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Negotiating renal dysfunction when treating patients with heart failure

Valentina Carubelli1, Marco Metra1, Lars H Lund2

  • 1a Division of Cardiology, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health , University and Civil Hospital of Brescia , Brescia , Italy.

Expert Review of Cardiovascular Therapy
|January 3, 2018
PubMed

Insights

Chronic kidney disease (CKD) is common in heart failure (HF), with no specific treatments for cardiorenal syndrome. This review explores heart-kidney interactions and therapeutic challenges in managing these intertwined conditions.

Area of Science:

  • Cardiology
  • Nephrology
  • Cardiorenal Medicine

Background:

  • Chronic kidney disease (CKD) is a frequent comorbidity in heart failure (HF).
  • Cardiorenal syndrome lacks specific treatments, despite the close pathophysiological link between heart and kidney function.
  • CKD adversely affects HF outcomes, while cardiovascular events are leading causes of mortality in CKD patients.

Purpose of the Study:

  • To review the interaction between heart and kidney function.
  • To describe the consequences of cardiorenal syndrome.
  • To focus on the application of current therapeutics for cardiorenal syndrome.

Main Methods:

  • Literature review of cardiorenal syndrome.
  • Analysis of pathophysiological mechanisms.
  • Discussion of therapeutic management challenges.

Main Results:

  • Multiple mechanisms, including hemodynamic, neurohormonal, and inflammatory mediators, contribute to cardiorenal syndrome.
  • Managing HF drugs in CKD patients presents challenges, such as reduced diuretic response and increased risk of kidney function decline.
  • Balancing cardiac and renal outcomes is a critical aspect of clinical practice.

Conclusions:

  • The intricate relationship between heart and kidney necessitates a careful therapeutic approach.
  • Optimizing treatment for cardiorenal syndrome requires a nuanced understanding of both cardiac and renal physiology.
  • Further research is needed to develop targeted therapies for cardiorenal syndrome.
Abstract

Keywords:
Heart failurechronic kidney diseaserenal dysfunctiontreatment

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