Short-term effect of evidence-based medicine heart failure therapy on glomerular filtration rate in elderly patients with chronic cardiorenal syndrome.

摘要

To the Editor: Renal failure is a frequent problem complicating chronic heart failure (CHF). Chronic kidney disease is common commorbidity in older patients with CHF. Impaired renal function is associated with morbidity and mortality in elderly patients with CHF. This risk becomes evident at an estimated glomerular filtration rate (eGFR) less than 60mL/min per 1.73 m~2 (<1.0mL/s per 1.73 m~2). And approximately one-third to half of patients with CHF have renal insufficiency, with an eGFR less than 60mL/min per 1.73 m~2. Despite growing recognition of combined cardiac and renal dysfunction, or cardiorenal syndrome, its underlying pathophysiology is not well understood, and no consensus as to its appropriate management has been reached. Evidence supports use of angiotensin-converting enzyme (ACE) inhibitors, angioten-sin-receptor blockers (ARBs), beta-blockers, and aldoste-rone antagonists to improve survival in patients with CHF, but there is little evidence with which to weigh the risks and benefits in elderly patients with renal dysfunction. The objective of the present study was to assess the short-term effect of evidence-based pharmacotherapy in elderly patients with chronic cardiorenal syndrome cardiorenal syndrome.