The interaction between heart failure, renal failure and anemia - the cardio-renal anemia syndrome.
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.
Silverberg
Donald S
DS
Department of Nephrology and Cardiology, Tel Aviv Medical Center, Tel Aviv, Israel. donald@netvision.net.il
Wexler
Dov
D
Blum
Miriam
M
Wollman
Yoram
Y
Schwartz
Doron
D
Sheps
David
D
Keren
Gad
G
Iaina
Adrian
A
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