{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T21:58:17Z","timestamp":1793656697594,"version":"4.5.1"},"reference-count":45,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2025,6,12]],"date-time":"2025-06-12T00:00:00Z","timestamp":1749686400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,7,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:p>Heart failure (HF) and chronic kidney disease (CKD) are closely interconnected conditions. Congestion, a central element in HF and CKD pathophysiology, progresses from haemodynamic changes to pulmonary oedema, with asymptomatic pulmonary congestion and an isolated increase in brain natriuretic peptide (BNP) as an intermediate step. Management strategies include sodium restriction, diuretics and emerging technologies for fluid monitoring. Diuretics, while essential, present challenges such as resistance and side effects, necessitating combination therapies and alternatives, like SGLT-2 inhibitors and, in special cases, ultrafiltration. Personalized approaches are critical to improving clinical outcomes in HF and CKD.<\/jats:p>","DOI":"10.1093\/ckj\/sfaf185","type":"journal-article","created":{"date-parts":[[2025,6,12]],"date-time":"2025-06-12T10:59:37Z","timestamp":1749725977000},"source":"Crossref","is-referenced-by-count":6,"title":["Decongestion in patients with advanced chronic kidney disease coexisting with heart failure"],"prefix":"10.1093","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6616-1996","authenticated-orcid":false,"given":"Carmine","family":"Zoccali","sequence":"first","affiliation":[{"name":"Renal Research Institute , New York, NY ,","place":["USA"]},{"name":"Institute of Molecular Biology and Genetics (Biogem) , Ariano Irpino ,","place":["Italy"]},{"name":"Associazione Ipertensione Nefrologia Trapianto Renal (IPNET) , c\/o Nefrologia, Grande Ospedale Metropolitano, Reggio Calabria ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adeera","family":"Levin","sequence":"additional","affiliation":[{"name":"University of British Columbia Division of Nephrology, Department of Medicine, , Vancouver, BC ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Mallamaci","sequence":"additional","affiliation":[{"name":"Associazione Ipertensione Nefrologia Trapianto Renal (IPNET) , c\/o Nefrologia, Grande Ospedale Metropolitano, Reggio Calabria ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Giugliano","sequence":"additional","affiliation":[{"name":"Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School , Boston, MA,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raffaele","family":"De Caterina","sequence":"additional","affiliation":[{"name":"Chair of Cardiology, University of Pisa and Cardiology Division, Pisa University Hospital , Pisa ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,6,12]]},"reference":[{"key":"2025091917410967500_bib1","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1007\/s10741-009-9148-8","article-title":"Why, when, and how to assess pulmonary congestion in heart failure: pathophysiological, clinical, and methodological implications","volume":"15","author":"Picano","year":"2010","journal-title":"Heart Fail Rev"},{"key":"2025091917410967500_bib2","doi-asserted-by":"publisher","first-page":"1503","DOI":"10.1111\/echo.13657","article-title":"The lung water cascade in heart failure","volume":"34","author":"Picano","year":"2017","journal-title":"Echocardiography"},{"key":"2025091917410967500_bib3","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1097\/00005382-198807000-00006","article-title":"New concepts about the pathophysiology of pulmonary edema","volume":"3","author":"Staub","year":"1988","journal-title":"J Thorac Imaging"},{"key":"2025091917410967500_bib4","doi-asserted-by":"crossref","first-page":"1244","DOI":"10.1093\/eurheartj\/ehv745","article-title":"Detection and prognostic value of pulmonary congestion by lung ultrasound in ambulatory heart failure patients","volume":"37","author":"Platz","year":"2016","journal-title":"Eur Heart J"},{"key":"2025091917410967500_bib5","doi-asserted-by":"crossref","first-page":"1372","DOI":"10.1681\/ASN.2017101102","article-title":"The ebb and flow of echocardiographic cardiac function parameters in relationship to hemodialysis treatment in patients with ESRD","volume":"29","author":"Loutradis","year":"2018","journal-title":"J Am Soc Nephrol"},{"key":"2025091917410967500_bib6","doi-asserted-by":"crossref","first-page":"2491","DOI":"10.1681\/ASN.2016121341","article-title":"Chronic fluid overload and mortality in ESRD","volume":"28","author":"Zoccali","year":"2017","journal-title":"J Am Soc Nephrol"},{"key":"2025091917410967500_bib7","doi-asserted-by":"crossref","first-page":"757","DOI":"10.2215\/CJN.14591121","article-title":"Detecting and treating lung congestion with kidney failure","volume":"17","author":"Zoccali","year":"2022","journal-title":"Clin J Am Soc Nephrol"},{"key":"2025091917410967500_bib8","first-page":"e009879","article-title":"Sodium restriction in patients with heart failure: a systematic review and meta-analysis of randomized clinical trials","volume":"16","author":"Colin-Ramirez","year":"2023","journal-title":"Circ Heart Fail"},{"key":"2025091917410967500_bib9","doi-asserted-by":"crossref","first-page":"730","DOI":"10.1002\/ejhf.3244","article-title":"Dietary sodium and fluid intake in heart failure. 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