Related Experiment Video
Updated: May 6, 2026
16:11
Implantation of the Syncardia Total Artificial Heart
Published on: July 18, 2014
36.9K
Heart Failure-Focus on Kidney Replacement Therapy: Why, When, and How?
Ewa Wojtaszek1, Marlena Kwiatkowska-Stawiarczyk1, Małgorzata Sobieszczańska-Małek2
1Department of Nephrology, Dialysis and Internal Diseases, Medical University of Warsaw, 02-097 Warsaw, Poland.
International Journal of Molecular Sciences
|March 27, 2025
Summary
Heart failure (HF) and cardiorenal syndrome (CRS) management is challenging, especially with diuretic resistance. This review explores kidney replacement therapies as a potential solution for advanced CRS patients.
Area of Science:
- Cardiology
- Nephrology
- Critical Care Medicine
Background:
- Heart failure (HF) significantly contributes to morbidity and mortality.
- Kidney dysfunction is a major complication in advanced HF, affecting nearly half of patients as cardiorenal syndrome (CRS).
- Managing advanced HF with CRS presents considerable clinical challenges.
Purpose of the Study:
- To review current evidence on kidney replacement therapies for cardiorenal syndrome.
- To discuss extracorporeal and peritoneal-based techniques for CRS management.
Main Methods:
- Literature review of current evidence.
- Analysis of kidney replacement techniques in CRS patients.
Main Results:
- Diuretics are first-line for decongestion but often lead to resistance in CRS.
- Persistent congestion and worsening kidney function may necessitate kidney replacement therapy.
- Extracorporeal and peritoneal dialysis are presented as therapeutic options.
Conclusions:
- Kidney replacement therapy is a crucial consideration for advanced CRS patients with diuretic resistance.
- Both extracorporeal and peritoneal dialysis techniques offer potential solutions for managing complex CRS cases.
Related Concept Videos
01:33Hormonal Regulation
32.8K
The renin-aldosterone system is an endocrine system which guides the renal absorption of water and electrolytes, thus managing blood pressure and osmoregulation. Activation of the system begins in the kidneys with a small cluster of cells adjacent to the afferent and efferent blood vessels of the renal corpuscle. As the nephrons are filtering blood, juxtaglomerular cells monitor blood pressure. If they detect a decrease in pressure, they release the hormone renin into the bloodstream.
32.8K
01:17Pathophysiology of Heart Failure
1.4K
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...
1.4K
01:26Heart Failure Drugs: Inotropic Agents
476
Positive inotropic agents are commonly used as the first line of treatment for heart failure. One such agent is digoxin, derived from the genus Digitalis, which has been known for centuries but effectively utilized since 1785. However, these cardiac glycosides can have potentially toxic effects due to their mechanism of action, which involves inhibiting Na+/K+-ATPase and increasing contractility. Digoxin is absorbed orally and distributed in various tissues, including the CNS. It has a long...
476
01:22Heart Failure Drugs: Diuretics
309
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...
309
01:26Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
354
The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
354
01:27Dialysis
244
Renal failure occurs when the kidneys lose their ability to filter waste products from the blood effectively. It can be classified into two types: acute renal failure (ARF) and chronic renal failure (CRF).
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
244