title: Pharmacologic strategies to preserve renal function in acute decompensated heart failure.
abstract: Over a million patients get hospitalized with the diagnosis of acute decompensated heart failure which poses an insurmountable financial burden on the health care system. Heart failure alone incurs over 30 billion dollars with half the cost spent towards acute hospitalizations. Majority of the treatment strategies have focused towards decongesting patients which often comes with the cost of worsening renal function. Renal dysfunction in the setting of acute decompensated heart failure portends worse morbidity and mortality. Recently, there has been a change in the focus with shift towards therapies attempting to conserve renal function. In the past decade, we have witnessed several large randomized controlled trials testing the established as well as emerging therapies in this subset of population with mixed results. This review intends to provide a comprehensive overview of the pharmacologic therapies commonly utilized in the management of acute decompensated heart failure and the body of evidence supporting these strategies.
authors.affiliation: Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH, 44195, USA.
authors.forename: Sachin
authors.initials: S
authors.lastname: Kumar
authors.forename: David O
authors.initials: DO
authors.lastname: Taylor
mesh_terms: D000208:Acute Disease; D002316:Cardiotonic Agents / Q000009:adverse effects / Q000627:therapeutic use; D004232:Diuretics / Q000009:adverse effects / Q000627:therapeutic use; D006333:Heart Failure / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D051437:Renal Insufficiency / Q000209:etiology / Q000517:prevention & control*; D014665:Vasodilator Agents / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D002316:Cardiotonic Agents; D004232:Diuretics; D014665:Vasodilator Agents