-old mutant SOCS2-deficient high growth (HG) and normal wild-type mice (N) underwent 5/6 nephrectomy (CKD) or sham operation (C) and were sacrificed after 12 weeks, generating 4 groups: C-N, C-HG, CKD-N, CKD-HG. Results: Somatic growth, inhibited in CKD-N, increased significantly in CKD-HG. Liver p-STAT5, a key intracellular signal of GH receptor (GHR) activation, was decreased in CKD-N but not in CKD-HG. Serum Cr as well as histopathological scores of renal fibrosis were similar in both CKD groups. Kidney fibrogenic (TGF-β and collagen type IV mRNA) and inflammatory precursors (IL6, STAT3, and SOCS3 mRNA) were similarly increased in C-HG, CKD-HG, and CKD-N versus C-N. Renal GHR mRNA was decreased in C-HG, CKD-HG, and CKD-N versus C-N. Kidney p-STAT5 was decreased in CKD-N but not elevated in CKD-HG. Conclusions: CKD-related growth retardation is overcome by SOCS2 silencing, in association with increased hepatic STAT5 phosphorylation. Renal insufficiency is not worsened by SOCS2 absence, as kidney GHR and STAT5 are not upregulated. This may be due to elevated kidney proinflammatory cytokines and their mediators, phospho-STAT3 and SOCS3, which may counteract for the absence in SOCS2 and explain the renal safety of prolonged GH therapy in CKD.
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30

Iacoviello, Massimo, Francesco Monitillo, Marta Leone, et al. "The Renal Arterial Resistance Index Predicts Worsening Renal Function in Chronic Heart Failure Patients." Cardiorenal Medicine 7, no. 1 (2016): 42–49. http://dx.doi.org/10.1159/000448405.

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Background/Aim: The renal arterial resistance index (RRI) is a Doppler measure, which reflects abnormalities in the renal blood flow. The aim of this study was to verify the value of RRI as a predictor of worsening renal function (WRF) in a group of chronic heart failure (CHF) outpatients. Methods: We enrolled 266 patients in stable clinical conditions and on conventional therapy. Peak systolic velocity and end diastolic velocity of a segmental renal artery were obtained by pulsed Doppler flow, and RRI was calculated. Creatinine serum levels were evaluated at baseline and at 1 year, and the changes were used to assess WRF occurrence. Results: During follow-up, 34 (13%) patients showed WRF. RRI was associated with WRF at univariate (OR: 1.13; 95% CI: 1.07-1.20) as well as at a forward stepwise multivariate logistic regression analysis (OR: 1.09; 95% CI: 1.03-1.16; p = 0.005) including the other univariate predictors. Conclusions: Quantification of arterial renal perfusion provides a new parameter that independently predicts the WRF in CHF outpatients. Its possible role in current clinical practice to better define the risk of cardiorenal syndrome progression is strengthened.
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31

Dorofeeva, N. P., D. N. Ivanchenko, O. G. Mashtalova, et al. "POSSIBILITIES OF ENDOVASCULAR TREATMENT OF PATIENTS WITH INFRARENAL AORTIC OCCLUSION." Journal of Clinical Practice 8, no. 1 (2017): 25–29. http://dx.doi.org/10.17816/clinpract8125-29.

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Quality of life is one of the indicators for a comprehensive assessment of the patient’s condition. Depression and reduced kidney function can impair the quality of life. Cognitive impairmen taffects negatively on patients’ quality of life. We examined 47 patients with stable angina pectoris. It was found that the presence of depressive symptoms is associated with a reduction in the quality of life with using the SF-36 scale. Worsening renal function was also associated with the deterioration of quality of life and worsening of depressive symptoms. The cognitive dysfunction has progressed with decreasing renal function.
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32

Afsal, Shaheen, K. Sujani, Shashank Viswanathan, Akshay Bhati, Harish BR, and Muralidhar Kanchi. "Off-Pump Technique May Prevent Worsening of Renal Function in CAD with CKD Undergoing CABG." Journal of Cardiac Critical Care TSS 05, no. 01 (2021): 007–11. http://dx.doi.org/10.1055/s-0041-1723857.

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AbstractCardiovascular disease (CVD) is a major cause for a significant proportion of all deaths and disability worldwide. Postoperative renal dysfunction following cardiac surgery is not an uncommon complication of cardiac surgery, which has serious implications with regard to morbidity, mortality, financial expenditure, and resource utilization. This study was performed to compare outcomes of patients with preoperative renal dysfunction with those having normal renal function undergoing off-pump coronary artery bypass grafting (OPCABG). Patients were divided into two categories, depending on their preoperative serum creatinine and glomerular filtration rate (GFR). The preoperative renal dysfunction was defined as serum creatinine >1.3 mg/dL and/or estimated GFR (eGFR) of <60 mL/min/1.73 m2. The category A patients had normal renal function defined as serum creatinine ≤1.3 mg/dL and/or eGFR of ≥60 mL/min/1.73 m2 while the category B patients had preoperative renal dysfunction that did not necessitate renal dialysis. Blood samples were collected from both category patients for serum creatinine prior to surgery, following surgery, on postoperative days 1, 2, 3, 4, 5, and on the day of discharge. The occurrence of acute kidney injury (AKI) was defined as an increase in the serum creatinine levels of ≥0.3 mg/dL within 48 hours or an increase of ≥1.5 above baseline known or presumed to have occurred within the previous 7 days based on Kidney Disease Improving Global Outcomes criteria. This study demonstrated that there was worsening of renal function in 7.4% of patients with normal renal function and 10.74% of patients with renal dysfunction that was not statistically different. Based on the results, we conclude that preoperative renal dysfunction may be a contributing predictor of AKI following OPCABG, and we recommend that the patients with more severe renal dysfunction with eGFR of 45–60 mL/min should be studied to demonstrate this hypothesis.
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33

Mulryan, Philip, Claire O’Brien, Marek Mazur, and Stephen Power. "Renal artery stenosis stenting with unmasking and embolisation of a renal arteriovenous fistula." BMJ Case Reports 16, no. 10 (2023): e256560. http://dx.doi.org/10.1136/bcr-2023-256560.

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A man in his 70s was presented to the emergency department with uncontrollable hypertension and worsening renal function on a background of atherosclerosis-related bilateral renal artery stenosis. Following progressive deterioration in renal function and refractory hypertension, the patient was referred to interventional radiology for consideration of renal artery stenting. Following stenting of the right renal artery, a large renal arteriovenous fistula became apparent, which required emergent embolisation. Both procedures were successful, with excellent clinical and radiological responses.
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34

Peterson, Evan J., Tien M. H. Ng, Komal A. Patel, Mimi Lou, and Uri Elkayam. "Association of admission vs. nadir serum albumin concentration with short-term treatment outcomes in patients with acute heart failure." Journal of International Medical Research 46, no. 9 (2018): 3665–74. http://dx.doi.org/10.1177/0300060518777349.

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Objectives Hypoalbuminemia occurs in 25% to 76% of patients hospitalized for acute heart failure (HF) and is associated with increased mortality. Hypoalbuminemia may predispose patients to intravascular volume depletion, hypotension, and acute worsening of renal function; however, its association with treatment outcomes during hospitalization is unknown. Methods This retrospective cohort study involved 414 adult patients hospitalized for HF requiring intravenous diuretics. Temporal changes in serum albumin and the association of hypoalbuminemia with urine output, renal function changes, blood pressure, use of intravenous vasoactive drugs, and short-term outcomes were assessed. Results Serum albumin decreased in most patients (72%) during hospitalization. Hypoalbuminemia was present in 29% and 50% of patients based on the mean admission and nadir serum albumin level, respectively. Hypoalbuminemia as assessed by the nadir albumin level was associated with an increased risk of acute worsening of renal function. A nadir albumin level of <3.0 g/dL remained significantly associated in the multivariate analyses. Conclusions Serum albumin commonly decreases during hospitalization for acute HF. Hypoalbuminemia assessed using the nadir level during hospitalization, not the admission level, was associated with an increased risk of acute worsening of renal function. The timing of serum albumin measurement may influence its utility as a biomarker.
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35

He, Xin, Bin Dong, Weihao Liang, et al. "Worsening of Renal Function Among Hospitalized Patients With Acute Heart Failure." Mayo Clinic Proceedings 97, no. 9 (2022): 1619–30. http://dx.doi.org/10.1016/j.mayocp.2022.06.016.

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36

Ahmed, Moeed, Neil Alouch, Arslan Ahmed, and Sunil K. Jagadesh. "Worsening of renal function and uncontrolled hypertension from intravitreal bevacizumab injections." Baylor University Medical Center Proceedings 34, no. 4 (2021): 527–29. http://dx.doi.org/10.1080/08998280.2021.1885285.

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37

Wettersten, Nicholas W., Stephen Duff, Yu Horiuchi, Alan S. Maisel, Patrick Murray, and Joachim Ix. "IMPLICATIONS OF WORSENING RENAL FUNCTION BEFORE PRESENTATION FOR ACUTE HEART FAILURE." Journal of the American College of Cardiology 79, no. 9 (2022): 371. http://dx.doi.org/10.1016/s0735-1097(22)01362-6.

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38

Elgendy, Islam Y., and Hani Jneid. "Worsening renal function after transcatheter aortic valve replacement: Infrequent but deleterious." Catheterization and Cardiovascular Interventions 98, no. 1 (2021): 195–96. http://dx.doi.org/10.1002/ccd.29811.

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39

Metra, Marco, and Carlo Lombardi. "Renin-Angiotensin System Blockade and Worsening Renal Function in Heart Failure." Journal of the American College of Cardiology 64, no. 11 (2014): 1114–16. http://dx.doi.org/10.1016/j.jacc.2014.04.080.

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40

Balko, Ryan, Christopher Scott, S. Jeson Sangaralingham, Richard Rodeheffer, and Horng Chen. "Predictors of Worsening Renal Function Over Time: A Population Based Study." Journal of Cardiac Failure 24, no. 8 (2018): S13. http://dx.doi.org/10.1016/j.cardfail.2018.07.040.

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41

Brunner-La Rocca, Hans-Peter, Christian Knackstedt, Luc Eurlings, et al. "Impact of worsening renal function related to medication in heart failure." European Journal of Heart Failure 17, no. 2 (2014): 159–68. http://dx.doi.org/10.1002/ejhf.210.

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42

Lazovic, Marko, Sonja Radenkovic, Dijana Stojanovic, et al. "Worsening of renal function in patients hospitalized with acutely decompensated heart failure." Vojnosanitetski pregled 75, no. 11 (2018): 1083–88. http://dx.doi.org/10.2298/vsp170226038l.

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Background/Aim. A predictor of a poor prognosis, renal dysfunction often manifests in patients with heart failure, and is associated with an increased mortality in these patients. The aim of the parent study was to determine risk factors associated with worsening renal function (WRF) in patients hospitalized for acutely decompensated heart failure. Methods. The study included 330 patients with acutely decompensated heart failure. Patients who developed WRF (n = 215, mean age 72.4 ? 9.8 years) were in the clinical group, and patients without WRF (n = 115, mean age 59.8 ? 11.7 years) were in the control group. Patients in the clinical group were observed according to: the age, gender, lipids, electrolytes, smoking, hypertension, and type of heart failure, with reduced or preserved left ventricle ejection fraction (HFrEF or HFpEF). We used logistic regression to calculate non-adjusted odds ratio (OR) and 95% confidence intervals for occurrence of WRF. Results. WRF was determined in 65.2% of patients with heart failure. Non-adjusted OR showed that there was a significant risk for development of WRF with age (OR = 4.3; p < 0.01), total cholesterol > 5.2 mmol/L (OR = 1.6; p < 0.05), hyponatremia < 135 mmol/L, (OR = 2.8; p < 0.01), smoking (OR = 3.9; p < 0.01), hypertension (OR = 2.0; p < 0.05), and with the presence of HFrEF (OR = 1.3; p < 0.01). Presence of HFpEF, hypokalemia, < 3.5 mmol/L, plasma triglycerides, > 1.7 mmol/L, and gender, did not have any significance for the development of renal damage. Conclusion. Patients? age, total cholesterol, hyponatremia, smoking, hypertension, and HFrEF were significant risk factors for worsening renal function in heart failure patients. Comparing predictive values, age could be the best prognostic tool for early identification of patients at risk for WRF.
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43

Mazimba, Sula, Peter McCullough, Mitchell Rosner, Eliany Mejia-Lopez, and Kenneth Bilchick. "CHANGES IN RENAL PERFUSION PRESSURE DURING HEMODYNAMICALLY GUIDED THERAPY IS ASSOCIATED WITH WORSENING RENAL FUNCTION." Journal of the American College of Cardiology 69, no. 11 (2017): 768. http://dx.doi.org/10.1016/s0735-1097(17)34157-8.

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44

Shirakabe, Akihiro, Noritake Hata, Nobuaki Kobayashi, et al. "Worsening renal function definition is insufficient for evaluating acute renal failure in acute heart failure." ESC Heart Failure 5, no. 3 (2018): 322–31. http://dx.doi.org/10.1002/ehf2.12264.

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45

Mostafa, Amir, Karim Said, Walid Ammar, Ahmed Elsayed Eltawil, and Magdy Abdelhamid. "New renal haemodynamic indices can predict worsening of renal function in acute decompensated heart failure." ESC Heart Failure 7, no. 5 (2020): 2581–88. http://dx.doi.org/10.1002/ehf2.12835.

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46

Harvey, R. Donald, Sagar Lonial, Priti Patel, Leanne McCulloch, Ruben Niesvizky, and Jonathan L. Kaufman. "Summary of treatment-emergent renal events from patients treated with single-agent carfilzomib from four phase II studies in relapsed and/or refractory multiple myeloma." Journal of Clinical Oncology 30, no. 15_suppl (2012): e18569-e18569. http://dx.doi.org/10.1200/jco.2012.30.15_suppl.e18569.

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e18569 Background: Patients (pts) with multiple myeloma (MM) are vulnerable to renal injury and impairment both from their disease and treatment-related adverse events (AEs). Carfilzomib (CFZ) is a selective proteasome inhibitor with proven efficacy in MM. Safety data have been compiled from over 700 pts who have received single-agent CFZ. All were pretreated and included individuals with varying degrees of renal function, including hemodialysis pts. Herein we present an analysis of the incidence and severity of CFZ treatment-emergent renal events from 526 pts in four phase 2 trials. Methods: Pts from the 003-A0, 003-A1, 004, and 005 trials were included in this analysis. In all studies, CFZ was dosed on Days 1, 2, 8, 9, 15, and 16 of a 28-day cycle (C). Doses were 20 mg/m2 in C1 for all studies escalating to 27 mg/m2 in C2 per individual protocol, except 005 (15 mg/m2 in C1, 20 mg/m2 in C2, and 27 mg/m2 in C3). Renal AEs—the incidence, frequency, and resolution of episodes of worsening renal function, defined minimally as a doubling of serum creatinine from baseline—and shifts in other laboratory parameters were tabulated and summarized based on NCI CTCAE v.3 criteria. Results: The majority of pts (71%) had renal dysfunction (CrCl <50 mL/min) at baseline. Overall, 87% experienced no significant worsening of renal function during the course of treatment. Transient worsening was reported in 31 pts (6%) with a median duration of 1.4 weeks and a median of 1.0 episode per patient; non-transient worsening was reported in 37 pts (7%) with 8 (2%) of those permanently discontinuing treatment due to a renal dysfunction AE. 38 patients (7.2%) experienced Grade 3/4 acute renal failure, of which 31 were Grade 3. The percentage of patients in 003-A0, 003-A1, and 004 whose creatinine levels shifted to Grade 3 or 4 from any lower grade was <5%. Results from 005 showed no major PK differences in pts with a wide range of renal function. Conclusions: Treatment-emergent renal events resulting in CFZ discontinuation were uncommon. Based on the findings from this cross trial analysis, CFZ dose and schedule need not be adjusted in pts with baseline renal dysfunction, including pts on hemodialysis.
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Koniari, Katerina, Marinos Nikolaou, Ioannis Paraskevaidis, and John Parissis. "Therapeutic Options for the Management of the Cardiorenal Syndrome." International Journal of Nephrology 2011 (2011): 1–10. http://dx.doi.org/10.4061/2011/194910.

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Patients with heart failure often present with impaired renal function, which is a predictor of poor outcome. The cardiorenal syndrome is the worsening of renal function, which is accelerated by worsening of heart failure or acute decompensated heart failure. Although it is a frequent clinical entity due to the improved survival of heart failure patients, still its pathophysiology is not well understood, and thus its therapeutic approach remains controversial and sometimes ineffective. Established therapeutic strategies, such as diuretics and inotropes, are often associated with resistance and limited clinical success. That leads to an increasing concern about novel options, such as the use of vasopressin antagonists, adenosine A1 receptor antagonists, and renal-protective dopamine. Initial clinical trials have shown quite encouraging results in some heart failure subpopulations but have failed to demonstrate a clear beneficial role of these agents. On the other hand, ultrafiltration appears to be a more promising therapeutic procedure that will improve volume regulation, while preserving renal and cardiac function. Further clinical studies are required in order to determine their net effect on renal function and potential cardiovascular outcomes. Until then, management of the cardiorenal syndrome remains quite empirical.
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Singh, Dhssraj, Kevin Shrestha, and Wai Hong Wilson Tang. "INSUFFICIENT NATRIURETIC RESPONSE TO FUROSEMIDE PREDICTS WORSENING RENAL FUNCTION IN ACUTE DECOMPENSATED HEART FAILURE INDEPENDENT OF BASELINE RENAL FUNCTION." Journal of the American College of Cardiology 57, no. 14 (2011): E217. http://dx.doi.org/10.1016/s0735-1097(11)60217-9.

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Hanna, Ramy M., Lama Abdelnour, Huma Hasnain, Umut Selamet, and Ira Kurtz. "Intravitreal bevacizumab-induced exacerbation of proteinuria in diabetic nephropathy, and amelioration by switching to ranibizumab." SAGE Open Medical Case Reports 8 (January 2020): 2050313X2090703. http://dx.doi.org/10.1177/2050313x20907033.

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Certain diabetic and hypertensive patients started on intravitreal vascular endothelial growth factor inhibition for diabetic retinopathy may experience worsening of hypertension and proteinuria. The etiology of this is the newly recognized absorption of intravitreally injected vascular endothelial growth factor inhibitors, and the susceptibility of patients with pre-existing renal disease to exacerbations depends on the degree of systemic absorption. There are eighteen reported cases of worsening hypertension, woresening proteinuria, worsening renal function, thrombotic microangiopathy, and glomerular disease noted after initiation of intravitreal vascular endothelial growth factor blockade. This nineteenth case demonstrates worsening hypertension and proteinuria with the start of bevacizumab. Both blood pressure and proteinuria parameters showed overall improvement with switching to the less absorbed and lower potency agent ranibizumab. There was a slight rise in serum creatinine after bevacizumab therapy, which stabilized at a new baseline, and the serum creatinine remained stable on ranibizumab. There were no other nephrotoxic exposures that explained the mild rise in serum creatinine. Because of improvement in renal function and proteinuria, a renal biopsy was deferred for the time. This case re-demonstrates the risk of worsening proteinuria with vascular endothelial growth factor inhibitors when given intravitreally in some patients. The demonstration of improvement in blood pressure and proteinuria with the use of lower potency agents like ranibizumab is novel and an important concept confirming observations from pharmacokinetic studies. The switch to ranibizumab offers a therapeutic option when proteinuria worsens with intravitreal vascular endothelial growth factor blockade, and the patient requires ongoing intravitreal therapy for treatment of diabetic retinopathy.
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Urban, Szymon, Mikołaj Błaziak, Maksym Jura, et al. "Machine Learning Approach to Understand Worsening Renal Function in Acute Heart Failure." Biomolecules 12, no. 11 (2022): 1616. http://dx.doi.org/10.3390/biom12111616.

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Acute heart failure (AHF) is a common and severe condition with a poor prognosis. Its course is often complicated by worsening renal function (WRF), exacerbating the outcome. The population of AHF patients experiencing WRF is heterogenous, and some novel possibilities for its analysis have recently emerged. Clustering is a machine learning (ML) technique that divides the population into distinct subgroups based on the similarity of cases (patients). Given that, we decided to use clustering to find subgroups inside the AHF population that differ in terms of WRF occurrence. We evaluated data from the three hundred and twelve AHF patients hospitalized in our institution who had creatinine assessed four times during hospitalization. Eighty-six variables evaluated at admission were included in the analysis. The k-medoids algorithm was used for clustering, and the quality of the procedure was judged by the Davies–Bouldin index. Three clinically and prognostically different clusters were distinguished. The groups had significantly (p = 0.004) different incidences of WRF. Inside the AHF population, we successfully discovered that three groups varied in renal prognosis. Our results provide novel insight into the AHF and WRF interplay and can be valuable for future trial construction and more tailored treatment.
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