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. 2011 Feb;34(2):113-6.
doi: 10.1002/clc.20831.

Renal dysfunction in heart failure is due to congestion but not low output

Maya Guglin  1 , Abel Rivero, Fadi Matar, Marcos Garcia
Affiliations

Renal dysfunction in heart failure is due to congestion but not low output

Maya Guglin et al. Clin Cardiol. 2011 Feb.

Abstract

Background: Renal dysfunction in heart failure is thought to be due to poor perfusion of the kidney.

Hypothesis: We tested the hypothesis that passive congestion is more important than poor perfusion.

Methods: We retrospectively studied the data on 178 patients who underwent right heart catheterization for evaluation of heart failure and had serum creatinine (Cr) measured on the same day.

Results: Serum Cr and glomerular filtration rate (GFR) correlated with central venous pressure (r = 0.22, P = 0.001 and r = -0.55, P < 0.0001, respectively) and renal perfusion pressure (r = 0.21, P = 0.001 and r = 0.27, P = 0.015, respectively). Neither correlated with cardiac index or left ventricular ejection fraction. Serum Cr was significantly higher and GFR was significantly lower in the upper tertile of central venous pressure, pulmonary capillary wedge pressure as well as in the lower tertile of renal perfusion pressure.

Conclusions: Renal dysfunction in heart failure is determined more by passive congestion than by low perfusion.

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Figures

Figure 1
Figure 1
Glomerular filtration rate vs central venous pressure. Abbreviations: CVP, central venous pressure; GFR, glomerular filtration rate
Figure 2
Figure 2
Glomerular filtration rate vs pulmonary capillary wedge pressure. Abbreviations: GFR, glomerular filtration rate; PCWP, pulmonary capillary wedge pressure
Figure 3
Figure 3
Glomerular filtration rate vs ejection fraction. Abbreviations: GFR, glomerular filtration rate; EF, ejection fraction
See this image and copyright information in PMC

Comment in

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