Agata Bielecka-Dabrowa1,2, Breno Godoy3, Joerg C Schefold4, Michael Koziolek5, Maciej Banach1, Stephan von Haehling6. 1. Department of Hypertension, Chair of Nephrology and Hypertension, Medical University of Lodz, Zeromskiego 113, 90-549, Lodz, Poland. 2. Department of Cardiology and Congenital Diseases of Adults, Polish Mother's Memorial Hospital Research Institute (PMMHRI), Rzgowska 281/289, 93-338, Lodz, Poland. 3. Department of Cardiology and Pneumology, University of Göttingen Medical Centre, Robert-Koch-Strasse 40, 37075, Göttingen, Germany. 4. Department of Intensive Care Medicine, Inselspital Bern University Hospital, University of Bern, 3010, Bern, Switzerland. 5. Department of Nephrology and Rheumatology, University Medical Centre Göttingen, Göttingen, Germany. 6. Department of Cardiology and Pneumology, University of Göttingen Medical Centre, Robert-Koch-Strasse 40, 37075, Göttingen, Germany. stephan.von.haehling@web.de.
Abstract
PURPOSE OF REVIEW: Acute decompensated heart failure (ADHF) is one of the biggest challenges in the management of chronic heart failure. Despite several advances in medical and device therapy, high readmission and mortality rates continue to be a burden on healthcare systems worldwide. The aim of the current review is to provide an overview on current as well as future approaches in cardiorenal interactions in patients with ADHF. RECENT FINDINGS: One of the strongest predictors of adverse outcomes in ADHF is renal dysfunction, referred to as cardiorenal syndromes (CRS) or cardiorenal interactions. Patients with ADHF frequently develop worsening of renal function (WRF) and/or acute kidney injury (AKI). Recent studies brought new information about biomarkers in diagnosing and predicting prognosis of CRS. Among others, dry weight at hospital discharge is considered a surrogate marker of successful treatment in ADHF patients with/without renal dysfunction. The etiology of WRF appears to be an important factor for determining risk related to WRF as well as clinical management. The hypertonic saline used as adjunctive therapy for intravenous loop diuretics and/or induction of aquaresis (e.g., using tolvaptan) may be promising and efficient approaches in the future.
PURPOSE OF REVIEW: Acute decompensated heart failure (ADHF) is one of the biggest challenges in the management of chronic heart failure. Despite several advances in medical and device therapy, high readmission and mortality rates continue to be a burden on healthcare systems worldwide. The aim of the current review is to provide an overview on current as well as future approaches in cardiorenal interactions in patients with ADHF. RECENT FINDINGS: One of the strongest predictors of adverse outcomes in ADHF is renal dysfunction, referred to as cardiorenal syndromes (CRS) or cardiorenal interactions. Patients with ADHF frequently develop worsening of renal function (WRF) and/or acute kidney injury (AKI). Recent studies brought new information about biomarkers in diagnosing and predicting prognosis of CRS. Among others, dry weight at hospital discharge is considered a surrogate marker of successful treatment in ADHF patients with/without renal dysfunction. The etiology of WRF appears to be an important factor for determining risk related to WRF as well as clinical management. The hypertonic saline used as adjunctive therapy for intravenous loop diuretics and/or induction of aquaresis (e.g., using tolvaptan) may be promising and efficient approaches in the future.
Authors: Andrew K Roy; Catherine Mc Gorrian; Cecelia Treacy; Edel Kavanaugh; Alice Brennan; Niall G Mahon; Patrick T Murray Journal: Cardiorenal Med Date: 2013-02-26 Impact factor: 2.041
Authors: Mattia A E Valente; Adriaan A Voors; Kevin Damman; Dirk J Van Veldhuisen; Barrie M Massie; Christopher M O'Connor; Marco Metra; Piotr Ponikowski; John R Teerlink; Gad Cotter; Beth Davison; John G F Cleland; Michael M Givertz; Daniel M Bloomfield; Mona Fiuzat; Howard C Dittrich; Hans L Hillege Journal: Eur Heart J Date: 2014-02-28 Impact factor: 29.983
Authors: Kevin Damman; Mattia A E Valente; Dirk J van Veldhuisen; John G F Cleland; Christopher M O'Connor; Marco Metra; Piotr Ponikowski; Gad Cotter; Beth Davison; Michael M Givertz; Daniel M Bloomfield; Hans L Hillege; Adriaan A Voors Journal: Int J Mol Sci Date: 2017-07-08 Impact factor: 5.923
Authors: Jose Luis Holgado; Cristina Lopez; Antonio Fernandez; Inmaculada Sauri; Ruth Uso; Jose Luis Trillo; Sara Vela; Julio Nuñez; Josep Redon; Adrian Ruiz Journal: ESC Heart Fail Date: 2020-02-14
Authors: Cristina Lopez; Jose Luis Holgado; Antonio Fernandez; Inmaculada Sauri; Ruth Uso; Jose Luis Trillo; Sara Vela; Carlos Bea; Julio Nuñez; Ana Ferrer; Javier Gamez; Adrian Ruiz; Josep Redon Journal: J Clin Med Date: 2020-06-15 Impact factor: 4.241