Can we prevent or treat renal dysfunction in chronic heart failure?

摘要

We aimed to summarize the predictors of renal dysfunction and present strategies to prevent and/or treat renal dysfunction in Chronic Heart Failure (CHF). Several factors may predict renal dysfunction in CHF, including older age, comorbidities (anemia, hypertension, diabetes), severity of underlying heart disease (systolic and diastolic dysfunction, central venous pressure) as well as certain therapies in specific circumstances (diuretics, nonsteroid acute inflammatory drugs, and renine-angiotensin-aldosterone (RAAS) inhibitors). Thus, prevention of renal dysfunction is possible in CHF by treating comorbidities and underlying heart disease as well as by monitoring therapies with potential toxic renal effect. At present, there is no specific treatment for renal dysfunction, but several new entities are under investigation. In conclusion, prevention of renal dysfunction is possible in CHF, but treatment is still under investigation. New studies are necessary to establish whether a specific algorithm may be used to prevent renal dysfunction in CHF patients.