How to motivate nephrologists to think more "cardiac" and cardiologists to think more "renal"?
Kes, P.; Milicić, D.; Basić-Jukić, N.
Acta Medica Croatica Casopis Hravatske Akademije Medicinskih Znanosti 65(Suppl 3): 85-89
2011
ISSN/ISBN: 1330-0164 PMID: 23120822 Document Number: 654979
Cardiovascular diseases and cardiac complications are the major causes of death in patients with chronic kidney disease (CKD). Recently, even a modest degree of impaired kidney function (i.e. low estimated glomerular filtration rate or albuminuria) has been recognized as a powerful cardiovascular risk factor, with a predictive value comparable to that of the classical cardiovascular risk factors. The risk of acute myocardial infarction, angina pectoris, or pulmonary edema associated with left ventricular failure is as high as 10% per year, and the incidence of sudden cardiac death, congestive heart failure. ischemic heart disease, and complex ventricular arrhythmias has been reported to be 9%, 10%, 17% to 31%, and 18%, respectively. Recently, cardiology and nephrology experts proposed that evaluation of renal function should be part of the work-up of patients with cardiovascular disease. All patients with kidney disease should be screened for evidence of cardiovascular disease. Patients with CKD need to be managed from cardiological diseases like the other patients from general population (including percutaneous coronary interventions, and cardiovascular surgery procedures). Some risks of treatment, such as bleeding and technical complications, are certainly more frequent in renal patients, but, overall, cardiologists should treat renal patients with the same vigor as nonrenal patients. There is very important to exchange ideas and informations between cardiologists and nephrologists. It is time to make departmental barriers more permeable and to motivate cardiologists to think more renal' and nephrologists to think more "cardial".