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The kidney in cardiac failure: today’s perspective

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Critical Care Nephrology

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Abstract

An old German saying to describe the extremes of thoroughness compares this job symbolically (“etwas auf Herz and Nieren prüfen”) with a meticulous examination of the heart and the kidney together. In this way, the saying tacitly implies that the heart and the kidney are at the center of things — but only if in cooperation. As we now know, the heart, the kidney, and the blood vessel organs constitute the essential limbs of the cardiovascular perfusion system, the functions of which are regulated in an organized manner. To the physician scientist, cardiac failure therefore should make for an interesting abnormality: it challenges the compensatory capabilities of the kidney. Given that the latter receives the highest blood perfusion rate amongst the parenchymal organs of the body — at least under normal conditions — and that it is endowed with an unparalleled array of vascular control mechanisms, it is clear that cardiac failure will be a telling condition as regards the biological function of the kidney — and its many fine details. The present contribution will broadly outline the conceptual framework of renal function in heart failure as it evolved over the last 150 years (Fig. 1); it will then mainly focus on the many aspects of recent and ongoing progress that has been made. The way(s) in which the kidney appears to be — relatively — protected from ischemic acute tubular necrosis in cardiac failure will also be addressed.

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  1. Peter Gross
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  2. Martin Schadt
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  3. Jens Passauer
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  4. Dierk Werner
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  5. Eckhart Büssemaker
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Gross, P., Schadt, M., Passauer, J., Werner, D., Büssemaker, E. (1998). The kidney in cardiac failure: today’s perspective. In: Critical Care Nephrology. Springer, Dordrecht. https://doi.org/10.1007/978-94-011-5482-6_84

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  • DOI: https://doi.org/10.1007/978-94-011-5482-6_84

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