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NDT Advance Access originally published online on March 16, 2009
Nephrology Dialysis Transplantation 2009 24(7):2024-2026; doi:10.1093/ndt/gfp109
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© The Author [2009]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org


A critical look at acute decompensated heart failure from a nephrologist's perspective

Christopher T. Chan

Division of Nephrology, Toronto General Hospital, University Health Network, Toronto, Canada

Correspondence and offprint requests to: Christopher T. Chan; E-mail: christopher.chan@uhn.on.ca

Keywords: acute decompensated heart failure; kidney function; prognosis; treatment

The first 10% of the full text of this article appears below.

Acutely decompensated heart failure is associated with significant morbidity and mortality. It is responsible for $30 billion overall annual cost in the United States alone [1]. Recent evidence has demonstrated the clinical importance of kidney function in the risk stratification, clinical presentation and prognostication of patients with heart failure. Despite great anticipation that the clinical use of aquaretics and natriuretic peptides would turn out to be beneficial, these therapies have failed to improve survival in patients with heart failure. Against this background adjunct approaches, e.g. ultrafiltration and continuous positive airway pressure (CPAP) ventilation, are gaining increasing interest as a treatment strategy. In the following update, we review the emerging appreciation of the role kidney function . . . [Full Text of this Article]



   Renal function and outcome of heart failure
 


   Systolic versus diastolic heart failure—equally poor prognosis
 


   Pharmacological intervention—efficacy of novel agents
 


   Novel interventions on the horizon—ultrafiltration and CPAP
 

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