Cardiorenal Syndrome in Acute Heart Failure: Revisiting Paradigms

Núñez, Julio; Miñana, Gema; Santas, Enrique; Bertomeu-González, Vicente

doi:10.1016/j.rec.2014.10.016

Cited by 54 publications

(75 citation statements)

References 89 publications

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“…По данным различных авторов, ОСН осложняется развитием ОПП в 10-40 % случаев [25][26][27][28]. Несмотря на высокую распространенность, ОПП до сих пор таит в себе диагностические, прогностические и терапевти-ческие сложности.…”

Section: Discussionunclassified

The prevalence of renal dysfunction and its influence on the prognosis of patients with acute heart failure

Mezhonov¹,

Vyalkina²,

Шалаев³

2017

RHFJ

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Section: Discussionunclassified

The prevalence of renal dysfunction and its influence on the prognosis of patients with acute heart failure

Mezhonov¹,

Vyalkina²,

Шалаев³

2017

RHFJ

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“…Kalp yetmezliğindeki hipervoleminin oluş mekanziması şekilde gösterilmiştir (Şekil 1). (15)(16)(17)(18). Bu hastalarda diüretiklerin daha yüksek dozlarda veya kombine kullanımı gerekebilir.…”

Section: Kalp Yetmezliğinde Volüm Fazlalığının Patogeneziunclassified

Ultrafiltration Treatment in Heart Failure

Altunören¹,

Güngör²,

Yılmaz³

2016

Turk Neph Dial Transpl

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özKalp yetmezliği genel popülasyonda sık görülen bir hastalık olup ciddi morbidite ve mortalite sebebidir. Tedavide su ve tuz kısıtlamasının yanında temel olarak diüretikler kullanılmaktadır. Ancak diüretik tedavisine yetersiz cevap ve bazı yan etkileri diüretiklerin kullanımlarını kısıtlamaktadır. Ayrıca diüretiklerin kalp yetmezliğinin patogenezinde yer alan nörohumoral aktivasyonu artırdığı da düşünülmektedir. Ultrafiltrasyon, su ve solütlerin konvektif klerensi temeline dayanan bir tedavi yöntemidir ve kalp yetmezliği tedavisinde diüretiğe dirençli olgularda uzun zamandır kullanılmaktadır. Bu derlemede ultrafiltrasyon tedavisinin kalp yetmezliği tedavisindeki yeri irdelendi. AnAhtAR sözcükleR: Diüretik, Kalp yetmezliği, Periton diyalizi, Ultrafiltrasyon AbstRActHeart failure is a common disorder in the general population and causes serious mortality and morbidity. Diuretic agents are generally used in addition to salt and water restriction in its treatment. However, an insufficient response and some adverse affects restrict the usage of diuretics. Furthermore, it is believed that diuretic agents also increase neurohumoral activation that has been cited in the pathogenesis of heart failure. Ultrafiltration is a treatment method based on the convective clearance of water and solutes and has been used for a long time in the treatment of diuretic-resistant heart failure. In this review article, we discuss the place of ultrafiltration in the treatment of heart failure.

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“…Renal dysfunction in AHF patients involves complex and multifactorial mechanisms by haemodynamic (renal arterial hypoperfusion and renal venous congestion) and non‐haemodynamic factors, and these mechanisms have not been completely elucidated. Recent studies have suggested that a WRF has not been associated with a poor outcome in some patients, thereby indicating the need to redefine a WRF in AHF patients 3, 4. AHF patients sometimes have acute renal failure on admission, so patients not having WRF (defined as an increase <0.3 mg/dL in the serum creatinine level vs. the value on admission) might include those who already have acute renal failure on admission.…”

Section: Introductionmentioning

confidence: 99%

Worsening renal function definition is insufficient for evaluating acute renal failure in acute heart failure

et al. 2018

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AimsWhether or not the definition of a worsening renal function (WRF) is adequate for the evaluation of acute renal failure in patients with acute heart failure is unclear.Methods and resultsOne thousand and eighty‐three patients with acute heart failure were analysed. A WRF, indicated by a change in serum creatinine ≥0.3 mg/mL during the first 5 days, occurred in 360 patients while no‐WRF, indicated by a change <0.3 mg/dL, in 723 patients. Acute kidney injury (AKI) upon admission was defined based on the ratio of the serum creatinine value recorded on admission to the baseline creatinine value and placed into groups based on the degree of AKI: no‐AKI (n = 751), Class R (risk; n = 193), Class I (injury; n = 41), or Class F (failure; n = 98). The patients were assigned to another set of four groups: no‐WRF/no‐AKI (n = 512), no‐WRF/AKI (n = 211), WRF/no‐AKI (n = 239), and WRF/AKI (n = 121). A multivariate logistic regression model found that no‐WRF/AKI and WRF/AKI were independently associated with 365 day mortality (hazard ratio: 1.916; 95% confidence interval: 1.234–2.974 and hazard ratio: 3.622; 95% confidence interval: 2.332–5.624). Kaplan–Meier survival curves showed that the rate of any‐cause death during 1 year was significantly poorer in the no‐WRF/AKI and WRF/AKI groups than in the WRF/no‐AKI and no‐WRF/no‐AKI groups and in Class I and Class F than in Class R and the no‐AKI group.ConclusionsThe presence of AKI on admission, especially Class I and Class F status, is associated with a poor prognosis despite the lack of a WRF within the first 5 days. The prognostic ability of AKI on admission may be superior to WRF within the first 5 days.

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Cardiorenal Syndrome in Acute Heart Failure: Revisiting Paradigms

Cited by 54 publications

References 89 publications

The prevalence of renal dysfunction and its influence on the prognosis of patients with acute heart failure

The prevalence of renal dysfunction and its influence on the prognosis of patients with acute heart failure

Ultrafiltration Treatment in Heart Failure

Worsening renal function definition is insufficient for evaluating acute renal failure in acute heart failure

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