Pharmacologic therapy in patients with chronic heart failure and chronic kidney disease: a complex issue.
Chronic kidney disease is common in patients with chronic heart failure and has important clinical implications. The coexistence of these two syndromes is associated with a higher risk of adverse outcome and increases the difficulties of heart failure treatment because of the complex interplay between renal dysfunction and pharmacologic therapy. The underrepresentation of patients with chronic kidney disease in most heart failure trials contributes to the suboptimal treatment of this high-risk population in clinical practice. In the present review, we briefly examine the pathophysiologic mechanisms connecting chronic kidney disease and chronic heart failure and discuss the therapeutic approach to patients affected by both conditions.
Acquarone
Nicola
N
Struttura Complessa di Medicina Interna, Ente Ospedaliero Ospedali Galliera, Genoa, Italy. nicola.acquarone@galliera.it
Castello
Cristoforo
C
Antonucci
Giancarlo
G
Lione
Sergio
S
Bellotti
Paolo
P
D002317:Cardiovascular Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002908:Chronic Disease; D006331:Heart Diseases / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D007674:Kidney Diseases / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology; D007677:Kidney Function Tests; D016896:Treatment Outcome
D002317:Cardiovascular Agents