The Kidney in Heart Failure: The Role of Venous Congestion

Heart failure can lead to renal impairment, an interaction now termed “cardiorenal syndrome.” The prevalent physiological explanation for the renal impairment that accompanies heart failure centers around the forward failure hypothesis, which emphasizes the role of left ventricular dysfunction in ca...

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Main Authors: Alvaro Tamayo-Gutierrez, Hassan N. Ibrahim
Format: Article
Language:English
Published: Houston Methodist DeBakey Heart & Vascular Center 2022-09-01
Series:Methodist DeBakey Cardiovascular Journal
Subjects:
Online Access:https://account.journal.houstonmethodist.org/index.php/up-j-mdbcj/article/view/1121
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author Alvaro Tamayo-Gutierrez
Hassan N. Ibrahim
author_facet Alvaro Tamayo-Gutierrez
Hassan N. Ibrahim
author_sort Alvaro Tamayo-Gutierrez
collection DOAJ
description Heart failure can lead to renal impairment, an interaction now termed “cardiorenal syndrome.” The prevalent physiological explanation for the renal impairment that accompanies heart failure centers around the forward failure hypothesis, which emphasizes the role of left ventricular dysfunction in causing edema, and the backward failure hypothesis, which singles out venous congestion as the dominant mechanism of edema and reduced glomerular filtration rate. In this review, we provide an appraisal on venous congestion, an extremely important contributor that has received little attention. We also summarize the pharmacology of loop diuretics, explain current understanding of diuretic resistance, and address controversies regarding decongestive treatments.
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publisher Houston Methodist DeBakey Heart & Vascular Center
record_format Article
series Methodist DeBakey Cardiovascular Journal
spelling doaj-art-b5e317c3b2bd4bb484a587be98eada752025-08-20T03:25:50ZengHouston Methodist DeBakey Heart & Vascular CenterMethodist DeBakey Cardiovascular Journal1947-61082022-09-0118441010.14797/mdcvj.1121849The Kidney in Heart Failure: The Role of Venous CongestionAlvaro Tamayo-Gutierrez0https://orcid.org/0000-0001-5536-4926Hassan N. Ibrahim1https://orcid.org/0000-0002-1567-9592Division of Renal Diseases and Hypertension, Houston Methodist Hospital, Houston, TexasDivision of Kidney Diseases, Hypertension & Transplantation, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TexasHeart failure can lead to renal impairment, an interaction now termed “cardiorenal syndrome.” The prevalent physiological explanation for the renal impairment that accompanies heart failure centers around the forward failure hypothesis, which emphasizes the role of left ventricular dysfunction in causing edema, and the backward failure hypothesis, which singles out venous congestion as the dominant mechanism of edema and reduced glomerular filtration rate. In this review, we provide an appraisal on venous congestion, an extremely important contributor that has received little attention. We also summarize the pharmacology of loop diuretics, explain current understanding of diuretic resistance, and address controversies regarding decongestive treatments.https://account.journal.houstonmethodist.org/index.php/up-j-mdbcj/article/view/1121heart failurecardiorenal syndromevenous congestionglomerular filtration rate
spellingShingle Alvaro Tamayo-Gutierrez
Hassan N. Ibrahim
The Kidney in Heart Failure: The Role of Venous Congestion
Methodist DeBakey Cardiovascular Journal
heart failure
cardiorenal syndrome
venous congestion
glomerular filtration rate
title The Kidney in Heart Failure: The Role of Venous Congestion
title_full The Kidney in Heart Failure: The Role of Venous Congestion
title_fullStr The Kidney in Heart Failure: The Role of Venous Congestion
title_full_unstemmed The Kidney in Heart Failure: The Role of Venous Congestion
title_short The Kidney in Heart Failure: The Role of Venous Congestion
title_sort kidney in heart failure the role of venous congestion
topic heart failure
cardiorenal syndrome
venous congestion
glomerular filtration rate
url https://account.journal.houstonmethodist.org/index.php/up-j-mdbcj/article/view/1121
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