title: Cardiorenal syndrome in acute decompensated heart failure.
abstract: Cardiorenal syndrome (CRS) commonly occurs during treatment of acute decompensated heart failure (ADHF) and is associated with poor clinical outcome. The pathophysiology of CRS entails a complex interaction between hemodynamic alterations, including reduced renal perfusion, increased venous pressure and activation of multiple neurohormonal systems. Attempts to effectively treat congestion while preserving renal function in ADHF are often met with limited clinical success and often require therapeutic decisions that reflect a compromise between potential benefits and harm. At present, there is no evidence-based intervention specifically targeted at renal function. Recent Phase III randomized trials, using novel agents in patients with ADHF, have largely failed to demonstrate any benefits of therapy on renal and clinical outcomes. Early diagnosis of CRS using novel markers of tubular injury may allow for timely interventions and attenuate progression. Future studies are needed to further elucidate the pathophysiology of this complex syndrome and identify new potential targets for effective evidence-based treatments.
authors.affiliation: Department of Cardiology, Rambam Medical Center and the Rappaport Research Institute, Technion, Israel Institute of Technology, Bat Galim, Haifa, Israel. daronson@tx.technion.ac.il
authors.forename: Doron
authors.initials: D
authors.lastname: Aronson
mesh_terms: D000208:Acute Disease; D058186:Acute Kidney Injury / Q000209:etiology* / Q000628:therapy; D000818:Animals; D015415:Biomarkers / Q000378:metabolism; D059347:Cardio-Renal Syndrome / Q000175:diagnosis / Q000503:physiopathology*; D017326:Clinical Trials, Phase III as Topic; D018450:Disease Progression; D042241:Early Diagnosis; D006333:Heart Failure / Q000150:complications*; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D013997:Time Factors
chemical_list: D015415:Biomarkers