{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T03:48:58Z","timestamp":1790740138312,"version":"4.1.0"},"reference-count":110,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2021,4,9]],"date-time":"2021-04-09T00:00:00Z","timestamp":1617926400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000057","name":"National Institute of General Medical Sciences","doi-asserted-by":"publisher","award":["K23 GM140268"],"award-info":[{"award-number":["K23 GM140268"]}],"id":[{"id":"10.13039\/100000057","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000057","name":"National Institute of General Medical Sciences","doi-asserted-by":"publisher","award":["P50 GM-111152"],"award-info":[{"award-number":["P50 GM-111152"]}],"id":[{"id":"10.13039\/100000057","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000057","name":"National Institute of General Medical Sciences","doi-asserted-by":"publisher","award":["R01 GM110240"],"award-info":[{"award-number":["R01 GM110240"]}],"id":[{"id":"10.13039\/100000057","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["UL1TR001427"],"award-info":[{"award-number":["UL1TR001427"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>With advances in critical care, patients who would have succumbed in previous eras now survive through hospital discharge. Many survivors suffer from chronic organ dysfunction and induced frailty, representing an emerging chronic critical illness (CCI) phenotype. Persistent and worsening cardiovascular and renal disease are primary drivers of the CCI phenotype and have pathophysiologic synergy, potentiating one another and generating a downward spiral of worsening disease and clinical outcomes manifest as cardio-renal syndromes. In addition to pharmacologic therapies (e.g., diuretics, beta adrenergic receptor blockers, angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, and blood pressure control), special consideration should be given to behavioral modifications that avoid the pitfalls of polypharmacy and suboptimal renal and hepatic dosing, to which CCI patients may be particularly vulnerable. Smoking cessation, dietary modifications (e.g., early high-protein nutrition and late low-sodium diets), and increased physical activity are advised. Select patients benefit from cardiac re-synchronization therapy or renal replacement therapy. Coordinated, patient-centered care bundles may improve compliance with standards of care and patient outcomes. Given the complex, heterogeneous nature of cardiovascular and renal disease in CCI and the dismal long-term outcomes, further research is needed to clarify pathophysiologic mechanisms of cardio-renal syndromes in CCI and develop targeted therapies.<\/jats:p>","DOI":"10.3390\/jcm10081601","type":"journal-article","created":{"date-parts":[[2021,4,12]],"date-time":"2021-04-12T03:04:06Z","timestamp":1618196646000},"page":"1601","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Cardiovascular and Renal Disease in Chronic Critical Illness"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5354-443X","authenticated-orcid":false,"given":"Tyler J.","family":"Loftus","sequence":"first","affiliation":[{"name":"Department of Surgery, University of Florida Health, Gainesville, FL 32603, USA"},{"name":"Precision and Intelligent Systems in Medicine (PrismaP), College of Medicine, University of Florida, Gainesville, FL 32611, USA"},{"name":"Sepsis and Critical Illness Research Center, University of Florida Health, Gainesville, FL 32610, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda C.","family":"Filiberto","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Florida Health, Gainesville, FL 32603, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tezcan","family":"Ozrazgat-Baslanti","sequence":"additional","affiliation":[{"name":"Precision and Intelligent Systems in Medicine (PrismaP), College of Medicine, University of Florida, Gainesville, FL 32611, USA"},{"name":"Sepsis and Critical Illness Research Center, University of Florida Health, Gainesville, FL 32610, USA"},{"name":"Department of Medicine, University of Florida Health, Gainesville, FL 32603, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saraswathi","family":"Gopal","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Florida Health, Gainesville, FL 32603, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5745-2863","authenticated-orcid":false,"given":"Azra","family":"Bihorac","sequence":"additional","affiliation":[{"name":"Precision and Intelligent Systems in Medicine (PrismaP), College of Medicine, University of Florida, Gainesville, FL 32611, USA"},{"name":"Sepsis and Critical Illness Research Center, University of Florida Health, Gainesville, FL 32610, USA"},{"name":"Department of Medicine, University of Florida Health, Gainesville, FL 32603, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,4,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"R81","DOI":"10.1186\/cc12695","article-title":"Changes in hospital mortality for United States intensive care unit admissions from 1988 to 2012","volume":"17","author":"Zimmerman","year":"2013","journal-title":"Crit. Care"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1546","DOI":"10.1056\/NEJMoa022139","article-title":"The epidemiology of sepsis in the United States from 1979 through 2000","volume":"348","author":"Martin","year":"2003","journal-title":"N. Engl. J. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1097\/01.CCM.0000295313.08084.58","article-title":"Mortality and length-of-stay outcomes, 1993\u20132003, in the binational Australian and New Zealand intensive care adult patient database","volume":"36","author":"Moran","year":"2008","journal-title":"Crit. Care Med."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Hutchings, A., Durand, M.A., Grieve, R., Harrison, D., Rowan, K., Green, J., Cairns, J., and Black, N. (2009). Evaluation of modernisation of adult critical care services in England: Time series and cost effectiveness analysis. BMJ Brit. Med. J., 339.","DOI":"10.1136\/bmj.b4353"},{"key":"ref_5","first-page":"339","article-title":"The chronically critically ill: To save or let die?","volume":"30","author":"Girard","year":"1985","journal-title":"Respir Care"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1097\/CCM.0000000000000710","article-title":"The epidemiology of chronic critical illness in the United States","volume":"43","author":"Kahn","year":"2015","journal-title":"Crit. Care Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"A449","DOI":"10.1186\/2197-425X-3-S1-A449","article-title":"Risk factors for death in chronic critical illness","volume":"3","author":"Lokhandwala","year":"2015","journal-title":"Intensive Care Med. Exp."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1038\/nrneph.2017.2","article-title":"Acute kidney disease and renal recovery: Consensus report of the Acute Disease Quality Initiative (ADQI) 16 Workgroup","volume":"13","author":"Chawla","year":"2017","journal-title":"Nat. Rev. Nephrol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1056\/NEJMra1214243","article-title":"Acute Kidney Injury and Chronic Kidney Disease as Interconnected Syndromes","volume":"371","author":"Chawla","year":"2014","journal-title":"N. Engl. J. Med."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Chronic Kidney Disease Prognosis Consortium, Matsushita, K., van der Velde, M., Astor, B.C., Woodward, M., Levey, A.S., de Jong, P.E., Coresh, J., and Gansevoort, R.T. (2010). Association of estimated glomerular filtration rate and albuminuria with all-cause and cardiovascular mortality in general population cohorts: A collaborative meta-analysis. Lancet, 375, 2073\u20132081.","DOI":"10.1016\/S0140-6736(10)60674-5"},{"key":"ref_11","first-page":"713","article-title":"Cardiovascular disease in patients with chronic kidney disease","volume":"5","author":"Wright","year":"2009","journal-title":"Vasc. Health Risk Manag."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1038\/nrneph.2013.250","article-title":"Cardiorenal syndrome--current understanding and future perspectives","volume":"10","author":"Braam","year":"2014","journal-title":"Nat. Rev. Nephrol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"703","DOI":"10.1093\/eurheartj\/ehp507","article-title":"Cardio-renal syndromes: Report from the consensus conference of the acute dialysis quality initiative","volume":"31","author":"Ronco","year":"2010","journal-title":"Eur. Heart J."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1511","DOI":"10.3389\/fimmu.2018.01511","article-title":"Chronic Critical Illness and the Persistent Inflammation, Immunosuppression, and Catabolism Syndrome","volume":"9","author":"Hawkins","year":"2018","journal-title":"Front. Immunol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1002\/ncp.10024","article-title":"Chronic Critical Illness: Application of What We Know","volume":"33","author":"Rosenthal","year":"2018","journal-title":"Nutr. Clin. Pr."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"566","DOI":"10.1016\/S2213-2600(16)30098-4","article-title":"Timing of onset and burden of persistent critical illness in Australia and New Zealand: A retrospective, population-based, observational study","volume":"4","author":"Iwashyna","year":"2016","journal-title":"Lancet Respir. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1989","DOI":"10.1097\/CCM.0000000000002697","article-title":"The Epidemiology of Chronic Critical Illness after Severe Traumatic Injury at Two Level-One Trauma Centers*","volume":"45","author":"Mira","year":"2017","journal-title":"Crit. Care Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1097\/TA.0000000000001758","article-title":"Benchmarking clinical outcomes and the immunocatabolic phenotype of chronic critical illness after sepsis in surgical intensive care unit patients","volume":"84","author":"Stortz","year":"2018","journal-title":"J. Trauma Acute Care Surg."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1993","DOI":"10.1001\/archinte.166.18.1993","article-title":"Brain dysfunction\u2013Another burden for the chronically critically ill","volume":"166","author":"Nelson","year":"2006","journal-title":"Arch. Intern. Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"R9","DOI":"10.1186\/cc5667","article-title":"Differences in one-year health outcomes and resource utilization by definition of prolonged mechanical ventilation: A prospective cohort study","volume":"11","author":"Cox","year":"2007","journal-title":"Crit. Care"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1161\/CIR.0b013e318282ab8f","article-title":"Executive summary: Heart disease and stroke statistics--2013 update: A report from the American Heart Association","volume":"127","author":"Go","year":"2013","journal-title":"Circulation"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"2089","DOI":"10.1111\/j.1523-1755.2005.00365.x","article-title":"Definition and classification of chronic kidney disease: A position statement from Kidney Disease: Improving Global Outcomes (KDIGO)","volume":"67","author":"Levey","year":"2005","journal-title":"Kidney Int."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1038\/ki.2013.153","article-title":"Raising awareness of acute kidney injury: A global perspective of a silent killer","volume":"84","author":"Lewington","year":"2013","journal-title":"Kidney Int."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1411","DOI":"10.1007\/s00134-015-3934-7","article-title":"Epidemiology of acute kidney injury in critically ill patients: The multinational AKI-EPI study","volume":"41","author":"Hoste","year":"2015","journal-title":"Intensive Care Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1038\/ki.2012.427","article-title":"Acute kidney injury: Global health alert","volume":"83","author":"Li","year":"2013","journal-title":"Kidney Int."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1681\/ASN.2007080837","article-title":"Acute Kidney Injury Increases Risk of ESRD among Elderly","volume":"20","author":"Ishani","year":"2009","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1001\/jama.294.7.813","article-title":"Acute renal failure in critically ill patients\u2014A multinational, multicenter study","volume":"294","author":"Uchino","year":"2005","journal-title":"JAMA-J. Am. Med. Assoc."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Ozrazgat-Baslanti, T., Loftus, T.J., Mohandas, R., Wu, Q., Brakenridge, S., Brumback, B., Efron, P.A., Anton, S., Moore, F.A., and Moldawer, L.L. (2020). Clinical Trajectories of Acute Kidney Injury in Surgical Sepsis: A Prospective Observational Study. Ann. Surg.","DOI":"10.1097\/SLA.0000000000004360"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1341","DOI":"10.1038\/ki.2010.536","article-title":"Lower estimated glomerular filtration rate and higher albuminuria are associated with all-cause and cardiovascular mortality. A collaborative meta-analysis of high-risk population cohorts","volume":"79","author":"Matsushita","year":"2011","journal-title":"Kidney Int."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1016\/S0140-6736(13)60595-4","article-title":"Chronic kidney disease and cardiovascular risk: Epidemiology, mechanisms, and prevention","volume":"382","author":"Gansevoort","year":"2013","journal-title":"Lancet"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"492","DOI":"10.1016\/j.ahj.2005.03.055","article-title":"Kidney function and anemia as risk factors for coronary heart disease and mortality: The Atherosclerosis Risk in Communities (ARIC) Study","volume":"151","author":"Astor","year":"2006","journal-title":"Am. Heart J."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1307","DOI":"10.1681\/ASN.2006101159","article-title":"Reduced kidney function as a risk factor for incident heart failure: The Atherosclerosis Risk in Communities (ARIC) study","volume":"18","author":"Kottgen","year":"2007","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"U2946","DOI":"10.1161\/CIRCULATIONAHA.111.020982","article-title":"Chronic Kidney Disease Is Associated With the Incidence of Atrial Fibrillation The Atherosclerosis Risk in Communities (ARIC) Study","volume":"123","author":"Alonso","year":"2011","journal-title":"Circulation"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"610","DOI":"10.1046\/j.1523-1755.2003.00109.x","article-title":"Chronic kidney disease, anemia, and incident stroke in a middle-aged, community-based population: The ARIC Study","volume":"64","author":"Abramson","year":"2003","journal-title":"Kidney Int."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1681\/ASN.2005111204","article-title":"Kidney function and risk of peripheral arterial disease: Results from the Atherosclerosis Risk in Communities (ARIC) Study","volume":"18","author":"Wattanakit","year":"2007","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1038\/ki.2010.531","article-title":"Lower estimated GFR and higher albuminuria are associated with adverse kidney outcomes. A collaborative meta-analysis of general and high-risk population cohorts","volume":"80","author":"Gansevoort","year":"2011","journal-title":"Kidney Int."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1001\/archinte.164.6.659","article-title":"Longitudinal follow-up and outcomes among a population with chronic kidney disease in a large managed care organization","volume":"164","author":"Keith","year":"2004","journal-title":"Arch. Intern. Med."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1016\/S0272-6386(96)90357-1","article-title":"Prevalent left ventricular hypertrophy in the predialysis population: Identifying opportunities for intervention","volume":"27","author":"Levin","year":"1996","journal-title":"Am. J. Kidney Dis."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"S24","DOI":"10.1053\/ajkd.2000.19928","article-title":"Cardiovascular disease in chronic renal insufficiency","volume":"36","author":"Levin","year":"2000","journal-title":"Am. J. Kidney Dis."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1161\/CIRCULATIONAHA.106.678342","article-title":"Chronic kidney disease: Effects on the cardiovascular system","volume":"116","author":"Schiffrin","year":"2007","journal-title":"Circulation"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"592","DOI":"10.1161\/01.HYP.0000159190.71253.c3","article-title":"Stiffness of capacitive and conduit arteries: Prognostic significance for end-stage renal disease patients","volume":"45","author":"Pannier","year":"2005","journal-title":"Hypertension"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1038\/ki.2009.200","article-title":"Changes in adiponectin and the risk of sudden death, stroke, myocardial infarction, and mortality in hemodialysis patients","volume":"76","author":"Drechsler","year":"2009","journal-title":"Kidney Int."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"921","DOI":"10.1053\/j.ajkd.2011.02.376","article-title":"Sudden cardiac death in hemodialysis patients: An in-depth review","volume":"57","author":"Green","year":"2011","journal-title":"Am. J. Kidney Dis."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1038\/nrneph.2011.62","article-title":"Statins, inflammation and kidney disease","volume":"7","author":"Krane","year":"2011","journal-title":"Nat. Rev. Nephrol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"801","DOI":"10.1001\/jama.2016.0287","article-title":"The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)","volume":"315","author":"Singer","year":"2016","journal-title":"JAMA"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1303","DOI":"10.1097\/00003246-200107000-00002","article-title":"Epidemiology of severe sepsis in the United States: Analysis of incidence, outcome, and associated costs of care","volume":"29","author":"Angus","year":"2001","journal-title":"Crit. Care Med."},{"key":"ref_47","unstructured":"Torio, C.M., and Andrews, R.M. (2006). National Inpatient Hospital Costs: The Most Expensive Conditions by Payer, 2011: Statistical Brief #160, Healthcare Cost and Utilization Project (HCUP) Statistical Briefs."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"k4891","DOI":"10.1136\/bmj.k4891","article-title":"Sepsis associated acute kidney injury","volume":"364","author":"Poston","year":"2019","journal-title":"BMJ"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"816","DOI":"10.1007\/s00134-017-4755-7","article-title":"Acute kidney injury in sepsis","volume":"43","author":"Bellomo","year":"2017","journal-title":"Intensive Care Med."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"432","DOI":"10.1097\/TA.0b013e31829de6cd","article-title":"Acute kidney injury is surprisingly common and a powerful predictor of mortality in surgical sepsis","volume":"75","author":"White","year":"2013","journal-title":"J. Trauma Acute Care Surg."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1016\/j.jss.2010.11.923","article-title":"Surgical sepsis and organ crosstalk: The role of the kidney","volume":"167","author":"White","year":"2011","journal-title":"J. Surg. Res"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"2570","DOI":"10.1097\/CCM.0b013e31829860fc","article-title":"National surgical quality improvement program underestimates the risk associated with mild and moderate postoperative acute kidney injury","volume":"41","author":"Bihorac","year":"2013","journal-title":"Crit. Care Med."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1207","DOI":"10.1097\/SLA.0000000000000732","article-title":"Cost and Mortality Associated With Postoperative Acute Kidney Injury","volume":"261","author":"Hobson","year":"2015","journal-title":"Ann. Surg."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1055","DOI":"10.1378\/chest.113.4.1055","article-title":"Serum cardiac troponin T as a prognostic marker in early sepsis","volume":"113","author":"Spies","year":"1998","journal-title":"Chest"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1775","DOI":"10.1097\/00003246-199909000-00012","article-title":"Myocardial cell injury in septic shock","volume":"27","author":"Turner","year":"1999","journal-title":"Crit. Care Med."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1007\/s001340050008","article-title":"Myocardial necrosis in ICU patients with acute non-cardiac disease: A prospective study","volume":"26","author":"Arlati","year":"2000","journal-title":"Intensive Care Med."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1016\/j.ijcard.2003.02.005","article-title":"Cardiac troponin I predicts myocardial dysfunction and adverse outcome in septic shock","volume":"95","author":"Mehta","year":"2004","journal-title":"Int. J. Cardiol."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"2004","DOI":"10.1016\/S0735-1097(03)00421-2","article-title":"Troponin as a risk factor for mortality in critically ill patients without acute coronary syndromes","volume":"41","author":"Ammann","year":"2003","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"M146","DOI":"10.1093\/gerona\/56.3.M146","article-title":"Frailty in older adults: Evidence for a phenotype","volume":"56","author":"Fried","year":"2001","journal-title":"J. Gerontol. A Biol. Sci. Med. Sci."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"1497","DOI":"10.1097\/CCM.0000000000003970","article-title":"Impact of Critical Illness on Resource Utilization: A Comparison of Use in the Year Before and After ICU Admission","volume":"47","author":"Hirshberg","year":"2019","journal-title":"Crit. Care Med."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1016\/j.ccc.2016.12.001","article-title":"Persistent Inflammation, Immunosuppression and Catabolism Syndrome","volume":"33","author":"Mira","year":"2017","journal-title":"Crit. Care Clin."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1164\/rccm.201512-2344OC","article-title":"Mechanisms of Chronic Muscle Wasting and Dysfunction after an Intensive Care Unit Stay","volume":"194","author":"Hussain","year":"2016","journal-title":"Am. J. Respir. Crit. Care"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"A75-A75","DOI":"10.1136\/thoraxjnl-2014-206260.147","article-title":"Tumour Necrosis Factor Receptor 1 Shedding Is Related to Acute Skeletal Muscle Wasting in Critical Illness","volume":"69","author":"Puthucheary","year":"2014","journal-title":"Thorax"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"1591","DOI":"10.1001\/jama.2013.278481","article-title":"Acute Skeletal Muscle Wasting in Critical Illness","volume":"310","author":"Puthucheary","year":"2013","journal-title":"JAMA J. Am. Med. Assoc."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"1491","DOI":"10.1097\/TA.0b013e318256e000","article-title":"Persistent inflammation and immunosuppression: A common syndrome and new horizon for surgical intensive care","volume":"72","author":"Gentile","year":"2012","journal-title":"J. Trauma. Acute. Care Surg."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1111\/j.1365-2796.2009.02204.x","article-title":"Relation between renal function, presentation, use of therapies and in-hospital complications in acute coronary syndrome: Data from the SWEDEHEART register","volume":"268","author":"Szummer","year":"2010","journal-title":"J. Intern. Med."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"938","DOI":"10.1038\/sj.ki.5002159","article-title":"Clinical presentation of myocardial infarction contributes to lower use of coronary angiography in patients with chronic kidney disease","volume":"71","author":"Charytan","year":"2007","journal-title":"Kidney Int."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"2941","DOI":"10.1161\/01.CIR.0000041254.30637.34","article-title":"Predictive value of cardiac troponin I and T for subsequent death in end-stage renal disease","volume":"106","author":"Apple","year":"2002","journal-title":"Circulation"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"1787","DOI":"10.1001\/jama.2017.16326","article-title":"Derivation and External Validation of Prediction Models for Advanced Chronic Kidney Disease Following Acute Kidney Injury","volume":"318","author":"James","year":"2017","journal-title":"JAMA"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"i2416","DOI":"10.1136\/bmj.i2416","article-title":"Prediction models for cardiovascular disease risk in the general population: Systematic review","volume":"353","author":"Damen","year":"2016","journal-title":"BMJ"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1146\/annurev-publhealth-031914-122747","article-title":"Uses of electronic health records for public health surveillance to advance public health","volume":"36","author":"Birkhead","year":"2015","journal-title":"Annu. Rev. Public Health"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"1142","DOI":"10.1093\/jamia\/ocx080","article-title":"Electronic health record adoption in US hospitals: The emergence of a digital \u201cadvanced use\u201d divide","volume":"24","author":"Holmgren","year":"2017","journal-title":"J. Am. Med. Inf. Assoc."},{"key":"ref_73","unstructured":"(2019, February 23). Stanford Medicine 2017 Health Trends Report: Harnessing the Power of Data in Health. Available online: http:\/\/med.stanford.edu\/content\/dam\/sm\/sm-news\/documents\/StanfordMedicineHealthTrendsWhitePaper2017.pdf."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1002\/bjs5.50232","article-title":"Cardiovascular death and progression to end-stage renal disease after major surgery in elderly patients","volume":"4","author":"Lysak","year":"2020","journal-title":"BJS Open"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"2072","DOI":"10.1046\/j.1523-1755.2000.00056.x","article-title":"Tobacco, hypertension, and vascular disease: Risk factors for renal functional decline in an older population","volume":"57","author":"Bleyer","year":"2000","journal-title":"Kidney Int."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"1244","DOI":"10.1016\/S0140-6736(11)60749-6","article-title":"Minimum amount of physical activity for reduced mortality and extended life expectancy: A prospective cohort study","volume":"378","author":"Wen","year":"2011","journal-title":"Lancet"},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"690","DOI":"10.1053\/j.ajkd.2004.12.013","article-title":"Association of physical activity with mortality in the US dialysis population","volume":"45","author":"Stack","year":"2005","journal-title":"Am. J. Kidney Dis."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1093\/aje\/kwp442","article-title":"Physical activity and albuminuria","volume":"171","author":"Robinson","year":"2010","journal-title":"Am. J. Epidemiol."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1186\/s13054-014-0591-0","article-title":"Proteins and amino acids are fundamental to optimal nutrition support in critically ill patients","volume":"18","author":"Weijs","year":"2014","journal-title":"Crit. Care"},{"key":"ref_80","doi-asserted-by":"crossref","unstructured":"Weijs, P.J.M., Looijaard, W.G.P.M., Beishuizen, A., Girbes, A.R.J., and Oudemans-van Straaten, H.M. (2014). Early high protein intake is associated with low mortality and energy overfeeding with high mortality in non-septic mechanically ventilated critically ill patients. Crit. Care, 18.","DOI":"10.1186\/s13054-014-0701-z"},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1016\/j.clnu.2011.12.006","article-title":"Provision of protein and energy in relation to measured requirements in intensive care patients","volume":"31","author":"Allingstrup","year":"2012","journal-title":"Clin. Nutr."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1097\/CCM.0000000000002083","article-title":"Greater Protein and Energy Intake May Be Associated With Improved Mortality in Higher Risk Critically Ill Patients: A Multicenter, Multinational Observational Study","volume":"45","author":"Compher","year":"2017","journal-title":"Crit. Care Med."},{"key":"ref_83","doi-asserted-by":"crossref","unstructured":"Heyland, D.K., Dhaliwal, R., Jiang, X.R., and Day, A.G. (2011). Identifying critically ill patients who benefit the most from nutrition therapy: The development and initial validation of a novel risk assessment tool. Crit. Care, 15.","DOI":"10.1186\/cc10546"},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"1895","DOI":"10.1016\/S0140-6736(04)16360-5","article-title":"Support of the metabolic response to burn injury","volume":"363","author":"Herndon","year":"2004","journal-title":"Lancet"},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1016\/S0272-6386(12)80313-1","article-title":"The Modification of Diet in Renal-Disease Study\u2013Design, Methods, and Results from the Feasibility Study","volume":"20","author":"Striker","year":"1992","journal-title":"Am. J. Kidney Dis."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"1213","DOI":"10.1681\/ASN.2007090970","article-title":"Role of remission clinics in the longitudinal treatment of CKD","volume":"19","author":"Ruggenenti","year":"2008","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"1493","DOI":"10.1093\/eurheartj\/ehr017","article-title":"Albuminuria and blood pressure, independent targets for cardioprotective therapy in patients with diabetes and nephropathy: A post hoc analysis of the combined RENAAL and IDNT trials","volume":"32","author":"Holtkamp","year":"2011","journal-title":"Eur. Heart J."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"73","DOI":"10.7326\/0003-4819-135-2-200107170-00007","article-title":"Angiotensin-converting enzyme inhibitors and progression of nondiabetic renal disease. A meta-analysis of patient-level data","volume":"135","author":"Jafar","year":"2001","journal-title":"Ann. Intern. Med."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1053\/j.ackd.2011.06.005","article-title":"CKD treatment: Time to alter the focus to albuminuria?","volume":"18","author":"Parekh","year":"2011","journal-title":"Adv. Chronic Kidney Dis."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"918","DOI":"10.1056\/NEJMoa0910975","article-title":"Intensive blood-pressure control in hypertensive chronic kidney disease","volume":"363","author":"Appel","year":"2010","journal-title":"N. Engl. J. Med."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"771","DOI":"10.1038\/sj.ki.5001514","article-title":"Survival predictability of time-varying indicators of bone disease in maintenance hemodialysis patients","volume":"70","author":"Kuwae","year":"2006","journal-title":"Kidney Int."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"2208","DOI":"10.1097\/01.ASN.0000133041.27682.A2","article-title":"Mineral metabolism, mortality, and morbidity in maintenance hemodialysis","volume":"15","author":"Block","year":"2004","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1159\/000078700","article-title":"Impact of serum parathyroid hormone concentration and its regulatory factors on arterial stiffness in patients undergoing maintenance hemodialysis","volume":"22","author":"Suzuki","year":"2004","journal-title":"Blood Purif."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"2482","DOI":"10.1056\/NEJMoa1205624","article-title":"Effect of cinacalcet on cardiovascular disease in patients undergoing dialysis","volume":"367","author":"Investigators","year":"2012","journal-title":"N. Engl. J. Med."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"e137","DOI":"10.1161\/CIR.0000000000000509","article-title":"2017 ACC\/AHA\/HFSA Focused Update of the 2013 ACCF\/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology\/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America","volume":"136","author":"Yancy","year":"2017","journal-title":"Circulation"},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"2129","DOI":"10.1093\/eurheartj\/ehw128","article-title":"2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC)Developed with the special contribution of the Heart Failure Association (HFA) of the ESC","volume":"37","author":"Ponikowski","year":"2016","journal-title":"Eur. Heart J."},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"2388","DOI":"10.1093\/eurheartj\/ehn309","article-title":"ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2008: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2008 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association of the ESC (HFA) and endorsed by the European Society of Intensive Care Medicine (ESICM)","volume":"29","author":"Dickstein","year":"2008","journal-title":"Eur. Heart J."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1007\/s10047-007-0384-1","article-title":"Domestic and foreign trends in the prevalence of heart failure and the necessity of next-generation artificial hearts: A survey by the Working Group on Establishment of Assessment Guidelines for Next-Generation Artificial Heart Systems","volume":"10","author":"Tatsumi","year":"2007","journal-title":"J. Artif. Organs"},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"1022","DOI":"10.1016\/j.kint.2016.09.053","article-title":"Strategies for the optimal timing to start renal replacement therapy in critically ill patients with acute kidney injury","volume":"91","author":"Bagshaw","year":"2017","journal-title":"Kidney Int."},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"1833","DOI":"10.1056\/NEJMra0902710","article-title":"Hemodialysis","volume":"363","author":"Himmelfarb","year":"2010","journal-title":"N. Engl. J. Med."},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1161\/CIRCULATIONAHA.109.865352","article-title":"Use of evidence-based therapies in short-term outcomes of ST-segment elevation myocardial infarction and non-ST-segment elevation myocardial infarction in patients with chronic kidney disease: A report from the National Cardiovascular Data Acute Coronary Treatment and Intervention Outcomes Network registry","volume":"121","author":"Fox","year":"2010","journal-title":"Circulation"},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1056\/NEJMoa021778","article-title":"Multifactorial intervention and cardiovascular disease in patients with type 2 diabetes","volume":"348","author":"Gaede","year":"2003","journal-title":"N. Engl. J. Med."},{"key":"ref_103","doi-asserted-by":"crossref","unstructured":"Force, Remission Clinic Task, and Clinical Research Center \u201cAldo e Cele Dacc\u00f2\u201d (2011). The Remission Clinic approach to halt the progression of kidney disease. J. Nephrol., 24, 274\u2013281.","DOI":"10.5301\/JN.2011.7763"},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"580","DOI":"10.1056\/NEJMoa0706245","article-title":"Effect of a multifactorial intervention on mortality in type 2 diabetes","volume":"358","author":"Gaede","year":"2008","journal-title":"N. Engl. J. Med."},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"12","DOI":"10.2215\/CJN.02730313","article-title":"Incidence, outcomes, and comparisons across definitions of AKI in hospitalized individuals","volume":"9","author":"Zeng","year":"2014","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_106","doi-asserted-by":"crossref","unstructured":"Wu, V.C., Wu, P.C., Wu, C.H., Huang, T.M., Chang, C.H., Tsai, P.R., Ko, W.J., Chen, L., Wang, C.Y., and Chu, T.S. (2014). The impact of acute kidney injury on the long-term risk of stroke. J. Am. Heart Assoc., 3.","DOI":"10.1161\/JAHA.114.000933"},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1016\/j.cardfail.2009.12.020","article-title":"Prognostic significance of acute kidney injury after reperfused ST-elevation myocardial infarction: Synergistic acceleration of renal dysfunction and left ventricular remodeling","volume":"16","author":"Anzai","year":"2010","journal-title":"J. Card Fail."},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"R292","DOI":"10.1186\/cc13158","article-title":"Post-operative acute kidney injury and five-year risk of death, myocardial infarction, and stroke among elective cardiac surgical patients: A cohort study","volume":"17","author":"Hansen","year":"2013","journal-title":"Crit. Care"},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1016\/j.ijcard.2014.03.146","article-title":"Association of contrast-induced acute kidney injury with long-term cardiovascular events in acute coronary syndrome patients with chronic kidney disease undergoing emergent percutaneous coronary intervention","volume":"174","author":"Watabe","year":"2014","journal-title":"Int. J. Cardiol."},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"941","DOI":"10.2215\/CJN.01250119","article-title":"Quality Improvement Goals for Acute Kidney Injury","volume":"14","author":"Kashani","year":"2019","journal-title":"Clin. J. Am. Soc. Nephrol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/10\/8\/1601\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T13:26:40Z","timestamp":1760362000000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/10\/8\/1601"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4,9]]},"references-count":110,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2021,4]]}},"alternative-id":["jcm10081601"],"URL":"https:\/\/doi.org\/10.3390\/jcm10081601","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,4,9]]}}}