Renal dysfunction in heart failure patients: what is the evidence?

Congestive heart failure (CHF) is an increasingly common medical condition and the fastest growing cardiovascular diagnosis in North America. Over one-third of patients with heart failure also have renal insufficiency. It has been shown that renal insufficiency confers worsened outcomes to patients...

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Bibliographic Details
Published in:Heart failure reviews 2007-03, Vol.12 (1), p.37-47
Main Authors: Saltzman, Heath E, Sharma, Kumar, Mather, Paul J, Rubin, Sharon, Adams, Suzanne, Whellan, David Joshua
Format: Article
Language:English
Subjects:
Acute Disease
Adrenergic beta-Antagonists - therapeutic use
Angiotensin II Type 1 Receptor Blockers - therapeutic use
Angiotensin-Converting Enzyme Inhibitors - therapeutic use
Cardiac Catheterization - adverse effects
Cardiac Pacing, Artificial
Clinical trials
Clinical Trials as Topic
Congestive heart failure
Digoxin - therapeutic use
Heart failure
Heart Failure - complications
Heart Failure - drug therapy
Heart Failure - therapy
Humans
Kidney diseases
Milrinone - therapeutic use
Mineralocorticoid Receptor Antagonists - therapeutic use
Morbidity
Natriuretic Peptide, Brain - therapeutic use
Patients
Renal failure
Renal function
Renal insufficiency
Renal Insufficiency, Chronic - complications
Renal Insufficiency, Chronic - drug therapy
Renal Insufficiency, Chronic - therapy
Treatment Outcome
Ultrafiltration
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Summary:Congestive heart failure (CHF) is an increasingly common medical condition and the fastest growing cardiovascular diagnosis in North America. Over one-third of patients with heart failure also have renal insufficiency. It has been shown that renal insufficiency confers worsened outcomes to patients with heart failure. However, a majority of the larger and therapy-defining heart failure medication and device trials exclude patients with advanced renal dysfunction. These studies also infrequently perform subgroup analyses based on the degree of renal dysfunction. The lack of information on heart failure patients who have renal insufficiency likely contributes to their being prescribed mortality and morbidity reducing medications and receiving diagnostic and therapeutic procedures at lower rates than heart failure patients with normal renal function. Inclusion of patients with renal insufficiency in heart failure studies and published guidelines for medication, device, and interventional therapies would likely improve patient outcomes.
ISSN:1382-4147
1573-7322
DOI:10.1007/s10741-007-9006-5