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Renalism: Avoiding Procedure, More Harm than Good?

Radha K Adusumilli1, Steven Coca2

  • 1UTHSCSA, San Antonio, TX, USA.

Interventional Cardiology Clinics
|September 6, 2023
PubMed

Insights

Managing chronic kidney disease (CKD) is challenging due to its complex pathophysiology. Physicians fear worsening kidney function, hindering interventions that could improve outcomes for CKD patients, who face high cardiovascular disease risks.

Area of Science:

  • Nephrology
  • Cardiology
  • Internal Medicine

Background:

  • Chronic kidney disease (CKD) management presents significant pathophysiological complexities.
  • Cardiovascular disease (CVD) is a primary cause of mortality in CKD patients.
  • CKD patients are susceptible to acute kidney injury (AKI) and creatinine elevation.

Purpose of the Study:

  • To address the challenges in managing CKD patients.
  • To explore the impact of physician hesitancy on patient outcomes.
  • To identify barriers to providing essential interventions for CKD.

Main Methods:

  • Literature review on CKD pathophysiology and treatment.
  • Analysis of clinical guidelines and physician practices.
  • Case study review of interventions in CKD patients.

Main Results:

  • Physicians' fear of precipitating acute kidney injury (AKI) or worsening CKD (renalism) is a major barrier.
  • This fear prevents the delivery of interventions proven to reduce morbidity and mortality.
  • CKD patients face suboptimal care due to these management complexities.

Conclusions:

  • Overcoming the fear of renalism is crucial for effective CKD management.
  • Clinically indicated interventions should be prioritized despite potential risks.
  • Improved strategies are needed to enhance patient outcomes in chronic kidney disease.

Keywords:
Acute kidney injuryChronic kidney diseaseContrast-associated nephropathyRenalism

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