Cardiorenal syndrome in decompensated heart failure
- 27 April 2009
- Vol. 96 (4), 255-260
- https://doi.org/10.1136/hrt.2009.166256
Abstract
Worsening renal function during treatment of acute decompensated heart failure (ADHF) often complicates the treatment course of heart failure. Furthermore, the development of worsening renal function is a strong independent predictor of long-term adverse outcomes. Sometimes referred to as ‘cardiorenal syndrome,’ the definition varies widely, and the overall understanding of pathogenesis is limited. This is probably owing to the lack of precision and characterisation of renal compromise during treatment of heart failure. Traditionally, the predominant cause has been attributed to impairment of cardiac output and relative underfilling of arterial perfusion. Emerging data have led to a resurgence of interest in the importance of venous congestion and elevated intra-abdominal pressure rather than confining it to impaired forward cardiac output as the primary driver of renal impairment. These revived concepts may support the role of novel renal-sparing approaches to salt and water removal and renal preservation, but better ways to distinguish haemodynamic versus other nephrotoxic aetiologies are needed.Keywords
This publication has 55 references indexed in Scilit:
- Cardiorenal SyndromeJournal of the American College of Cardiology, 2008
- Cardiorenal and renocardiac syndromes: the need for a comprehensive classification and consensusNature Clinical Practice Nephrology, 2008
- Prevalence and significance of unrecognized renal insufficiency in patients with heart failureEuropean Heart Journal, 2008
- Worsening Renal Function and Prognosis in Heart Failure: Systematic Review and Meta-AnalysisJournal of Cardiac Failure, 2007
- High Prevalence of Renal Dysfunction and Its Impact on Outcome in 118,465 Patients Hospitalized With Acute Decompensated Heart Failure: A Report From the ADHERE DatabaseJournal of Cardiac Failure, 2007
- Prevalence and impact of worsening renal function in patients hospitalized with decompensated heart failure: results of the prospective outcomes study in heart failure (POSH)European Heart Journal, 2006
- Incidence, predictors at admission, and impact of worsening renal function among patients hospitalized with heart failureJournal of the American College of Cardiology, 2004
- The prognostic importance of different definitions of worsening renal function in congestive heart failureJournal of Cardiac Failure, 2002
- Renal Function, Neurohormonal Activation, and Survival in Patients With Chronic Heart FailureCirculation, 2000
- Correlates and impact on outcomes of worsening renal function in patients ≥65 years of age with heart failureThe American Journal of Cardiology, 2000