GLP-1 Receptor Agonists
Renal protection (FLOW trial), CVOT results with NNTs, anti-inflammatory mechanisms, protein requirements during therapy, agent selection guide, adverse effects management, and SGLT2i combination evidence.
HFpEF as a Cardiorenal-Metabolic Disease
Nephrology-focused review: MR overactivation, galectin-3, ARIC albuminuria data, Shah phenomapping (HR 4.2), CKM syndrome staging, SGLT2i evidence, FINEARTS-HF, CONFIDENCE trial, and the four pillars of cardiorenal protection.
Nephrotic Syndrome Presenting as Heart Failure
Edema overlap pathophysiology (underfill vs. overfill vs. cardiac), clinical differentiation at the bedside, BNP interpretation in nephrotic syndrome, ACR/PCR proteinuria phenotyping, amyloidosis as the cardiac-renal unifier, diuretic resistance mechanisms, and furosemide-albumin co-administration evidence.
Flash Pulmonary Edema
Cardiac, valvular, and renal etiologies with contemporary management. SCAPE pathophysiology, Pickering syndrome, NIPPV vs standard O2 outcomes, high-dose NTG protocols, volume management in valvular disease, and the redistribution vs. volume overload paradigm.
Aldosterone Blockade: MRA vs nsMRA vs Synthase Inhibitors
Comprehensive comparison of spironolactone/eplerenone, finerenone, and lorundrostat/baxdrostat. FINEARTS-HF, FIDELITY, TARGET-HTN data. Non-aldosterone MR activation (salt, cortisol, metabolic), 11β-HSD2 system, and anti-inflammatory mechanisms.
Edema Pathophysiology
Starling forces and revised Starling principle, CVI microangiopathy, right heart dysfunction and systemic congestion, renal tamponade hypothesis, loop diuretic mechanisms, furosemide-albumin interaction by albumin level (<2.0 vs 2.0–2.5 vs >2.5 g/dL), gut edema and oral diuretic resistance, bumetanide vs furosemide bioavailability.
Neurohormonal Modulation in Heart Failure
Optimizing treatment strategies across the HF disease spectrum. RAAS, sympathetic, natriuretic peptide, and endothelin pathways. Landmark trial evidence for ACEi/ARB, ARNI, beta-blockers, MRA, and SGLT2i. 35 min read.
SGLT2 Inhibitor Safety in High-Risk Patients
Risk-benefit assessment in patients with lower extremity cellulitis, sepsis, severe edema, and non-healing wounds. CANVAS/CREDENCE amputation data, Fournier gangrene incidence, wound healing physiology, and clinical decision framework. 19 min read.