Impact of Time-To-Treatment on Outcomes in Autoimmune Membranous Nephropathy.

Introduction: Despite new treatments, kidney dysfunction in autoimmune membranous nephropathy (aMN) remains challenging. Immunosuppression is initiated after "watchful-wait" to avoid side effects in patients who might achieve spontaneous remission; however, the impact of this approach on kidney function is unclear.

Methods: This was a retrospective longitudinal cohort study of patients with new consecutive aMN from 2003 to 2019 from 3 UK centers.

Interprofessional Clinician Perspectives on LVAD Deactivation Compared to Dialysis Discontinuation: A Cross-Sectional Study Using Vignettes.

Background: Requests for left ventricular assist device (LVAD) deactivation may pose unique emotional and moral burdens on clinicians.

Objectives: The authors aimed to explore the perspectives of interprofessional clinicians regarding LVAD deactivation across clinical settings compared to cessation of hemodialysis.

Methods: Vignette-based interviews were conducted with a sample of interprofessional clinicians at a heart and vascular center from April 14, 2023, to June 5, 2023.

Outcomes of Heart Failure Patients on Palliative Inotrope Therapy in the Hospice Setting: A Single Center Retrospective Cohort Study.

Chronic intravenous inotropic support (CIIS) is recommended as palliative therapy for end-stage heart failure (HF) but is underutilized in hospice settings. This study evaluates outcomes for patients on CIIS receiving hospice care. Retrospective cohort study using electronic health records of patients on CIIS admitted to hospice.

Post-Operative Pain Control Following LVAD Placement in a Patient with Prior History of Opioid Use Disorder: A Case Report.

For patients with an active or prior history of opioid use disorder (OUD), post-operative pain management following left ventricular assist device (LVAD) implantation can be challenging. It is imperative for an interdisciplinary team of specialists to collaborate to develop an individualized plan of care. Adopting multimodal analgesic strategies can minimize the risk of relapse and withdrawal.

A Retrospective Cohort Study of the Role of Palliative Care Consultation for Patients on Extracorporeal Membrane Oxygenation.

BackgroundExtracorporeal membrane oxygenation (ECMO) serves as a critical intervention for patients with severe cardiac and pulmonary dysfunction. Given the high rates of mortality and morbidity, as well as the impact on families, palliative care (PC) integration is recommended. We aimed to examine the indications and outcomes of ECMO patients at a tertiary care hospital and evaluate the impact of PC consultation on patient outcomes.

Cardiac Biomarkers Predict Major Adverse Cardiac Events (MACE) in Incident Haemodialysis Patients: Results from a Global Federated Database.

Despite its many advantages, haemodialysis (HD) has been shown to be associated with significant cardiovascular events, especially in patients commencing HD. Currently, there is no specific method to risk-stratify incident HD patients. Blood-based biomarkers provide insight into myocardial injury and stress.

Neutrophil-Lymphocyte Ratio and Urine Albumin-Creatinine Ratio As Indicators of Microvascular Complications in Type 2 Diabetes Mellitus: A Cross-Sectional Study.

Background Type 2 diabetes mellitus (T2DM) is associated with a high risk of developing microvascular complications such as diabetic nephropathy, diabetic neuropathy (DN), and diabetic retinopathy (DR), leading to significant morbidity. Early detection of these complications is crucial for improving patient outcomes. Neutrophil-lymphocyte ratio (NLR) and urine albumin-creatinine ratio (UACR) show promise as cost-effective and accessible biomarkers for the early detection of microvascular complications in T2DM.

Optimizing outcomes: Impact of palliative care consultation timing in the cardiovascular intensive care unit.

Background: ICU patients and their families experience significant stress due to illness severity and prognostic uncertainty, making palliative care (PC) integral for symptom management, family support, and end-of-life care goals. The impact of PC in the Cardiac Intensive Care Unit (CICU) remains unstudied.

Objective: We explore the impact of early palliative care consultation (PCC) on patient outcomes in the CICU, including mortality, length of stay, and family meeting frequency.

Routine cardiac biomarkers for the prediction of incident major adverse cardiac events in patients with glomerulonephritis: a real-world analysis using a global federated database.

Rationale & Objective: Glomerulonephritis (GN) is a leading cause of chronic kidney disease (CKD). Major adverse cardiovascular events (MACE) are prolific in CKD. The risk of MACE in GN cohorts is multifactorial.

Post-Transplant Cardiovascular Disease in Kidney Transplant Recipients: Incidence, Risk Factors, and Outcomes in the Era of Modern Immunosuppression.

: Post-transplant cardiovascular disease (PTCVD) poses a significant challenge in kidney transplantation, potentially impacting graft outcomes and patient survival. This retrospective study aimed to investigate the incidence, risk factors, and consequential impact of PTCVD in kidney transplant recipients (KTRs) devoid of pre-existing cardiovascular disease (CVD). : The cohort comprised 1114 KTRs, with 749 individuals included after excluding those with pre-existing CVD and early graft loss.

The current use of proteomics and metabolomics in glomerulonephritis: a systematic literature review.

Background: Glomerulonephritis inherently leads to the development of chronic kidney disease. It is the second most common diagnosis in patients requiring renal replacement therapy in the United Kingdom. Metabolomics and proteomics can characterise, identify and quantify an individual's protein and metabolite make-up.

The experiences among bereaved family members after a left ventricular assist device (LVAD) deactivation.

Background: The use of left ventricular assist devices (LVADs) is increasing with an estimated 2500 devices implanted each year. When burdens of the LVAD outweigh benefits, most individuals with LVADs will undergo deactivation in the hospital setting. While the decision to deactivate an LVAD is considered an ethical practice, little is known about the experience and needs of bereaved family members.

PLA2R Antibody Does Not Outperform Conventional Clinical Markers in Predicting Outcomes in Membranous Nephropathy.

Introduction: The prognostic value of PLA2R antibody (Ab) test in clinical practice remains unclear. We aimed to evaluate its ability in predicting hard outcomes in primary membranous nephropathy (PMN) after adjustments to conventional markers of disease activity.

Methods: A total of 222 patients diagnosed with PMN from January 2003 to July 2019 having had a serum PLA2R Ab test, were included from 3 centers in the north of England.

Determinants of Health and Outcomes in Medicare Recipients With Heart Disease: A Population Study.

Context: Heart disease (HD) is a primary cause of mortality and morbidity in the United States. While there is a growing body of evidence demonstrating the contribution of social determinants of health (SDoH) to HD outcomes, the impact of combined or individual SDoH on health-related quality of life (HRQoL) in patients with HD is not well understood.

Objectives: To analyze the National Health and Aging Trends Study (NHATS) to explore the relationship of SDoH with HRQoL, advance care planning, and treatment preferences in Medicare beneficiaries with HD.

Clinical Protocol for Left Ventricular Assist Device Deactivation at End of Life.

As patients live longer with left ventricular assist device (LVAD) support, many will either suffer an acute event or develop a gradual, progressive disease that results in a terminal prognosis. At the end-of-life, patients, and more often, their families, will be faced with the decision to deactivate the LVAD to allow natural death. The process of LVAD deactivation carries some distinct features that distinguish it from withdrawal of other forms of life-sustaining medical technology: multidisciplinary collaboration is paramount; prognosis after deactivation is short, typically minutes-hours; and premedication doses of symptom-focused medications are typically higher than other situations involving withdrawal of life-sustaining medical technologies given the precipitous decline in cardiac output following LVAD deactivation.

Clinical and histopathologic predictors of recurrent glomerulonephritis after kidney transplantation.

Introduction: We evaluated the long-term outcomes of recurrent glomerulonephritis (RGN) using clinical, histopathological, and demographic predictors.

Methods: A retrospective cohort study of kidney transplant recipients (KTR) in two renal centers between 2005 and 2020. Clinical and native kidney histological data were analyzed.

Benefits and Harms of Continuous Intravenous Inotropic Support as Palliative Therapy: A Single-Institution, Retrospective Analysis.

Use of continuous intravenous inotropic support (CIIS) strictly as palliative therapy for patients with ACC/AHA Stage D (end-stage) Heart Failure (HF) has increased significantly. The harms of CIIS therapy may detract from its benefits. To describe benefits (improvement in NYHA functional class) and harms (infection, hospitalization, days-spent-in-hospital) of CIIS as palliative therapy.