Aslam F, Haque A, Haque J, Joseph J. Heart failure in subjects with chronic kidney disease: Best management practices. World J Cardiol 2010; 2(5): 112-117 [PMID: 21160712 DOI: 10.4330/wjc.v2.i5.112]
Corresponding Author of This Article
Jacob Joseph, MD, Department of Medicine, Veterans Affairs Boston Healthcare System, Boston, MA 02132, United States. jacob.joseph@bmc.org
Article-Type of This Article
Guidelines For Clinical Practice
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World J Cardiol. May 26, 2010; 2(5): 112-117 Published online May 26, 2010. doi: 10.4330/wjc.v2.i5.112
Heart failure in subjects with chronic kidney disease: Best management practices
Farhan Aslam, Attiya Haque, Javeria Haque, Jacob Joseph
Farhan Aslam, Attiya Haque, Javeria Haque, Jacob Joseph, Department of Medicine, Brigham and Women’s Hospital, Boston, MA 02132, United States
Farhan Aslam, Jacob Joseph, Department of Medicine, Veterans Affairs Boston Healthcare System, Boston, MA 02132, United States
Jacob Joseph, Department of Medicine, Boston University School of Medicine, Boston, MA 02132, United States
Author contributions: Aslam F contributed to the research, writing the paper and providing references; Haque A and Haque J contributed equally to the research and providing references; Joseph J contributed to the research, provided references, and revised the paper.
Correspondence to: Jacob Joseph, MD, Department of Medicine, Veterans Affairs Boston Healthcare System, Boston, MA 02132, United States. jacob.joseph@bmc.org
Telephone: +1-857-2036841 Fax: +1-857-2035550
Received: March 30, 2010 Revised: April 20, 2010 Accepted: April 27, 2010 Published online: May 26, 2010
Abstract
Renal dysfunction is common in patients with heart failure (HF) and can complicate HF therapy. Treating patients with HF and kidney disease is difficult and requires careful assessment, monitoring and balancing of risk between potential benefits of treatment and adverse impact on renal function. In this review, we address the pathophysiological contexts and management options in this adversarial relation between the heart and the kidney, which exists in a substantial proportion of HF patients. Angiotensin converting enzyme inhibitors and β-blockers are associated with similar reductions in mortality in patients with and without renal insufficiency but usually are less often prescribed in patients with renal insufficiency. Careful monitoring of side effects and renal function should be done in all patients with renal insufficiency and prompt measures should be adopted to prevent further complications.
