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What physicians need to know about renal function in outpatients with heart failure
1Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
Cardiology
|May 14, 2015
Summary
Most heart failure (HF) outpatients have chronic kidney disease (CKD). This review summarizes cardiorenal pathophysiology and management principles for HF patients with renal dysfunction.
Area of Science:
- Cardiology
- Nephrology
- Internal Medicine
Background:
- Heart failure (HF) frequently coexists with chronic kidney disease (CKD) in outpatients.
- Glomerular filtration rate and albuminuria are key outcome predictors in HF patients.
- Patients with renal dysfunction are often excluded from HF clinical trials, limiting evidence-based treatment.
Purpose of the Study:
- To review the pathophysiology of renal dysfunction in HF outpatients.
- To outline principles for identifying and managing cardiorenal patients.
- To enhance physician capability in managing HF with coexisting renal dysfunction.
Main Methods:
- Literature review of cardiorenal pathophysiology.
- Synthesis of current evidence on HF and CKD management.
- Discussion of diagnostic and therapeutic strategies.
Main Results:
- Renal dysfunction is common and impacts HF prognosis.
- Lack of evidence exists for optimal cardiorenal patient treatment.
- Treatment nihilism may contribute to poor outcomes in this population.
Conclusions:
- Preserving renal function is crucial in HF management.
- Systematic identification and monitoring of renal disease are essential.
- Improved understanding and management strategies are needed for cardiorenal patients.
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