…and in patients with diabetes or renal failure the index may be falsely normal because of medial sclerosis — in that case add toe pressure measurement…

…inflammatory diseases (IMIDs) that include rheumatoid arthritis (RA), psoriatic arthritis, spondyloarthropathies, systemic lupus erythematosus (SLE), systemic sclerosis, vasculitides, mixed connective tissue disease, myositis, Sjögren syndrome…

…for example in pregnancy, acute glomerular disease or scleroderma renal crisis [1,2]. A hypertensive emergency means a markedly raised blood pressure together with ongoing…

…pressure in that leg ÷ highest arm pressure of the two arms Interpretation ABI Interpretation Action : : : 1.40 Incompressible vessels — medial sclerosis Measure the toe pressure…

…amputees, patients with hepatic cirrhosis — creatinine based eGFR substantially overestimates renal function. Staging of chronic kidney disease Stage eGFR Description : : : G1 ≥ 90 Normal or high…

…daily 1 g two to three times daily Pivmecillinam Dosed independently of renal function for a single course of treatment Trimethoprim 160 mg twice daily…

…the pulmonary embolism quick reference for risk stratification. Renal function eGFR (mL/min) Management : : 50 Standard dose, creatinine checked at least annually 30 50 Dose…

…causing afferent arteriolar vasoconstriction and reducing glomerular hyperfiltration. The cardiovascular and renal effects extend beyond glycaemic control. Proposed mechanisms include: Reduction in glomerular hypertension and…

…to sinus rhythm. Biomarkers and Laboratory Findings Renal function biomarkers are essential in the evaluation and ongoing management of patients on sotalol. Because the drug…

[calc_mdrd] The Modification of Diet in Renal Disease (MDRD) equation for estimating the Glomerular Filtration Rate (eGFR) is: eGFR = 175 × (Scr)^ 1…

…and pathophysiology Chronic kidney disease (CKD) is defined by abnormalities of renal structure or function that persist for more than 3 months and have health…

Cardiology Nephrology Definition and terminology Contrast associated acute kidney injury is an acute deterioration in renal function occurring after exposure to iodinated contrast media, particularly…

…kidney injury, AKI, is a syndrome of rapidly deteriorating renal function. Management is governed not by the creatinine value alone but by the course, urine…

…symptoms, the rate of rise, renal function and the clinical context , not by the potassium value alone. A normal ECG does not exclude dangerous hyperkalaemia…

…more stress, often corticosteroids, often impaired renal function. Prescribe basal insulin, mealtime insulin and the correction dose as three separate entries on the drug chart…

…together with the clinical picture, medication, fluid balance, renal function, electrolytes and supplemental oxygen [1]. Distinguish between: Acidaemia and alkalaemia , which describe the current pH…

…protocols. Children, pregnant women and patients with advanced renal failure, marked heart failure or circulatory shock require a specific protocol and early specialist involvement. DKA…

…normal renal and hepatic function, a non pregnant adult of normal weight, and individual assessment. See the separate quick reference for dosing in impaired renal…

…25–50 per cent and titrate. At a high dose, in old age or in renal failure, reduce it further. Starting doses in acute pain…

…often lacks abdominal pain and peritonism and instead presents as encephalopathy, renal failure or simply deterioration. The procedure itself is straightforward: ultrasound to find the…

…while maintaining or increasing kidney perfusion. Effects Dopamine 1 receptor agonists lower systemic blood pressure and increase renal perfusion. Time to onset of action 50…

…BLED score is an acronym that stands for: H ypertension A bnormal renal/liver function S troke B leeding history or predisposition L abile INR…

…of the HEMORR₂HAGES Score The acronym HEMORR₂HAGES represents the following parameters: H epatic or renal disease (1 point) E thanol abuse (1 point) M alignancy…

…age, sex, renal function, left ventricular ejection fraction) to provide a more personalized risk assessment. Key Variables in SYNTAX Score II Anatomical SYNTAX Score : Derived…

…abdominal aortic diameter exceeds 3 cm. Most AAAs are located below the renal arteries and are related to atherosclerotic disease. At least 90% of AAAs…

…field. Cardiac function is also dependent on circulatory, pulmonary, renal and neurohormonal factors. These factors, which influence cardiac function primarily by affecting ventricular function, include…

…thrombolysis regimens, renal function thresholds and the division of work between the ambulance service, the emergency department and the PCI laboratory may differ between Swedish…

…but organ damage or high risk. Treatment resistant hypertension. Suspected nocturnal hypertension or absent nocturnal dipping (diabetes, renal failure, sleep apnoea). Suspected hypotension: dizziness, syncope…

…Dose reduction in renal failure and in old age Amiodarone In severe haemodynamic compromise where the above cannot be used It also has a rhythm…

…150–250: add homocysteine or methylmalonic acid Folate 7 nmol/L Electrolytes and renal function See the renal parameters for the eGFR stages and albuminuria…

…or with continued glucose administration adapted to the cause. 8. Identify drugs, renal failure, alcohol, a missed meal, physical activity and any other precipitating factor…

…vasodilatation. D1 and D2 (dopamine receptors): activation of D1 and D2 in the kidneys and the splanchnic vascular bed leads to renal and mesenteric vasodilatation…

…reduction for incomplete cross tolerance. Indications Acute severe nociceptive pain where paracetamol and a COX inhibitor are not enough: fracture, renal colic, ischaemic pain, pancreatitis…

…the last dose, the renal function and the severity of the bleeding 7 Manage antiplatelet drugs according to their indication. Do not routinely stop aspirin…

…serum concentration. Alkalinisation increases renal elimination several fold and at the same time reduces the passage of salicylate into the central nervous system. Contact your…

…Indications Acute urinary retention. Chronic urinary retention with renal impairment or a large residual volume. A need for accurate measurement of urine output in a…

…event, where DOACs have proved inferior. Atrial fibrillation with marked renal failure or on dialysis, where DOACs lack documentation or have only weak evidence. Venous…

…g/dL in men or <12 g/dL in women (3 points) Severe Renal Disease: Estimated glomerular filtration rate (eGFR) <30 mL/min or dialysis…

…Catapress TTS 3 (0.3 mg/24hrs) Dosage in renal failure and renal replacement therapy: Dose as in normal renal function Adverse effects Excessive sedation…

…hours. Adverse effects Severe hypotension. Contraindications • Contraindicated in pregnancy, severe renal artery stenosis, severe hyperkalemia. • Avoid in acute heart failure and acute myocardial infarction. Enalaprilat…

…dose : 0.5 3.0 μg/kg/min + + + +++++ Low dose dopamine stimulates D1 receptors and induces vasodilation in coronary, renal, cerebral and mesenteric vessels…

…lactic acidosis). Fatal outcomes are rare. Renal failure increases risk of cyanide toxicity. Cyanide toxicity requires doses 2 μg/kg/minute. Use the lowest…

…after severe or prolonged ischaemia may be accompanied by rhabdomyolysis, with potential renal failure and increased mortality. Clinical presentation and symptoms Symptoms commonly develop rapidly…

…Plasma clearance is low, renal excretion is negligible, and doses do not require reduction in patients with renal disease; neither amiodarone nor desethylamiodarone is dialyzable…

…angiography and PCI, and is strongly influenced by the clinical setting, vascular access route, anticoagulation, renal function, age, comorbidity, and procedural complexity. Overall incidence and…

…dose and/or combine diuretic classes Diuretic resistance or end stage renal failure Consider renal replacement therapy Hypoperfusion with persistent organ injury Consider mechanical circulatory…

…alone is an entity in itself and may arise from non ischaemic cardiac conditions (such as myocarditis) or non cardiac conditions (such as renal failure)…

…hypertensive emergency, heart failure, and end stage renal disease, may produce elevated troponin concentrations. The probability of MI increases continuously as the absolute hs cTn…

…encephalopathy, acute heart failure, disseminated intravascular coagulation, and abrupt deterioration in renal function. By contrast, hypertensive urgency describes severe hypertension without clinical evidence of acute…

…The biologically active natriuretic peptides promote vasodilation, renal sodium and water excretion, and reduction of cardiac fibrosis through activation of the natriuretic peptide A receptor…

…undergoes extensive first pass hepatic metabolism through CYP3A4. Dose adjustment is required in severe hepatic or renal impairment, and clinically relevant interactions occur with CYP3A4…

…increased vascular stiffness, impaired coronary circulation, vascular calcification and myocardial fibrosis further accelerate cardiovascular and renal injury. Adipokine imbalance contributes to insulin resistance, β cell…

…treatment. Reported risks of myocardial infarction, stroke, end stage renal disease, and death may be two to six fold higher in affected adults. True, apparent…

…not universal, however. Delayed recognition may permit vascular remodelling and renal impairment to develop, leaving persistent hypertension despite correction of the initiating disorder. Earlier diagnosis…

…Marfan syndrome and Ehlers–Danlos syndrome. FMD may be clinically occult and can affect multiple vascular territories, including the renal, carotid, vertebral and coronary arteries…

…and outcome assessment. Predisposing factors Domain Factors associated with stent thrombosis Clinical Acute myocardial infarction, diabetes mellitus, renal failure, heart failure, hypercoagulability, prior brachytherapy Antiplatelet…

…older age, vascular disease and renal dysfunction. The commonly used CHA2DS2 VASc score incorporates the following variables: Risk factor Points Congestive heart failure 1 Hypertension…

…multiple QT prolonging medications, and drug accumulation secondary to renal or hepatic impairment or the inhibition of cytochrome P450 metabolism [1]. Nonmodifiable risk factors encompass…

…antidote is not available, it is essential to provide supportive care and maintain vital functions artificially until the substance undergoes renal elimination, hepatic elimination or…

…result in elevated cTnT levels. Although both troponin T and I may be chronically elevated in patients with renal failure, this is more pronounced for…