Cardiorenal Syndrome in Acute Heart Failure: Revisiting Paradigms

Revista Española De Cardiología
Julio NúñezVicente Bertomeu-González

Abstract

Cardiorenal syndrome has been defined as the simultaneous dysfunction of both the heart and the kidney. Worsening renal function that occurs in patients with acute heart failure has been classified as cardiorenal syndrome type 1. In this setting, worsening renal function is a common finding and is due to complex, multifactorial, and not fully understood processes involving hemodynamic (renal arterial hypoperfusion and renal venous congestion) and nonhemodynamic factors. Traditionally, worsening renal function has been associated with worse outcomes, but recent findings have revealed mixed and heterogeneous results, perhaps suggesting that the same phenotype represents a diversity of pathophysiological and clinical situations. Interpreting the magnitude and chronology of renal changes together with baseline renal function, fluid overload status, and clinical response to therapy might help clinicians to unravel the clinical meaning of renal function changes that occur during an episode of heart failure decompensation. In this article, we critically review the contemporary evidence on the pathophysiology and clinical aspects of worsening renal function in acute heart failure.

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Citations

Oct 8, 2016·Revista Portuguesa De Cardiologia : Orgão Oficial Da Sociedade Portuguesa De Cardiologia = Portuguese Journal of Cardiology : an Official Journal of the Portuguese Society of Cardiology·Ana Luísa Pinheiro da Silva, Manuel Joaquim Vaz da Silva
Jul 19, 2016·European Journal of Heart Failure·Julio NúñezJosep Comín-Colet
Dec 14, 2019·ESC Heart Failure·Vicente PerniasJulio Núñez
May 18, 2020·European Journal of Clinical Investigation·Weihao LiangChen Liu
Sep 12, 2021·European Journal of Internal Medicine·Rafael de la EspriellaJulio Núñez
Jul 30, 2020·Cardiorenal Medicine·Gema MiñanaUNKNOWN on behalf of IMPROVE-HF Investigators

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