Echocardioscopy in Cardiovascular Stratification of Chronic Kidney Diseases: The Nephrologist is the Protagonist

Abstract

Cardiovascular disease (CV) is the leading cause of morbidity and mortality in patients with chronic kidney disease (CKD). The increase in cardiac complications in patients with CKD has encouraged nephrologists to acquire the cardiac diagnostic competences in the use of ultrasound. A formal echocardiographic approach requires standard times and the immediate availability of the cardiac-sonographer. Therefore, a goal-directed cardiac ultrasound and a focused echocardiogram or echocardioscopy strategy were created specifically tailored to the non-cardiologists as well as internists, interventists and intensivists. The concept of echocardioscopy has been incompletely evaluated and it is necessary to find a curricular program to grant proficiency. The introduction of echocardioscopy in the nephrologist’s tasks has the advantage of widening the spectrum of the diagnostic of cardiac complications in CKD patients, but also confers several technical limitations. The aim of this revision is to analyze the use of the cardiac ultrasound equipment by the nephrologists and the requirements for the echocardioscopy strategy. In addition, it will specify the advantages and the disadvantages of cardiac-diagnostic management by nephrologists suggesting the possible clinical settings for the application of this method. (Cardionephrology)