Open AccessOrgan Cross Talk in the Critically Ill: The Heart and Kidney
Author(s) -
Robb D. Kociol,
Joseph G. Rogers,
Andrew Shaw
Publication year - 2009
Publication title -
blood purification
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 57
eISSN - 1421-9735
pISSN - 0253-5068
DOI - 10.1159/000207198
Subject(s) - cardiorenal syndrome , medicine , heart failure , furosemide , intensive care medicine , diuretic , vasopressin , tolvaptan , renal function , natriuretic peptide , acute decompensated heart failure , kidney , cardiology , pathophysiology
Heart failure results in significant morbidity and mortality in the United States. Chronic heart failure is often complicated by renal insufficiency. Further, acute decompensated heart failure is often complicated by worsening renal function or the development of diuretic resistance. Heart failure complicated by renal dysfunction has a significantly worse prognosis. The pathophysiology underlying this so-called cardiorenal syndrome (CRS) is unclear. It likely involves a combination of maladaptive neurohormonal activation and renal homeostatic mechanisms. The treatment (including recombinant B-type natriuretic peptide, ultrafiltration, continuous furosemide infusions and vasopressin antagonists) has thus far been marginally successful at best. Further research into the mechanism and treatment of CRS is required.