Cardionephrology from the point of view of the cardiologist: no more agree to disagree—getting to ‘yes’ for every patient

Abstract

Whether one wants to or not, interactions between the heart and the kidneys will exist and manifest nevertheless. Both from theoretical and clinical perspectives, it seems pretty justified the need for a subspecialty of cardio-nephrology. Our editorial is a cardiologist perspective on the paper of Diez and Ortiz published in the CKJ, related to the “Need for a cardio-nephrology subspecialty.” We analyze the historical similarities of the emergence of already ingrained clinical fields with the current needs in the cardio-nephrology sector. We motivate our approach based on novel cardiovascular diagnostic and therapeutic developments and significant pathophysiological differences from a cardiological perspective, accounting for the foundation of a novel sustainable medical field. One of the sensitive issues we also addressed was the operationality and applicability of the principles. We answered with some examples from high-risk debatable contexts to the question of where a cardio-nephrologist should be integrated. Clarifying the operationality aspects would be a positive shift towards improving Guidelines adherence in managing complex patients. In conclusion, we underline that the necessity of a cardio-nephrologist must be addressed from the operational and scientific perspective with the ultimate goal to reduce mortality and complications in cardio-renal patients.

Practical requirements for the development of an advanced cardiorenal unit

“…This necessitates training in heart and kidney disease and the creation of specific units to treat affected patients in a more complete and comprehensive manner. Multidisciplinary units, comprising mainly cardiologists and nephrologists, could fulfill an unmet medical need, with a considerable impact on healthcare [23][24][25][26][27].…”

Oncocardiology: close collaboration between oncologists, cardiologists, and nephrologists

“…Nephrologists and cardiologists collaborate to make treatment decisions for patients with kidney and heart conditions. They discuss various treatment options' potential risks and benefits, considering the patient's health and circumstances (4). Nephrologists and cardiologists work together to monitor patients undergoing cancer treatment for any signs of cardiac toxicity or kidney dysfunction.…”

Cardiovascular changes in young renal failure patients

“…Consequently, there is an increasing claim of the need for a cardionephrology subspecialty, which is also supported by the fact that partly conflicting pharmaceutical and clinical considerations are existed in the prevention of cardiovascular complications in chronic kidney disease patients [ 12 ]. Burlacu et al underline the importance of good cooperation between cardiologist and nephrologist for the best of each patient, to more agree to disagree [ 13 ].…”