The kidney in heart failure.
Renal dysfunction is a constant feature of congestive heart failure and is a stronger predictor of mortality than left ventricular ejection fraction or New York Heart Association classification. In heart failure, a reduction of glomerular filtration rate and renal plasma flow occurs, although the filtration fraction increases. There are many reason for this pattern. A reduction in effective circulating volume stimulates sympathetic activity and the renin-angiotensin-aldosterone system, and it is associated with increased concentrations of atrial natriuretic peptide, brain natriuretic peptide, and tumor necrosis factor alpha. Because in chronic kidney disease heart dysfunction commonly is present, an efficient cardiologist-nephrologist interaction should be promoted.
De Santo
Natale G
NG
First Division of Nephrology Second University of Naples, Naples, Italy. nataleg.desanto@unina2.it
Cirillo
Massimo
M
Perna
Alessandra
A
Pollastro
Rosa Maria
RM
Frangiosa
Annamaria
A
Di Stazio
Enzo
E
Iorio
Luigi
L
Andrea Di Leo
Vito
V
Anastasio
Pietro
P
D000368:Aged; D002309:Cardiology / Q000379:methods; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006333:Heart Failure / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D006801:Humans; D007400:Interprofessional Relations; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D009398:Nephrology / Q000379:methods; D051437:Renal Insufficiency / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D017595:Renal Plasma Flow / Q000502:physiology; D018570:Risk Assessment; D012720:Severity of Illness Index; D016019:Survival Analysis; D014655:Vascular Resistance / Q000502:physiology