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2015 ; 36
(23
): 1437-44
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The kidney in heart failure: an update
#MMPMID25838436
Damman K
; Testani JM
Eur Heart J
2015[Jun]; 36
(23
): 1437-44
PMID25838436
show ga
Heart and kidney are closely related in the clinical syndrome of heart failure
(HF). It is now sufficiently clear that renal dysfunction occurs frequently in
all phenotypes of HF, and when present, it is associated with higher mortality
and morbidity. While the pathophysiology is multifactorial, the most important
factors are a reduced renal perfusion and venous congestion. Recent interest has
focused on worsening renal function (WRF), a situation strongly related to
mortality, but seemingly only when HF status deteriorates. Unfortunately, to date
clinicians are unable to identify specifically those patients with a grim
prognosis following WRF. Although much has been learned on cardiorenal
interaction in HF, still more questions have been left unanswered. The coming
decade should provide us with more dedicated epidemiologic, mechanistic, and
controlled trials in HF patients with reduced renal function. An updated
classification of the cardiorenal syndrome that incorporates recent evidence and
points towards areas of interest and uncertainties, and areas where progress is
needed could facilitate this process. Ultimately, this should lead to preventive
and treatment strategies that can preserve renal function and associated outcome
in patients with HF.
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