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Title: | Evaluation of kidney function throughout theheart failure trajectory – a position statementfrom the Heart Failure Association of theEuropean Society of Cardiology | Authors: | MULLENS, Wilfried Damman, Kevin Testani, Jeffrey M. MARTENS, Pieter Mueller, Christian Lassus, Johan Tang, W. H. Wilson Skouri, Hadi VERBRUGGE, Frederik Orso, Francesco Hill, Loreena Dilek, Ural Lainscak, Mitcha Rossignol, Patrick Metra, Marco Mebazaa, Alexandre Seferovic, Petar Ruschitzka, Frank Coats, Andrew |
Issue Date: | 2020 | Publisher: | WILEY | Source: | EUROPEAN JOURNAL OF HEART FAILURE, 22 (4), p. 584-603 | Abstract: | Appropriate interpretation of changes in markers of kidney function is essential during the treatment of acute and chronic heart failure. Historically, kidney function was primarily assessed by serum creatinine and the calculation of estimated glomerular filtration rate. An increase in serum creatinine, also termed worsening renal function, commonly occurs in patients with heart failure, especially during acute heart failure episodes. Even though worsening renal function is associated with worse outcome on a population level, the interpretation of such changes within the appropriate clinical context helps to correctly assess risk and determine further treatment strategies. Additionally, it is becoming increasingly recognized that assessment of kidney function is more than just glomerular filtration rate alone. As such, a better evaluation of sodium and water handling by the renal tubules allows to determine the efficiency of loop diuretics (loop diuretic response and efficiency). Also, though neurohumoral blockers may induce modest deteriorations in glomerular filtration rate, their use is associated with improved long-term outcome. Therefore, a better understanding of the role of cardio-renal interactions in heart failure in symptom development, disease progression and prognosis is essential. Indeed, perhaps even misinterpretation of kidney function is a leading cause of not attaining decongestion in acute heart failure and insufficient dosing of guideline-directed medical therapy in general. This position paper of the Heart Failure Association Working Group on Cardio-Renal Dysfunction aims at improving insights into the interpretation of renal function assessment in the different heart failure states, with the goal of improving heart failure care. | Notes: | Mullens, W (reprint author), Ziekenhuis Oost Limburg, Dept Cardiol, Schiepse Bos 6, B-3600 Genk, Belgium. wilfried.mullens@zol.be |
Other: | Mullens, W (reprint author), Ziekenhuis Oost Limburg, Dept Cardiol, Schiepse Bos 6, B-3600 Genk, Belgium. wilfried.mullens@zol.be | Keywords: | Heart failure;Kidney function;Glomerular filtration;Tubular function;Biomarkers;Renal imaging;Worsening of renal function;Acute kidney injury;Diuretic response;Diuretic efficiency;Guidelines;Outcome | Document URI: | http://hdl.handle.net/1942/30752 | ISSN: | 1388-9842 | e-ISSN: | 1879-0844 | DOI: | 10.1002/ejhf.1697 | ISI #: | WOS:000505793100001 | Rights: | 2020 European Society of Cardiology | Category: | A1 | Type: | Journal Contribution | Validations: | ecoom 2021 |
Appears in Collections: | Research publications |
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