…failure across the ejection fraction spectrum, according to the guideline key points Patients with renal insufficiency and cardiovascular disease, irrespective of diabetes status The clearest…

…patients with hepatic cirrhosis — creatinine based eGFR substantially overestimates renal function. Staging of chronic kidney disease Stage eGFR Description : : : G1 ≥ 90 Normal or high G2…

…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…

…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…

…m² Abnormal urinalysis or renal imaging Mild progression risk, increased by proteinuria 3a 45–60 mL/min/1.73 m² Cardiovascular disease or other organ…

…Patient related risk factors The principal determinant of risk is baseline renal function. The risk is increased by: CKD, especially advanced CKD; diabetic kidney disease…

…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…

…3 IV Pneumonia, in chronic lung disease amoxicillin 750 mg × 3 PO 5–7 days or benzylpenicillin 3 g × 4 IV Pneumonia, suspected atypical pathogen…

…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 …

…Creatinine Clearance : Reduced renal function increases risk. Left Ventricular Ejection Fraction (LVEF) : Lower LVEF is associated with worse outcomes. Unprotected Left Main Disease : Increases complexity…

…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…

…abnormal 24 hour rhythm should prompt investigation for sleep apnoea, renal disease and secondary hypertension, and lead to one dose being moved to the evening…

…is titrated slowly. Caution in acute heart failure and in obstructive airways disease Verapamil or diltiazem When a beta blocker is contraindicated, for example in…

…a large change in TSH. During acute illness the TSH can be falsely low or high in the absence of thyroid disease; repeat it once…

…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…

…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…

…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…

…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…

…syndrome, particularly triple positive disease or after an arterial event, where DOACs have proved inferior. Atrial fibrillation with marked renal failure or on dialysis, where…

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

…induce severe hypotension. • Clonidine is not recommended in most patients with severe cardiovascular disease or in those who are otherwise haemodynamically unstable. The benefit of…

…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…

…recognition, specialist assessment and restoration of perfusion are essential. The abrupt arterial obstruction may result from progression of peripheral arterial disease, cardiac or aortic embolisation…

…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…

…risk factors The risk of adverse events is increased by: advanced age; diabetes mellitus; chronic kidney disease or renal failure; congestive heart failure; prior stroke…

…resistance or end stage renal failure Consider renal replacement therapy Hypoperfusion with persistent organ injury Consider mechanical circulatory support Refractory advanced disease Consider palliative care…

…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…

…age and are higher in patients with impaired renal function, reflecting both reduced clearance and the high prevalence of structural heart disease in this population…

…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…

…albumin/creatinine ratio reflects altered endothelial and renal pathophysiology in insulin resistance. Metabolic Dysfunction Associated Fatty Liver Disease Insulin resistance increases free fatty acid delivery…

…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…

…or renal disease The possibility of a secondary cause The medical and medication histories should specifically assess drugs or substances that may increase blood pressure…

…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…

…incomplete apposition, or persistent disease at the inflow or outflow edges. The contemporary incidence of stent thrombosis is approximately 1% during the first year after…

…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…

…to renal or hepatic impairment or the inhibition of cytochrome P450 metabolism [1]. Nonmodifiable risk factors encompass female sex, underlying genetic predisposition, structural heart disease…

…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…

…hypercalcemia. Less common causes are immobilization, sarcoidosis, thyrotoxicosis, familial hypocalciuric hypercalcemia, Addison's disease, renal failure, tamoxifen, lithium, thiazide diuretics, D vitamin and calcium overdose…

…scleroderma, and rheumatic fever. Aortic dissection rupturing into the pericardium. Idiopathic pericardial effusion. Renal failure, hypothyroidism, and hypercholesterolemia. Dressler syndrome. Iatrogenic damage to the pericardium…