The Kidney in Heart Failure: The Role of Venous Congestion

Authors

Alvaro Tamayo-Gutierrez
Hassan N Ibrahim

Publication Date

9-6-2022

Journal

Methodist Debakey Cardiovascular Journal

Abstract

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.

Keywords

heart failure, cardiorenal syndrome, venous congestion, glomerular filtration rate

Comments

PMID: 36132580