title: Current therapeutic strategies in cardiorenal syndrome.
abstract: Cardiorenal syndromes (CRS) are disorders of the heart and kidneys in which an acute or chronic dysfunction in one organ may induce acute or chronic dysfunction of the other. Primary disorders of one of these two organs often result in secondary dysfunction or injury of the other. The lack of specific trials in this field highlights the need for further studies aimed to assess titration and appropriate dosages of drugs, according to both the etiology of chronic heart failure (CHF) and also the severity of underlying renal dysfunction. Moreover, the most recent clinical trials evaluating clinical and renal outcome in acute heart failure syndromes (AHFS), failed to demonstrate an improvement in renal function and perfusion. Therefore, Current American and European Guidelines for AHFS does not provide specific recommendation for patients with renal impairment. In this scenario several questions regarding the drugs, their recommended dosage and potential adverse effects on cardiac and renal outcome need to be addressed. Subsequently, therapy inducing an improvement in the renal function, a reduction of neurohormonal activation and an improvement of renal blood flow, could lead to a reduction in mortality and hospitalization in patients with CRS.
authors.affiliation: Department of Internal Medicine, University of Siena, Siena, Italy. palazzuoli2@unisi.it
authors.forename: A
authors.initials: A
authors.lastname: Palazzuoli
authors.forename: A
authors.initials: A
authors.lastname: Geyer
authors.forename: A
authors.initials: A
authors.lastname: Malandrino
authors.forename: M
authors.initials: M
authors.lastname: Pellegrini
authors.forename: M
authors.initials: M
authors.lastname: Beltrami
authors.forename: M
authors.initials: M
authors.lastname: Gilleman
authors.forename: R
authors.initials: R
authors.lastname: Nuti
mesh_terms: D000208:Acute Disease; D059347:Cardio-Renal Syndrome / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality / Q000503:physiopathology; D002316:Cardiotonic Agents / Q000627:therapeutic use; D002908:Chronic Disease; D018450:Disease Progression; D015259:Dopamine Agents / Q000627:therapeutic use; D006333:Heart Failure / Q000188:drug therapy; D006801:Humans; D011379:Prognosis; D051437:Renal Insufficiency / Q000188:drug therapy; D012720:Severity of Illness Index; D049994:Sodium Potassium Chloride Symporter Inhibitors / Q000627:therapeutic use; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000627:therapeutic use
chemical_list: D002316:Cardiotonic Agents; D015259:Dopamine Agents; D049994:Sodium Potassium Chloride Symporter Inhibitors; D014665:Vasodilator Agents