title: The cardiorenal syndrome in heart failure: an evolving paradigm.
abstract: Heart failure constitutes a significant source of morbidity and mortality in the United States, and its incidence and prevalence continue to grow, increasing its burden on the healthcare system. Renal dysfunction in patients with heart failure is common and has been associated with adverse clinical outcomes. This interaction, termed the cardiorenal syndrome, is a complex phenomenon characterized by a pathophysiologic disequilibrium between the heart and the kidney, in which malfunction of 1 organ consequently promotes the impairment of the other. Multiple neurohumoral mechanisms are involved in this cardiorenal interaction, including the deficiency of and/or resistance to compensatory natriuretic peptides, leading to sodium retention, volume overload and organ remodeling. Management of patients with the cardiorenal syndrome can be challenging and should be individualized. Emerging therapies must address the function of both organs to secure better clinical outcomes. To this end, a multidisciplinary approach is recommended to achieve optimal results.
authors.affiliation: Department of Internal Medicine, SUNY Upstate Medical University, Syracuse, New York 13210, USA.
authors.forename: Shilpa
authors.initials: S
authors.lastname: Kshatriya
authors.forename: Hani
authors.initials: H
authors.lastname: Kozman
authors.forename: Danish
authors.initials: D
authors.lastname: Siddiqui
authors.forename: Luna
authors.initials: L
authors.lastname: Bhatta
authors.forename: Kan
authors.initials: K
authors.lastname: Liu
authors.forename: Ali
authors.initials: A
authors.lastname: Salah
authors.forename: Timothy
authors.initials: T
authors.lastname: Ford
authors.forename: Robert
authors.initials: R
authors.lastname: Michiel
authors.forename: Daniel
authors.initials: D
authors.lastname: Villarreal
mesh_terms: D000241:Adenosine / Q000037:antagonists & inhibitors; D006333:Heart Failure / Q000150:complications* / Q000401:mortality / Q000628:therapy; D006801:Humans; D007674:Kidney Diseases / Q000150:complications* / Q000628:therapy; D045283:Natriuretic Agents / Q000627:therapeutic use; D014462:Ultrafiltration; D014667:Vasopressins / Q000037:antagonists & inhibitors
chemical_list: D045283:Natriuretic Agents; D014667:Vasopressins; D000241:Adenosine