Management of chronic cardiorenal syndrome

Patients with heart failure (HF) often have renal dysfunction and patients with kidney disease develop congestive HF, therefore the concept of cardiorenal syndromes evolved which can be a chronic or acute cardiorenal syndrome. Both chronic renal and heart disease share comorbidities like anemia which cause symptoms, disease progression and increase the risk of hospital admission and mortality. Even though there are clinical guidelines for managing both dysfunctions separately, patients with severe HF or severe kidney disease have often been excluded from clinical trials of the respective other disorder. We outline here a summary of the current state of the art of the clinical practice to manage patients with chronic cardiorenal syndrome using drug therapy. We will furthermore focus on that management of anemia and iron deficiency in particular as there have been recent advances.