Heart failure and kidney dysfunction: epidemiology, mechanisms and management

Heart failure (HF) interacts with kidney disease via numerous pathophysiological pathways in both the acute and chronic settingMounting data indicate that the complex interplay between the heart and the kidneys involves haemodynamic, (neuro)homonal and cardiovascular disease-associated mechanismsAcceleration of HF or kidney dysfunction is driven by impairment of either the heart or kidneys via mechanisms including induction of inflammation, activation of the cellular immune system, metabolic disorders, anaemia and mineral and bone disorderIn an effort to differentiate respective underlying pathologies and to assess acute and/or chronic organ dysfunction over time, five subtypes of cardio-renal syndromes were proposedThe absence of a standardized terminology database and the lack of studies specific to cardio-renal syndrome has hampered efforts to develop novel treatments