Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2021 Aug;36(8):2531-2535.
doi: 10.1007/s00467-021-05100-0. Epub 2021 Jun 18.

Managing heart failure in dialysis patients

Daljit K Hothi  1
Affiliations
Review

Managing heart failure in dialysis patients

Daljit K Hothi. Pediatr Nephrol. 2021 Aug.

Abstract

The heart and the kidney are intimately connected. They communicate in a bidirectional manner through a variety of pathways, forming an interdependent relationship. Recognition of this co-dependency is crucial in managing patients with cardiorenal syndrome, as we begin to realise the inevitability of disease progression to both organs; and an approach that focuses treatment on one organ may result in worsening outcome on the other organ. When faced with patients with deteriorating cardiac disease, nephrologists tend to focus on stabilisation of cardiac function and accept the heart disease to be unmodifiable. Likewise, cardiac patients with persistent kidney failure are presented with a poor renal prognosis and prepared for kidney transplantation. Adopting a cardio-protective approach in combination with dialysis optimisation raises hope for a more positive outcome with evidence of cardiac and renal recovery in some patients.

Keywords: B-Blockers; Cardio-protective; Cardiorenal failure; Home haemodialysis; Paediatrics; Spironolactone.

PubMed Disclaimer

References

    1. Rangaswami J, Bhalla V, Blair JEA, Chang TI, Costa S, Lentine KL, Lerma EV, Mezue K, Molitch M, Mullens W, Ronco C, Tang WHW, McCullough PA, American Heart Association Council on the Kidney in Cardiovascular Disease and Council on Clinical Cardiology (2019) Cardiorenal syndrome: classification, pathophysiology, diagnosis, and treatment strategies: a scientific statement from the American Heart Association. Circulation 139:e840–e878 - DOI
    1. National Heart, Lung, and Blood Institute (2004) NHLBI Working Group: cardiorenal connections in heart failure and cardiovascular disease. https://www.nhlbi.nih.gov/events/2004/cardio-renal-connections-heartfail...
    1. Ronco C, McCullough P, Anker SD, Anand I, Aspromonte N, Bagshaw SM, Bellomo R, Berl T, Bobek I, Cruz DN, Daliento L, Davenport A, Haapio M, Hillege H, House AA, Katz N, Maisel A, Mankad S, Zanco P, Mebazaa A, Palazzuoli A, Ronco F, Shaw A, Sheinfeld G, Soni S, Vescovo G, Zamperetti N, Ponikowski P (2010) Cardio-renal syndromes: report from the Consensus Conference of the Acute Dialysis Quality Initiative. Eur Heart J 31:703–711 - DOI
    1. Hatamizadeh P, Fonarow GC, Budoff MJ, Darabian S, Kovesdy CP, Kalantar-Zadeh K (2013) Cardiorenal syndrome: pathophysiology and potential targets for clinical management. Nat Rev Nephrol 9:99–111 - DOI
    1. Vanderlaan RD, Caldarone CA, Backx PH (2014) Heart failure in congenital heart disease: the role of genes and hemodynamics. Pflugers Arch 466:1025–1035 - DOI

LinkOut - more resources