Renal dysfunction in heart failure portends adverse outcomes and often limits aggressive medical and decongestive therapies. Despite the high prevalence in this population, not all forms of renal dysfunction are prognostically or mechanistically equivalent: renal dysfunction can result from irreversible nephron loss secondary to diabetes or hypertension or it can develop secondary to the heart failure itself, i.e. the cardiorenal syndrome. Unfortunately, limited progress has been made with respect to differentiation of these potential mechanistic subtypes of renal dysfunction. Currently in the field, we are relegated to using serum creatinine as one of the only diagnostic tools which has led to a poor understanding of cardiorenal syndrome and number of failed clinical trials for its treatment. This lecture will cover proposed mechanisms behind cardiorenal dysfunction in heart failure while addressing both flawed metrics in its diagnosis and treatment while also suggesting potential strategies moving forward by focusing on some challenging patient cases.
Director of Heart Failure Clinical Research,
Temple Heart and Vascular Institute
Credits: None available.
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