Heart failure and kidney dysfunction: epidemiology, mechanisms and management.

Schefold, Joerg C.; Filippatos, Gerasimos; Hasenfuss, Gerd; Anker, Stefan D; von Haehling, Stephan (2016). Heart failure and kidney dysfunction: epidemiology, mechanisms and management. Nature reviews. Nephrology, 12(10), pp. 610-623. Nature Publishing Group 10.1038/nrneph.2016.113

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Heart failure (HF) is a major health-care problem and the prognosis of affected patients is poor. HF often coexists with a number of comorbidities of which declining renal function is of particular importance. A loss of glomerular filtration rate, as in acute kidney injury (AKI) or chronic kidney disease (CKD), independently predicts mortality and accelerates the overall progression of cardiovascular disease and HF. Importantly, cardiac and renal diseases interact in a complex bidirectional and interdependent manner in both acute and chronic settings. From a pathophysiological perspective, cardiac and renal diseases share a number of common pathways, including inflammatory and direct, cellular immune-mediated mechanisms; stress-mediated and (neuro)hormonal responses; metabolic and nutritional changes including bone and mineral disorder, altered haemodynamic and acid-base or fluid status; and the development of anaemia. In an effort to better understand the important crosstalk between the two organs, classifications such as the cardio-renal syndromes were developed. This classification might lead to a more precise understanding of the complex interdependent pathophysiology of cardiac and renal diseases. In light of exceptionally high mortality associated with coexisting HF and kidney disease, this Review describes important crosstalk between the heart and kidney, with a focus on HF and kidney disease in the acute and chronic settings. Underlying molecular and cellular pathomechanisms in HF, AKI and CKD are discussed in addition to current and future therapeutic approaches.

Item Type:

Journal Article (Review Article)

Division/Institute:

04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic of Intensive Care

UniBE Contributor:

Schefold, Joerg C.

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1759-507X

Publisher:

Nature Publishing Group

Language:

English

Submitter:

Mirella Aeberhard

Date Deposited:

09 Jan 2017 12:37

Last Modified:

09 Jan 2017 12:37

Publisher DOI:

10.1038/nrneph.2016.113

PubMed ID:

27573728

URI:

https://boris.unibe.ch/id/eprint/90456

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