title: Congestive heart failure and renal complications.
abstract: Congestive heart failure is the leading cause of hospital admission among patients over the age of 65 years. It affects population within the United States, including Puerto Rico, presenting itself as the leading cause of heart related deaths worldwide. Its management can include pharmacologic agents which will affect neuroendocrine axis mainly but also include novel non-pharmacologic approaches such as ultrafiltration. The coexistence of heart failure and renal dysfunctions are very common within our medical community, especially within the western hemisphere, causing greater concerns amongst the medical field with increased research and investigation activity. This clinical review article will address the theme of congestive heart failure, highlighting the edema formation concept, volume homeostasis, cardio-renal syndrome and neuroendocrine pathways. The management of acute decompensated heart failure is discussed, primarily focusing with available novel non-pharmacologic approaches.
authors.affiliation: Cardiology Section, Department of Medicine, VA Caribbean Healthcare System, Puerto Rico, USA.
authors.forename: Valentin J
authors.initials: VJ
authors.lastname: Del Rio-Santiago
authors.forename: Luis
authors.initials: L
authors.lastname: Rodriguez-Ospina
authors.forename: Héctor R
authors.initials: HR
authors.lastname: Córdova
authors.forename: Sonia I
authors.initials: SI
authors.lastname: Vicenty
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D017298:Bisoprolol / Q000627:therapeutic use; D002227:Carbazoles / Q000627:therapeutic use; D002302:Cardiac Output; D002316:Cardiotonic Agents / Q000627:therapeutic use; D000077261:Carvedilol; D002986:Clinical Trials as Topic; D004077:Digoxin / Q000627:therapeutic use; D004232:Diuretics / Q000627:therapeutic use; D004351:Drug Resistance; D045604:Extracellular Fluid / Q000502:physiology; D005919:Glomerular Filtration Rate; D006333:Heart Failure / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D006706:Homeostasis; D006801:Humans; D007674:Kidney Diseases / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology; D010349:Patient Compliance; D010353:Patient Education as Topic; D011412:Propanolamines / Q000627:therapeutic use; D017382:Reactive Oxygen Species; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology; D012084:Renin-Angiotensin System / Q000502:physiology; D013564:Sympathetic Nervous System / Q000503:physiopathology; D014462:Ultrafiltration
chemical_list: D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D002227:Carbazoles; D002316:Cardiotonic Agents; D004232:Diuretics; D011412:Propanolamines; D017382:Reactive Oxygen Species; D000077261:Carvedilol; D004077:Digoxin; D017298:Bisoprolol