Decongestion Guided By VExUS Score Or Lung Ultrasound For Renal Recovery In Patients With Cardiorenal Syndrome Type -1

Evaluation of Decongestion Guided By VExUS Score Or Lung Ultrasound For Renal Recovery In Patients With Cardiorenal Syndrome Type-1 : a Randomized Controlled Trial

the goal of this observational study is to evaluate the role of VEXUS score and lung ultrasound to guide decongestive therapy in patients with cardiorenal syndrome type -1. the main question it aims to answer is: Can the VEXUS score and lung ultrasound guide the efffect of decongestive therapy on KFR and decongestion metrics in patients with CRS-1 compared to standard assesment ?

Inclusion Criteria:

• • Patients of both genders aged 18-65 years old.

  • Patients with CRS1 criteria (worsening of renal function due to acute heart failure manifested by : ( Dyspnea , orthopnea ,hypoxia , congested neck veins , oliguria and congestion in imaging.)
  • Patients with Modified lung ultrasound score(LUSS) more than 15.

Exclusion Criteria:

• • Refusal to participate.

  • Patients with renal transplantation.
  • Unknowing baseline creatinine.
  • Patients with a life-threatening indication of RRT (defined as intractable hyperkalemia, acidosis, uremic symptoms) at enrollment,
  • RRT before recruitment,
  • known prehospitalization advanced chronic kidney disease (defined by an estimated GFR <30 mL/min/1.73 m2 or chronic RRT),
  • use of extracorporeal membrane oxygenation (ECMO),
  • diagnosis of hepatic cirrhosis or other condition with portal hypertension
  • Or postrenal causes of AKI