Skip to main content
SpringerLink
Log in

Challenging Complex Diseases

  • Chapter
  • First Online:
Cardio-Renal Clinical Challenges

  • 1374 Accesses

Abstract

Patients with concomitant cardiovascular disease, renal disease and diabetes represent a large proportion of all patients in cardiology, nephrology and diabetology. A progressively increased subspecialisation has led to that the cardiologists’ treats the heart, nephrologists’ the kidneys and endocrinologists’ the diabetes. At best, this causes the patient to spend substantial time visiting multiple specialists in each field, and at worst serious under-treatment of co-morbidities. Improved ways to organize and provide health-care are needed for this large, complex group of patients

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 159.00
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. World Health Organisation. World health statistics 2011. Geneva: WHO; 2011.

    Google Scholar 

  2. Coresh J, Selvin E, Stevens LA, et al. Prevalence of chronic kidney disease in the United States. JAMA. 2007;298:2038–47.

    Article  CAS  PubMed  Google Scholar 

  3. Go AS, Mozaffarian D, Roger VL, et al. Heart disease and stroke statistics–2013 update: a report from the American Heart Association. Circulation. 2013;127:e6–245.

    Article  PubMed  Google Scholar 

  4. Cowie CC, Rust KF, Ford ES, et al. Full accounting of diabetes and pre-diabetes in the U.S. population in 1988–1994 and 2005–2006. Diabetes Care. 2009;32:287–94.

    Article  PubMed Central  PubMed  Google Scholar 

  5. Wolff JL, Starfield B, Anderson G. Prevalence, expenditures, and complications of multiple chronic conditions in the elderly. Arch Intern Med. 2002;162:2269–76.

    Article  PubMed  Google Scholar 

  6. Suckling R, Gallagher H. Chronic kidney disease, diabetes mellitus and cardiovascular disease: risks and commonalities. J Ren Care. 2012;38 Suppl 1:4–11.

    Article  PubMed  Google Scholar 

  7. Ronco C, Haapio M, House AA, et al. Cardiorenal syndrome. J Am Coll Cardiol. 2008;52:1527–39.

    Article  PubMed  Google Scholar 

  8. Izquierdo MC, Perez-Gomez MV, Sanchez-Nino MD, et al. Klotho, phosphate and inflammation/ageing in chronic kidney disease. Nephrol Dial Transplant. 2012;27 Suppl 4:iv6–10.

    PubMed  Google Scholar 

  9. Grundy SM, Benjamin IJ, Burke GL, et al. Diabetes and cardiovascular disease: a statement for healthcare professionals from the American Heart Association. Circulation. 1999;100:1134–46.

    Article  CAS  PubMed  Google Scholar 

  10. Anavekar NS, McMurray JJ, Velazquez EJ, et al. Relation between renal dysfunction and cardiovascular outcomes after myocardial infarction. N Engl J Med. 2004;351:1285–95.

    Article  CAS  PubMed  Google Scholar 

  11. Wright RS, Reeder GS, Herzog CA, et al. Acute myocardial infarction and renal dysfunction: a high-risk combination. Ann Intern Med. 2002;137:563–70.

    Article  PubMed  Google Scholar 

  12. McCullough PA, Soman SS, Shah SS, et al. Risks associated with renal dysfunction in patients in the coronary care unit. J Am Coll Cardiol. 2000;36:679–84.

    Article  CAS  PubMed  Google Scholar 

  13. Santopinto JJ, Fox KA, Goldberg RJ, et al. Creatinine clearance and adverse hospital outcomes in patients with acute coronary syndromes: findings from the global registry of acute coronary events (GRACE). Heart. 2003;89:1003–8.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  14. Rashidi A, Sehgal AR, Rahman M, et al. The case for chronic kidney disease, diabetes mellitus, and myocardial infarction being equivalent risk factors for cardiovascular mortality in patients older than 65 years. Am J Cardiol. 2008;102:1668–73.

    Article  PubMed  Google Scholar 

  15. Haynes R, Staplin N, Emberson J, et al. Evaluating the contribution of the cause of kidney disease to prognosis in CKD: results from the Study of Heart and Renal Protection (SHARP). Am J Kidney Dis. 2014;64(1):40–8.

    Article  PubMed Central  PubMed  Google Scholar 

  16. Szummer K, Lundman P, Jacobson SH, et al. Cockcroft-Gault is better than the Modification of Diet in Renal Disease study formula at predicting outcome after a myocardial infarction: data from the Swedish Web-system for Enhancement and Development of Evidence-based care in Heart disease Evaluated According to Recommended Therapies (SWEDEHEART). Am Heart J. 2010;159:979–86.

    Article  PubMed  Google Scholar 

  17. Szummer K, Lundman P, Jacobson SH, et al. Influence of renal function on the effects of early revascularization in non-ST-elevation myocardial infarction: Circulation. 2009;120:851–8.

    Google Scholar 

  18. Molino D, De Lucia D, Gaspare De Santo N. Coagulation disorders in uremia. Semin Nephrol. 2006;26:46–51.

    Article  CAS  PubMed  Google Scholar 

  19. Tsai TT, Messenger JC, Brennan JM, et al. Safety and efficacy of drug-eluting stents in older patients with chronic kidney disease: a report from the linked CathPCI registry-CMS claims database. J Am Coll Cardiol. 2011;58:1859–69.

    Article  PubMed  Google Scholar 

  20. Jennrich JA. Some aspects of the nursing care for patients on hemodialysis. Heart Lung. 1975;4:885–9.

    CAS  PubMed  Google Scholar 

  21. Curtis BM, Ravani P, Malberti F, et al. The short- and long-term impact of multi-disciplinary clinics in addition to standard nephrology care on patient outcomes. Nephrol Dial Transplant. 2005;20:147–54.

    Article  PubMed  Google Scholar 

  22. Thanamayooran S, Rose C, Hirsch DJ. Effectiveness of a multidisciplinary kidney disease clinic in achieving treatment guideline targets. Nephrol Dial Transplant. 2005;20:2385–93.

    Article  PubMed  Google Scholar 

  23. Chen YR, Yang Y, Wang SC, et al. Effectiveness of multidisciplinary care for chronic kidney disease in Taiwan: a 3-year prospective cohort study. Nephrol Dial Transplant. 2013;28:671–82.

    Article  CAS  PubMed  Google Scholar 

  24. Bayliss EA, Bhardwaja B, Ross C, et al. Multidisciplinary team care may slow the rate of decline in renal function. Clin J Am Soc Nephrol. 2011;6:704–10.

    Article  PubMed Central  PubMed  Google Scholar 

  25. Hemmelgarn BR, Manns BJ, Zhang J, et al. Association between multidisciplinary care and survival for elderly patients with chronic kidney disease. J Am Soc Nephrol. 2007;18:993–9.

    Article  PubMed  Google Scholar 

  26. Barrett BJ, Garg AX, Goeree R, et al. A nurse-coordinated model of care versus usual care for stage 3/4 chronic kidney disease in the community: a randomized controlled trial. Clin J Am Soc Nephrol. 2011;6:1241–7.

    Article  PubMed Central  PubMed  Google Scholar 

  27. Peeters MJ, van Zuilen AD, van den Brand JAJG, et al. Nurse practitioner care improves renal outcome in patients with CKD. J Am Soc Nephrol. 2014;25:390–8.

    Article  PubMed  Google Scholar 

  28. KDIGO working group. KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int Suppl. 2013;3:1–150.

    Google Scholar 

  29. Epping-Jordan JE, Pruitt SD, Bengoa R, et al. Improving the quality of health care for chronic conditions. Qual Saf Health Care. 2004;13:299–305.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  30. Clark S, Farrington K, Chilcot J. Nonadherence in dialysis patients: prevalence, measurement, outcome, and psychological determinants. Semin Dial. 2014;27:42–9.

    Article  PubMed  Google Scholar 

  31. Pote Jr WW. The treatment of diabetes mellitus. Calif Med. 1958;88:123–6.

    PubMed Central  PubMed  Google Scholar 

  32. Wang CCL, Reusch JEB. Diabetes and cardiovascular disease: changing the focus from glycemic control to improving long-term survival. Am J Cardiol. 2012;110:58B–68.

    Article  PubMed Central  PubMed  Google Scholar 

  33. Gaede P, Lund-Andersen H, Parving HH, et al. Effect of a multifactorial intervention on mortality in type 2 diabetes. N Engl J Med. 2008;358:580–91.

    Article  CAS  PubMed  Google Scholar 

  34. Emberson JR, Whincup PH, Morris RW, et al. Re-assessing the contribution of serum total cholesterol, blood pressure and cigarette smoking to the aetiology of coronary heart disease: impact of regression dilution bias. Eur Heart J. 2003;24:1719–26.

    Article  CAS  PubMed  Google Scholar 

  35. Perk J, De Backer G, Gohlke H, et al. European Guidelines on cardiovascular disease prevention in clinical practice (version 2012). The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice. Eur Heart J. 2012;33:1635–701.

    Google Scholar 

  36. Li C, Engstrom G, Hedblad B, et al. Blood pressure control and risk of stroke: a population-based prospective cohort study. Stroke. 2005;36:725–30.

    Article  PubMed  Google Scholar 

  37. Wolf-Maier K, Cooper RS, Kramer H, et al. Hypertension treatment and control in five European countries, Canada, and the United States. Hypertension. 2004;43:10–7.

    Article  CAS  PubMed  Google Scholar 

  38. Rich MW, Beckham V, Wittenberg C, et al. A multidisciplinary intervention to prevent the readmission of elderly patients with congestive heart failure. N Engl J Med. 1995;333:1190–5.

    Article  CAS  PubMed  Google Scholar 

  39. Cintron G, Bigas C, Linares E, et al. Nurse practitioner role in a chronic congestive heart failure clinic: in-hospital time, costs, and patient satisfaction. Heart Lung. 1983;12:237–40.

    CAS  PubMed  Google Scholar 

  40. Stewart S, Marley JE, Horowitz JD. Effects of a multidisciplinary, home-based intervention on unplanned readmissions and survival among patients with chronic congestive heart failure: a randomised controlled study. Lancet. 1999;354:1077–83.

    Article  CAS  PubMed  Google Scholar 

  41. McMurray JJ, Adamopoulos S, Anker SD, et al. ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: Eur Heart J. 2012;33:1787–847.

    Google Scholar 

  42. Yancy CW, Jessup M, Bozkurt B, et al. 2013 ACCF/AHA guideline for the management of heart. Circulation. 2013;128:e240–327.

    Google Scholar 

  43. National quality forum. Preferred practices and performance measures for measuring and reporting care coordination: a consensus report. Washington, DC. http://www.qualityforum.org/. 2010.

  44. Aldhizer TG, Solle MM, Bohrer RO. A multidisciplinary audit of diabetes mellitus. J Fam Pract. 1979;8:947–51.

    CAS  PubMed  Google Scholar 

  45. Gurner U. Aldreteam vision och verklighet. Gavleborg County; 2010.

    Google Scholar 

  46. Levin A, Chaudhry MR, Djurdjev O, et al. Diabetes, kidney disease and cardiovascular disease patients. Assessing care of complex patients using outpatient testing and visits: additional metrics by which to evaluate health care system functioning. Nephrol Dial Transplant. 2009;24:2714–20.

    Article  PubMed  Google Scholar 

  47. Qvarnstrom M, Wettermark B, Ljungman C, et al. Antihypertensive treatment and control in a large primary care population of 21 167 patients. J Hum Hypertens. 2011;25:484–91.

    Article  CAS  PubMed  Google Scholar 

  48. SWEDEHEART. Annual report SWEDEHEART 2011. http://www.ucr.uu.se/swedeheart/index.php/arsrapporter. 2012.

  49. Ovretveit J, Gillies R, Rundall TG, et al. Quality of care for chronic illnesses. Int J Health Care Qual Assur. 2008;21:190–202.

    Article  PubMed  Google Scholar 

  50. Maslin-Prothero SE, Bennion AE. Integrated team working: a literature review. Int J Integr Care. 2010;10:e043.

    PubMed Central  PubMed  Google Scholar 

  51. Curry N, Harris M, Gunn LH, et al. Integrated care pilot in north-west London: a mixed methods evaluation. Int J Integr Care. 2013;13:e027.

    PubMed Central  PubMed  Google Scholar 

  52. Weber C, Beaulieu M, Djurdjev O, et al. Towards rational approaches of health care utilization in complex patients: an exploratory randomized trial comparing a novel combined clinic to multiple specialty clinics in patients with renal disease-cardiovascular disease-diabetes. Nephrol Dial Transplant. 2012;27 Suppl 3:iii104–10.

    PubMed  Google Scholar 

  53. Porter M, Teisberg EO. Redefining health care: creating value-based competition on results. Boston: Harvard Business School Publishing; 2006.

    Google Scholar 

  54. Ekman I, Swedberg K, Taft C, et al. Person-centered care–ready for prime time. Eur J Cardiovasc Nurs. 2011;10:248–51.

    Article  PubMed  Google Scholar 

  55. Olsson LE, Jakobsson Ung E, Swedberg K, et al. Efficacy of person-centred care as an intervention in controlled trials – a systematic review. J Clin Nurs. 2013;22:456–65.

    Article  PubMed  Google Scholar 

  56. Henbest RJ, Stewart M. Patient-centredness in the consultation. 2: does it really make a difference? Fam Pract. 1990;7:28–33.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Cardiology, Department of Clinical Sciences, Karolinska Institutet, Danderyd University Hospital, Stockholm, 18288, Sweden

    Jonas Spaak MD, PhD

Authors
  1. Jonas Spaak MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jonas Spaak MD, PhD .

Editor information

Editors and Affiliations

  1. Renal and Transplantation Department, Guy's Hospital, London, United Kingdom

    David Goldsmith

  2. Gr. T. Popa University of Medicine and Pharmacy, Iasi, Romania

    Adrian Covic

  3. Karolinska Institutet Danderyd University Hospital, Stockholm, Sweden

    Jonas Spaak

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Spaak, J. (2015). Challenging Complex Diseases. In: Goldsmith, D., Covic, A., Spaak, J. (eds) Cardio-Renal Clinical Challenges. Springer, Cham. https://doi.org/10.1007/978-3-319-09162-4_20

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-09162-4_20

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-09161-7

  • Online ISBN: 978-3-319-09162-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation