Carollo Caterina, Evola Salvatore, Sorce Alessandra, Cirafici Emanuele, Bennici Miriam, Mulè Giuseppe, Geraci Giulio
Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (ProMISE) "G. D'Alessandro", University of Palermo, 90133 Palermo, Italy.
Catheterization Laboratory, Department of Medicine and Cardiology, Azienda Ospedaliera Universitaria Policlinico "P. Giaccone", 90127 Palermo, Italy.
J Clin Med. 2025 Mar 19;14(6):2102. doi: 10.3390/jcm14062102.
: Cardiorenal Syndrome (CRS) represents a growing global health challenge due to the increasing prevalence of coexisting kidney and heart disease. The complex pathophysiology of CRS demands an integrated, multidisciplinary approach involving both nephrology and cardiology. However, specialized care models remain limited, leading to fragmented management and suboptimal outcomes. : A Kidney-Heart Outpatient Service was established at "Paolo Giaccone" University Hospital in Palermo in May 2023 to provide coordinated, multidisciplinary care for non-hospitalized patients with CRS. The service involves structured patient assessments, including medical history, physical examinations, laboratory tests, imaging, and a collaborative therapeutic plan formulated by nephrologists and cardiologists. Preliminary patient data were collected and analysed to assess demographic characteristics, comorbidities, and clinical outcomes. : Among the first 115 patients evaluated, most were male and over 70 years old. Hypertension (91%) and diabetes were the leading comorbidities, with CKD stage G3b being the most prevalent. Cardiovascular conditions such as atrial fibrillation (18%), prior myocardial infarction (17%), and heart failure (15%) were frequently observed. Three patient deaths occurred, and one progressed to hemodialysis. : The Kidney-Heart Outpatient Service represents a novel, patient-centered model for CRS management, aiming to improve clinical outcomes and reduce hospital admissions through multidisciplinary collaboration. Longitudinal follow-up and expanded data collection are essential to validate the long-term efficacy of this approach and refine management strategies for CRS patients. Ongoing research efforts will focus on tracking patient outcomes over extended periods, optimizing therapeutic strategies, and further integrating nephrology and cardiology training. The goal is to establish a sustainable and scalable framework for CRS management that enhances patient care and reduces the healthcare burden.
由于并存的肾脏和心脏疾病患病率不断上升，心肾综合征（CRS）对全球健康构成了日益严峻的挑战。CRS复杂的病理生理学需要肾病学和心脏病学相结合的多学科综合方法。然而，专门的护理模式仍然有限，导致管理分散且结果不理想。2023年5月，巴勒莫的“保罗·贾科内”大学医院设立了心肾门诊服务，为非住院CRS患者提供协调的多学科护理。该服务包括结构化的患者评估，包括病史、体格检查、实验室检查、影像学检查，以及由肾病学家和心脏病学家制定的联合治疗计划。收集并分析了初步患者数据，以评估人口统计学特征、合并症和临床结果。在前115名接受评估的患者中，大多数为男性且年龄超过70岁。高血压（91%）和糖尿病是主要合并症，其中CKD G3b期最为常见。经常观察到心血管疾病，如心房颤动（18%）、既往心肌梗死（17%）和心力衰竭（15%）。发生了3例患者死亡，1例进展为血液透析。心肾门诊服务代表了一种新颖的、以患者为中心的CRS管理模式，旨在通过多学科协作改善临床结果并减少住院次数。长期随访和扩大数据收集对于验证该方法的长期疗效以及完善CRS患者的管理策略至关重要。正在进行的研究工作将集中于长期跟踪患者结果、优化治疗策略以及进一步整合肾病学和心脏病学培训。目标是建立一个可持续且可扩展的CRS管理框架，以加强患者护理并减轻医疗负担。
