The puzzle of kidney dysfunction in heart failure: an introduction

Metra, Marco; Voors, Adriaan A.

doi:10.1007/s10741-012-9304-4

Cited by 7 publications

(8 citation statements)

References 17 publications

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“…the theory of aberrant fluid re-distribution rather than accumulation). Besides, due to the fact that some studies have reported inconsistencies between serum creatinine levels compared with novel biomarkers (urinary or systemic Neutrophil Gelatinase-Associated Lipocalin [NGAL]) and cyctatin-C (27)(28)(29)(30), it has been suggested that creatinine might not be an ideal tool for studying the true changes in renal function in this patient population (31). A unifying overview of the…”

Section: Proposed Mechanisms Of Wrf In Adhfmentioning

confidence: 99%

Cardiorenal Interactions in Acute Decompensated Heart Failure: Contemporary Concepts Facing Emerging Controversies

Kazory¹,

Elkayam²

2014

Journal of Cardiac Failure

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Section: Proposed Mechanisms Of Wrf In Adhfmentioning

confidence: 99%

Cardiorenal Interactions in Acute Decompensated Heart Failure: Contemporary Concepts Facing Emerging Controversies

Kazory¹,

Elkayam²

2014

Journal of Cardiac Failure

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“…Considerable reduction of GFR may accompany the weeny elevation of serum creatinine concentration, especially in patients with advanced age and low muscle mass ( 8 ). In addition, the uplift of serum creatinine is comparatively lagged behind AKI and is insensitive to tubular impairment ( 67 ). These characteristics impose restrictions on the utilization of creatinine.…”

Section: Markers For Wrfmentioning

confidence: 99%

Insights of Worsening Renal Function in Type 1 Cardiorenal Syndrome: From the Pathogenesis, Biomarkers to Treatment

Hui

et al. 2021

Front. Cardiovasc. Med.

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Type-1 cardiorenal syndrome refers to acute kidney injury induced by acute worsening cardiac function. Worsening renal function is a strong and independent predictive factor for poor prognosis. Currently, several problems of the type-1 cardiorenal syndrome have not been fully elucidated. The pathogenesis mechanism of renal dysfunction is unclear. Besides, the diagnostic efficiency, sensitivity, and specificity of the existing biomarkers are doubtful. Furthermore, the renal safety of the therapeutic strategies for acute heart failure (AHF) is still ambiguous. Based on these issues, we systematically summarized and depicted the research actualities and predicaments of the pathogenesis, diagnostic markers, and therapeutic strategies of worsening renal function in type-1 cardiorenal syndrome.

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Section: Prevalence and Clinical Impact Of Chronic Kidney Dysfunctionmentioning

confidence: 99%

“…The potential reasons for this ambiguity should be researched in several interplays of multiple factors: the selected population, unknown kidney status and associated comorbidities before hospitalisation. 6,7,9 Several studies demonstrate that approximately 20-40% of patients with ADHF develop renal impairment, based on the RIFLE criteria. 3,16 This wide range in the reported incidence is largely caused by the variability in the definition of WRF and in the observed time at risk, and it is also due to the heterogeneity of study populations.…”

Section: Prevalence and Clinical Impact Of Chronic Kidney Dysfunctionmentioning

confidence: 99%

“…5 This process is due to HF, RD and fluid overload but there are several other factors involved in CRS, such as systemic and renal haemodynamic alterations, parenchymal tubular and glomerular damage, increased neuroendocrine activity, inflammatory and endothelial activation, diuretic resistance, increased venous pressure and systemic vasoconstriction. 6 All these factors can influence in different ways the maintenance or the worsening of CRS. 7 Nevertheless, CRS definition and categorisation encompasses acute HF leading to acute kidney injury (AKI) (CRS type 1) and chronic HF associated with CKD (CRS type 2).…”

Section: Introductionmentioning

confidence: 99%

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Chronic kidney disease and worsening renal function in acute heart failure: different phenotypes with similar prognostic impact?

Palazzuoli

Lombardi

Ruocco

et al. 2016

European Heart Journal: Acute Cardiovascular Care

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Nearly a third of patients with acute heart failure experience concomitant renal dysfunction. This condition is often associated with increased costs of care, length of hospitalisation and high mortality. Although the clinical impact of chronic kidney disease (CKD) has been well established, the exact clinical significance of worsening renal function (WRF) during the acute and post-hospitalisation phases is not completely understood. Therefore, it is still unclear which of the common laboratory markers are able to identify WRF at an early stage. Recent studies comparing CKD with WRF showed contradictory results; this could depend on a different WRF definition, clinical characteristics, haemodynamic disorders and the presence of prior renal dysfunction in the population enrolled. The current definition of acute cardiorenal syndrome focuses on both the heart and kidney but it lacks precise laboratory marker cut-offs and a specific diagnostic approach. WRF and CKD could represent different pathophysiological mechanisms in the setting of acute heart failure; the traditional view includes reduced cardiac output with systemic and renal vasoconstriction. Nevertheless, it has become a mixed model that encompasses both forward and backward haemodynamic dysfunction. Increased central venous pressure, renal congestion with tubular obliteration, tubulo-glomerular feedback and increased abdominal pressure are all potential additional contributors. The impact of WRF on patients who experience preserved renal function and individuals affected with CKD is currently unknown. Therefore it is extremely important to understand the origins, the clinical significance and the prognostic impact of WRF on CKD.

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The puzzle of kidney dysfunction in heart failure: an introduction

Cited by 7 publications

References 17 publications

Cardiorenal Interactions in Acute Decompensated Heart Failure: Contemporary Concepts Facing Emerging Controversies

Cardiorenal Interactions in Acute Decompensated Heart Failure: Contemporary Concepts Facing Emerging Controversies

Insights of Worsening Renal Function in Type 1 Cardiorenal Syndrome: From the Pathogenesis, Biomarkers to Treatment

Chronic kidney disease and worsening renal function in acute heart failure: different phenotypes with similar prognostic impact?

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