Related Experiment Video

Updated: May 15, 2026

A Mouse 5/6th Nephrectomy Model That Induces Experimental Uremic Cardiomyopathy
07:52

A Mouse 5/6th Nephrectomy Model That Induces Experimental Uremic Cardiomyopathy

Published on: November 7, 2017

Concomitant renal and hepatic dysfunctions in chronic heart failure: clinical implications and prognostic

Gerhard Poelzl1, Michael Ess, Andreas Von der Heidt

  • 1Dep. of Internal Medicine III, Cardiology, Innsbruck Medical University, Austria. gerhard.poelzl@uki.at

European Journal of Internal Medicine
|December 26, 2012
PubMed

Insights

Chronic heart failure patients with impaired kidney and liver function face a higher risk of adverse outcomes. Concurrent dysfunction significantly worsens prognosis, highlighting the importance of monitoring both organs.

Area of Science:

  • Cardiology
  • Nephrology
  • Hepatology

Background:

  • Cardio-renal syndrome is prevalent in chronic heart failure (CHF).
  • Liver function, indicated by GGT, is increasingly recognized as a predictor in CHF.
  • Joint assessment of renal and hepatic function in CHF is warranted.

Purpose of the Study:

  • To investigate the characteristics and prognostic significance of renal and hepatic dysfunction in CHF patients.
  • To explore the relationship between renal and hepatic impairment and disease severity.
  • To identify predictors of renal and hepatic dysfunction in CHF.

Main Methods:

  • Evaluated clinical and laboratory data of 1290 ambulatory CHF patients.
  • Assessed hemodynamics in 253 patients.
  • Defined endpoint as all-cause mortality or heart transplantation.

Main Results:

  • Prevalence of reduced eGFR and elevated GGT was 25% and 44%, respectively.
  • Renal and hepatic dysfunctions were linked to disease severity and independently predicted adverse outcomes.
  • Venous congestion, not cardiac index, predicted changes in eGFR and GGT.

Conclusions:

  • Renal and hepatic dysfunction correlate with functional status and portend a poor prognosis in mild to moderate CHF.
  • Concurrent renal and hepatic impairment signifies disease progression and increased risk.
  • Venous congestion, rather than forward failure, appears to drive renal and hepatic dysfunction in these patients.
Abstract

Related Concept Videos

Heart Failure I: Introduction01:27

Heart Failure I: Introduction

Heart failure refers to a clinical syndrome caused by structural or functional cardiac disorders that prevent the heart from pumping an adequate amount of blood to meet the body's metabolic needs. This condition often arises from myocardial infarction or ischemia, leading to decreased cardiac output, reduced tissue perfusion, impaired gas exchange, fluid volume imbalance, and decreased functional ability.Heart failure can result from disruptions in the mechanisms that regulate cardiac output...
Heart Failure Drugs: Diuretics01:22

Heart Failure Drugs: Diuretics

Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...
Heart Failure VI: Adjunct Therapies01:22

Heart Failure VI: Adjunct Therapies

Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
Heart Failure III: Clinical Manifestations01:26

Heart Failure III: Clinical Manifestations

Heart failure (HF) manifests primarily as dyspnea, fatigue, and fluid retention, resulting in peripheral and pulmonary edema. Symptoms may vary depending on which ventricle is more affected, left or right.Left-Sided Heart FailureAlso known as left ventricular failure, this condition results from the left ventricle's inability to fill or eject sufficient blood into the systemic circulation. It leads to pulmonary congestion, which occurs when the left ventricle fails to eject blood effectively...
Pathophysiology of Heart Failure01:17

Pathophysiology of Heart Failure

Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
Heart Failure V: Medical Management01:30

Heart Failure V: Medical Management

Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...