{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T20:51:03Z","timestamp":1790887863390,"version":"4.1.0"},"reference-count":19,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2025,12,24]],"date-time":"2025-12-24T00:00:00Z","timestamp":1766534400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Kidney360"],"published-print":{"date-parts":[[2026,4]]},"abstract":"\n Key Points<\/jats:title>\n \n \n \n Patients hospitalized with concomitant cardiac and kidney disease have high morbidity. Interdisciplinary care models may help improve outcomes.<\/jats:p>\n <\/jats:list-item>\n \n This descriptive single-center study shows the outcomes and feasibility of a cardio-nephrology service to care for patients with cardiovascular-kidney-metabolic syndrome.<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n <\/jats:sec>\n \n Background<\/jats:title>\n The cardiovascular-kidney-metabolic syndrome, estimated to affect up to 90% of US adults, is increasingly recognized as a disease spectrum that requires an interdisciplinary approach. The purpose of this descriptive study was to characterize the patients and the clinical outcomes of a specialized cardio-nephrology inpatient service. These data were compared with data from comparable patients before the service's launch.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This was a retrospective observational study of a specialized Kidney-Heart service that was launched at the University of Washington in 2020 to serve as the nephrology service for patients hospitalized with primary cardiac disease. Chart review was pursued to obtain patient demographics, reason for consult and hospital outcomes in the first 2.5 years of the service. We also obtained data from a historical cohort of patients with a cardiology diagnosis seen by the general nephrology consult service as a comparator. Descriptive analyses were performed to characterize demographics, consult categories, and primary reasons for hospitalization in patients seen on the Kidney-Heart service versus the historical cohort.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The mean age for the patients seen on the Kidney-Heart service was 63 (SD 15) versus 60 (SD 15) years in the comparator cohort (\n P<\/jats:italic>\n < 0.001). For the Kidney-Heart service, AKI was the most common reason for consult (57.7%), followed by CKD G5D (30.9%), diuretic management (8.9%), and electrolyte abnormalities (7.8%). Patients seen by the Kidney-Heart service were most commonly hospitalized for decompensated heart failure and cardiogenic shock (46.9%). The use of mechanical circulatory support was common (22%), and 48.2% of those patients required dialysis. AKI dialysis (36.7 versus 42%,\n P<\/jats:italic>\n = 0.05) and mortality rates (16.5% versus 25%,\n P<\/jats:italic>\n < 0.01) were lower in the Kidney-Heart service cohort versus the comparator cohort, although mean lengths of stay were longer (14 versus 11 days,\n P<\/jats:italic>\n < 0.001.) Follow-up in nephrology clinic within the University of Washington system was low for AKI patients at 1.7%.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Our single-center experience demonstrates a model by which a specialized cardio-nephrology service can be implemented and provide care for complex patients. Further implementation clinical trials are needed to determine whether integrated care models can improve cardiovascular-kidney-metabolic syndrome outcomes.<\/jats:p>\n <\/jats:sec>","DOI":"10.34067\/kid.0000001096","type":"journal-article","created":{"date-parts":[[2025,12,24]],"date-time":"2025-12-24T17:00:29Z","timestamp":1766595629000},"page":"816-822","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":3,"title":["Experience and Outcomes of a Dedicated Cardio-Nephrology Service"],"prefix":"10.34067","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-6690-5297","authenticated-orcid":false,"given":"Karen","family":"de Wolski","sequence":"first","affiliation":[{"name":"Division of Nephrology, Department of Medicine, University of Washington, Seattle, Washington"},{"name":"Division of Nephrology and Hypertension, Department of Medicine, Stony Brook University, Stony Brook, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6761-5606","authenticated-orcid":false,"given":"David K.","family":"Prince","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, University of Washington, Seattle, Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Mariuma","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, University of Washington, Seattle, Washington"},{"name":"Division of Nephrology and Hypertension, Department of Medicine, Stony Brook University, Stony Brook, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nayan","family":"Arora","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension, Department of Medicine, Oregon Health Sciences University, Portland, Oregon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tejas N.","family":"Velu","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, University of Washington, Seattle, Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayushi","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Washington, Seattle, Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9583-8628","authenticated-orcid":false,"given":"Nisha","family":"Bansal","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, University of Washington, Seattle, Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,12,24]]},"reference":[{"issue":"20","key":"B1-20260430","doi-asserted-by":"crossref","first-page":"1636","DOI":"10.1161\/CIR.0000000000001186","article-title":"A synopsis of the evidence for the science and clinical management of cardiovascular-kidney-metabolic (CKM) syndrome: a scientific statement from the American Heart Association","volume":"148","author":"Ndumele","year":"2023","journal-title":"Circulation."},{"issue":"21","key":"B2-20260430","doi-asserted-by":"crossref","first-page":"1858","DOI":"10.1001\/jama.2024.6892","article-title":"Prevalence of cardiovascular-kidney-metabolic syndrome stages in US adults, 2011-2020","volume":"331","author":"Aggarwal","year":"2024","journal-title":"JAMA."},{"issue":"11","key":"B3-20260430","doi-asserted-by":"crossref","first-page":"e2445309","DOI":"10.1001\/jamanetworkopen.2024.45309","article-title":"Prevalence of cardiovascular-kidney-metabolic syndrome stages by social determinants of health","volume":"7","author":"Zhu","year":"2024","journal-title":"JAMA Netw Open."},{"issue":"12","key":"B4-20260430","doi-asserted-by":"crossref","first-page":"2386","DOI":"10.1093\/ndt\/gfac153","article-title":"Long-term impact of cardiorenal syndromes on major outcomes based on their chronology: a comprehensive French Nationwide Cohort Study","volume":"37","author":"Halimi","year":"2022","journal-title":"Nephrol Dial Transplant."},{"issue":"7","key":"B5-20260430","doi-asserted-by":"crossref","first-page":"933","DOI":"10.2215\/CJN.0000000000000064","article-title":"Cardiorenal syndrome in the hospital","volume":"18","author":"McCallum","year":"2023","journal-title":"Clin J Am Soc Nephrol."},{"issue":"6","key":"B8-20260430","doi-asserted-by":"crossref","first-page":"813","DOI":"10.2215\/CJN.0000000000000361","article-title":"From cardiorenal syndrome to chronic cardiovascular and kidney disorder: a conceptual transition","volume":"19","author":"Zoccali","year":"2024","journal-title":"Clin J Am Soc Nephrol."},{"issue":"16","key":"B9-20260430","doi-asserted-by":"crossref","first-page":"e840","DOI":"10.1161\/CIR.0000000000000664","article-title":"Cardiorenal syndrome: classification, pathophysiology, diagnosis, and treatment strategies: a scientific statement from the American Heart Association","volume":"139","author":"Rangaswami","year":"2019","journal-title":"Circulation."},{"issue":"4","key":"B7-20260430","doi-asserted-by":"crossref","first-page":"749","DOI":"10.34067\/KID.0000602022","article-title":"Mission and 1-year outcomes of a cardiorenal subspecialty consultation service","volume":"3","author":"Bansal","year":"2022","journal-title":"Kidney360."},{"issue":"7","key":"B10-20260430","doi-asserted-by":"crossref","first-page":"1005","DOI":"10.2215\/CJN.17331120","article-title":"Nephrologist follow-up versus usual care after an acute kidney injury hospitalization (FUSION): A randomized controlled trial","volume":"16","author":"Silver","year":"2021","journal-title":"Clin J Am Soc Nephrol."},{"issue":"4","key":"B11-20260430","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1053\/j.ackd.2017.05.008","article-title":"Follow-up care in acute kidney injury: lost in transition","volume":"24","author":"Silver","year":"2017","journal-title":"Adv Chronic Kidney Dis."},{"issue":"1","key":"B12-20260430","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."},{"issue":"4","key":"B13-20260430","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1038\/s41581-019-0247-z","article-title":"Long-term outcomes of acute kidney injury and strategies for improved care","volume":"16","author":"James","year":"2020","journal-title":"Nat Rev Nephrol."},{"issue":"5","key":"B14-20260430","doi-asserted-by":"crossref","first-page":"1202","DOI":"10.1016\/j.kint.2020.08.022","article-title":"Renin-angiotensin aldosterone inhibitor use at hospital discharge among patients with moderate to severe acute kidney injury and its association with recurrent acute kidney injury and mortality","volume":"99","author":"Siew","year":"2021","journal-title":"Kidney Int."},{"key":"B15-20260430","doi-asserted-by":"crossref","first-page":"102615","DOI":"10.1016\/j.eclinm.2024.102615","article-title":"Projecting the economic burden of chronic kidney disease at the patient level (inside CKD): a microsimulation modelling study","volume":"72","author":"Chadban","year":"2024","journal-title":"EClinicalMedicine."},{"issue":"5","key":"B16-20260430","doi-asserted-by":"crossref","first-page":"1168","DOI":"10.1111\/ajt.14702","article-title":"An economic assessment of contemporary kidney transplant practice","volume":"18","author":"Axelrod","year":"2018","journal-title":"Am J Transplant."},{"key":"B17-20260430","doi-asserted-by":"crossref","first-page":"63","DOI":"10.2147\/RMHP.S130341","article-title":"Economic burden of hospitalizations of medicare beneficiaries with heart failure","volume":"10","author":"Kilgore","year":"2017","journal-title":"Risk Manag Healthc Policy."},{"issue":"3","key":"B18-20260430","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1016\/j.cardfail.2021.12.017","article-title":"Economic issues in heart failure in the United States","volume":"28","author":"Heidenreich","year":"2022","journal-title":"J Card Fail."},{"key":"B19-20260430","doi-asserted-by":"crossref","first-page":"110933","DOI":"10.1016\/j.jclinane.2022.110933","article-title":"Mortality and costs associated with acute kidney injury following major elective, non-cardiac surgery","volume":"82","author":"French","year":"2022","journal-title":"J Clin Anesth."},{"key":"B20-20260430","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1016\/j.pcad.2024.01.018","article-title":"Evolution of mechanical circulatory support for advanced heart failure","volume":"82","author":"Moeller","year":"2024","journal-title":"Prog Cardiovasc Dis."}],"container-title":["Kidney360"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.34067\/KID.0000001096","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T19:56:04Z","timestamp":1786478164000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.34067\/KID.0000001096"}},"subtitle":["A Step toward Integrated Cardiovascular-Kidney-Metabolic Syndrome Care"],"short-title":[],"issued":{"date-parts":[[2025,12,24]]},"references-count":19,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.34067\/kid.0000001096","relation":{},"ISSN":["2641-7650"],"issn-type":[{"value":"2641-7650","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,24]]},"assertion":[{"value":"2025-08-27","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-08","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}