title: The interaction between heart failure, renal failure and anemia - the cardio-renal anemia syndrome.
abstract: BACKGROUND
  Many patients with congestive heart failure (CHF) have chronic kidney insufficiency (CKI) and anemia.
  
  
  OBJECTIVE
  The purpose of this review is to clarify the relationship between these three factors and to study the effect of correction of anemia in CHF and CKI.
  
  
  RESULTS
  Anemia, CHF and CKI are each capable of causing or worsening each other. Thus they form a vicious circle which can result in progressive CHF, CKI and anemia. Aggressive therapy of CHF, CKI and control of the associated anemia with erythropoietin and i.v. iron can prevent the progression of CHF and CKI, reduce hospitalization, and improve quality of life.
  
  
  CONCLUSIONS
  CHF patients are a major source of end-stage renal failure patients and deserve special attention. If treated well and early, progressive heart failure and renal failure can be prevented. Cooperation between nephrologists, cardiologists, and other internists will improve the care of all three conditions and prevent their progression.
authors.affiliation: Department of Nephrology and Cardiology, Tel Aviv Medical Center, Tel Aviv, Israel. donald@netvision.net.il
authors.forename: Donald S
authors.initials: DS
authors.lastname: Silverberg
authors.forename: Dov
authors.initials: D
authors.lastname: Wexler
authors.forename: Miriam
authors.initials: M
authors.lastname: Blum
authors.forename: Yoram
authors.initials: Y
authors.lastname: Wollman
authors.forename: Doron
authors.initials: D
authors.lastname: Schwartz
authors.forename: David
authors.initials: D
authors.lastname: Sheps
authors.forename: Gad
authors.initials: G
authors.lastname: Keren
authors.forename: Adrian
authors.initials: A
authors.lastname: Iaina
mesh_terms: D000740:Anemia / Q000150:complications* / Q000188:drug therapy / Q000209:etiology; D042241:Early Diagnosis; D006333:Heart Failure / Q000150:complications* / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D051437:Renal Insufficiency / Q000150:complications* / Q000209:etiology / Q000517:prevention & control; D013577:Syndrome