title: The kidney in heart failure: an update.
abstract: Heart and kidney are closely related in the clinical syndrome of heart failure (HF). It is now sufficiently clear that renal dysfunction occurs frequently in all phenotypes of HF, and when present, it is associated with higher mortality and morbidity. While the pathophysiology is multifactorial, the most important factors are a reduced renal perfusion and venous congestion. Recent interest has focused on worsening renal function (WRF), a situation strongly related to mortality, but seemingly only when HF status deteriorates. Unfortunately, to date clinicians are unable to identify specifically those patients with a grim prognosis following WRF. Although much has been learned on cardiorenal interaction in HF, still more questions have been left unanswered. The coming decade should provide us with more dedicated epidemiologic, mechanistic, and controlled trials in HF patients with reduced renal function. An updated classification of the cardiorenal syndrome that incorporates recent evidence and points towards areas of interest and uncertainties, and areas where progress is needed could facilitate this process. Ultimately, this should lead to preventive and treatment strategies that can preserve renal function and associated outcome in patients with HF.
authors.affiliation: University of Groningen, Department of Cardiology, University Medical Center Groningen, Hanzeplein 1, 9700RB Groningen, The Netherlands k.damman@umcg.nl.
authors.forename: Kevin
authors.initials: K
authors.lastname: Damman
authors.affiliation: Department of Internal Medicine and Program of Applied Translational Research, Yale University, New Haven, CT, USA.
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Testani
mesh_terms: D058186:Acute Kidney Injury / Q000503:physiopathology; D015415:Biomarkers / Q000652:urine; D059347:Cardio-Renal Syndrome / Q000145:classification / Q000503:physiopathology* / Q000628:therapy; D042241:Early Diagnosis; D005544:Forecasting; D005919:Glomerular Filtration Rate / Q000502:physiology; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D007676:Kidney Failure, Chronic / Q000503:physiopathology; D015201:Meta-Analysis as Topic; D011379:Prognosis; D009626:Terminology as Topic
chemical_list: D015415:Biomarkers
keywords: Cardiorenal interaction; Heart failure; Renal dysfunction
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