title: What physicians need to know about renal function in outpatients with heart failure.
abstract: The majority of outpatients with heart failure (HF) have chronic kidney disease (CKD) as an important comorbidity. Both glomerular filtration rate and abnormal urinary albumin excretion are major predictors of outcome in HF patients. Despite this, patients with renal dysfunction have been systematically excluded from the large randomized HF trials. There is lack of evidence for optimal treatment in these cardiorenal patients and treatment nihilism may account in part for their bad prognosis. Identifying and monitoring the progression of renal disease and making an effort to preserve renal function should be an important task in the management of all patients with HF. In this review, the current understanding of the pathophysiology of renal dysfunction in outpatients with HF will be summarized. Furthermore, important principles of the identification and management of cardiorenal patients will be described in order to make the physician more capable of managing outpatients with HF and renal dysfunction.
authors.affiliation: Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
authors.forename: Bård
authors.initials: B
authors.lastname: Waldum-Grevbo
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000553:Ambulatory Care; D057911:Angiotensin Receptor Antagonists / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D015415:Biomarkers / Q000378:metabolism; D059347:Cardio-Renal Syndrome / Q000503:physiopathology* / Q000628:therapy; D003404:Creatinine / Q000378:metabolism; D017147:Defibrillators, Implantable; D004232:Diuretics / Q000627:therapeutic use; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D008297:Male; D000451:Mineralocorticoid Receptor Antagonists / Q000627:therapeutic use; D065667:Renal Elimination / Q000502:physiology
chemical_list: D000319:Adrenergic beta-Antagonists; D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D015415:Biomarkers; D004232:Diuretics; D000451:Mineralocorticoid Receptor Antagonists; D003404:Creatinine