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Management of the cardiorenal syndrome in acute heart failure.

Publication ,  Journal Article
Lazzarini, V; Felker, GM
Published in: Curr Treat Options Cardiovasc Med
August 2012

Interactions between the heart and kidney in the setting of acute heart failure are complex and have a substantial impact on patient care and outcomes. Further research is needed to better distinguish the different causes of kidney injury, allow its early and accurate prediction and detection, and identify therapeutic targets. Novel renal biomarkers could potentially provide a useful tool for this purpose. Restoration of optimal fluid status and resolution of renal venous congestion are important goals of therapy. Changes in serum creatinine, although an important marker of renal function, may not be associated with adverse outcomes, especially if they are transient and a consequence of more aggressive decongestion, or the appropriate titration of drugs affecting the renin-angiotensin-aldosterone axis. In addition to loop diuretics, a variety of drugs and strategies have been investigated in acute heart failure. Use of mineralocorticoid receptor antagonists and vasopressin antagonists may have potential benefits and should be further investigated. Inotropic agents should be limited in those clinical settings suggesting hypoperfusion. Ultrafiltration seems to provide a safe and effective tool to overcome diuretic resistance and optimize fluid status avoiding detrimental effects of diuretic therapy.

Duke Scholars

Published In

Curr Treat Options Cardiovasc Med

DOI

EISSN

1534-3189

Publication Date

August 2012

Volume

14

Issue

4

Start / End Page

342 / 355

Location

United States

Related Subject Headings

  • Cardiovascular System & Hematology
  • 3201 Cardiovascular medicine and haematology
 

Citation

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Lazzarini, V., & Felker, G. M. (2012). Management of the cardiorenal syndrome in acute heart failure. Curr Treat Options Cardiovasc Med, 14(4), 342–355. https://doi.org/10.1007/s11936-012-0186-5
Lazzarini, Valentina, and G Michael Felker. “Management of the cardiorenal syndrome in acute heart failure.Curr Treat Options Cardiovasc Med 14, no. 4 (August 2012): 342–55. https://doi.org/10.1007/s11936-012-0186-5.
Lazzarini V, Felker GM. Management of the cardiorenal syndrome in acute heart failure. Curr Treat Options Cardiovasc Med. 2012 Aug;14(4):342–55.
Lazzarini, Valentina, and G. Michael Felker. “Management of the cardiorenal syndrome in acute heart failure.Curr Treat Options Cardiovasc Med, vol. 14, no. 4, Aug. 2012, pp. 342–55. Pubmed, doi:10.1007/s11936-012-0186-5.
Lazzarini V, Felker GM. Management of the cardiorenal syndrome in acute heart failure. Curr Treat Options Cardiovasc Med. 2012 Aug;14(4):342–355.
Journal cover image

Published In

Curr Treat Options Cardiovasc Med

DOI

EISSN

1534-3189

Publication Date

August 2012

Volume

14

Issue

4

Start / End Page

342 / 355

Location

United States

Related Subject Headings

  • Cardiovascular System & Hematology
  • 3201 Cardiovascular medicine and haematology