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Worsening Renal Function in a Patient with Acute Heart Failure and Volume Overload

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Cardiorenal Syndrome in Heart Failure

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Abstract

Acute heart failure exacerbations center around volume overload and treatment of this disease process often requires aggressive diuresis in order to achieve symptomatic relief. The management of heart failure through the use of intravenous diuretics is at times limited due to renal function. An elevated Cr level, which has previously been associated with poor outcomes, is a common end-point in most AHF trials. However, recent data has called into question the validity of Cr as a marker of prognosis. The objective of this chapter is to review the mechanisms by which loop diuretics function, the efficacy of Cr as a marker of renal injury, potential novel markers, as well as alternative therapies to optimize decongestion in the setting of AHF.

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Authors and Affiliations

  1. Department of Internal Medicine, Stony Brook University Hospital, Stony Brook, NY, USA

    Ely Gracia MD

  2. Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA

    Javed Butler MD, MPH, MBA

  3. Department of Nephrology and Hypertension, Stony Brook University Hospital, Stony Brook, NY, USA

    Sandeep K. Mallipattu MD

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Correspondence to Javed Butler MD, MPH, MBA .

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Editors and Affiliations

  1. Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH, USA

    W. H. Wilson Tang

  2. Department of Internal Medicine, UZ Leuven, Leuven, Belgium

    Frederik H. Verbrugge

  3. Ziekenhuis Oost-Limburg, Genk University Hasselt, Genk, Belgium

    Wilfried Mullens

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Gracia, E., Butler, J., Mallipattu, S.K. (2020). Worsening Renal Function in a Patient with Acute Heart Failure and Volume Overload. In: Tang, W., Verbrugge, F., Mullens, W. (eds) Cardiorenal Syndrome in Heart Failure. Springer, Cham. https://doi.org/10.1007/978-3-030-21033-5_10

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