[Combined cardiorenal failure: a rapidly expanding clinical entity].
The cardiovascular diseases represent the chief cause of morbidity and mortality in Spain. The development of renal insufficiency has a definite prognostic value and modifies therapeutic options. Cardio-renal insufficiency (IC-R) is a differentiated entity, underestimated in our population, in which both cardiac and renal failure coexist. Patients with IC-R are genuine survivors of the application of diverse technologies and have a different hemodynamic and hydrosaline balance compared to that seen in patients with isolated cardiac or renal insufficiency. Early diagnosis and careful follow-up, both in hospital and at ambulatory level, along with a specific management, determine the prognosis of this entity. A key aspect in the control of these patients resides in the preservation of a delicate fluid balance, which is always individualized and personalized. This type of approach requires a particular type of training and mental attitude by healthcare professionals, with an integrated view of the multifactorial nature of IC-R. The design of a plan structured according to objectives and the full understanding of the individual equilibrium constitute the keystone in the management of IC-R. The present review, which is based on traditional concepts updated under a practical view, is aimed to call attention on a rapidly expanding clinical entitiy.
Caramelo
Carlos
C
Departamento de Medicina. Clínica de la Concepción. Universidad Autónoma de Madrid. Instituto Reina Sofía de Investigación Nefrológica. Madrid. España. ccaramelo@fjd.es
Gil
Paloma
P
D006333:Heart Failure / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D051437:Renal Insufficiency / Q000150:complications* / Q000175:diagnosis / Q000628:therapy