Evidence mapPaperPMID 42566439Full record

ArticlePloS one2026

Impact of infection on decongestion and kidney outcomes in patients with cardiorenal syndrome type 1.

Jonathan S Chávez-Iñiguez, Jose J Zaragoza, Ronaldo Escoto- Del Toro, Itzel Fong-Maravilla, Guillermo Navarro-Blackaller, Ramón Medina-González, Alejandro Martínez Gallardo-González, Luz Alcantar-Vallin, Juan A Gómez-Fregoso, Eduardo Mendoza-Gaitán and 3 more

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Article in PloS one, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

13 authors.

Jonathan S Chávez-IñiguezNephrology Service, Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara, Jalisco, Mexico.ORCID https://orcid.org/0000-0003-2786-6667
Jose J ZaragozaIntensive Care Unit, Hospital H + Queretaro, Santiago de Querétaro, Mexico.
Ronaldo Escoto- Del ToroNephrology Service, Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara, Jalisco, Mexico.
Itzel Fong-MaravillaUniversity of Guadalajara Health Sciences Center, Guadalajara, Jalisco, Mexico.
Guillermo Navarro-BlackallerNephrology Service, Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara, Jalisco, Mexico.
Ramón Medina-GonzálezNephrology Service, Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara, Jalisco, Mexico.ORCID https://orcid.org/0000-0002-7094-6964
Alejandro Martínez Gallardo-GonzálezNephrology Service, Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara, Jalisco, Mexico.
Luz Alcantar-VallinNephrology Service, Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara, Jalisco, Mexico.
Juan A Gómez-FregosoNephrology Service, Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara, Jalisco, Mexico.
Eduardo Mendoza-GaitánNephrology Service, Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara, Jalisco, Mexico.
Manuel Arizaga-NápolesNephrology Service, Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara, Jalisco, Mexico.
Juan B Ivey-MirandaHospital de Cardiologia, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
Guillermo García-GarcíaUniversity of Guadalajara Health Sciences Center, Guadalajara, Jalisco, Mexico.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundInfections are frequent precipitants of acute decompensated heart failure (ADHF) and may alter decongestive trajectories in patients with cardiorenal syndrome type 1 (CRS1), it may reduce diuretic efficacy and increase the risk of kidney injury. However, the impact of infection on decongestion and kidney outcomes in CRS1 remains unclear.

methodsWe conducted a prospective cohort study including 256 patients with CRS1 hospitalized at a tertiary center (2022-2024). Patients were stratified by the presence of infection, defined as clinical suspicion plus antibiotic therapy. The primary outcome was successful decongestion, assessed by symptoms, biomarkers (BNP/CA-125), and POCUS findings. Secondary outcomes included major adverse kidney events at 10 and 30 days (MAKE: death, kidney replacement therapy [KRT], or ≥25% eGFR decline).

resultsSeventy-two patients (28.1%) had infection, presenting with higher BNP (13,405 vs. 25,264 pg/mL, p = 0.012) and lower PaO2 (45 vs. 65.5 mmHg, p = 0.019). Furosemide exposure was comparable (600 vs. 580 mg, p = 0.62). Successful decongestion occurred in 61.4% of patients with infection vs. 59.8% without infection (p = 0.83). Infection was not independently associated with decongestion (aOR 1.28, 95% CI 0.65-2.51) or MAKE-30 (aOR 1.26, 95% CI 0.57-2.79).

conclusionsIn CRS1, infection was associated with more severe baseline congestion but did not compromise decongestion rates or increase short-term MAKE. These findings support the notion that achieving decongestion is feasible in patients with ADHF due to infection without an incremental risk of MAKE.

Indexed as

Cardio-Renal SyndromeInfectionsKidneyAgedDiureticsFemaleFurosemideHeart FailureHumansMaleMiddle AgedProspective StudiesDiureticsFurosemide

Identifiers

PMID42566439
PMCPMC13450727

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.