Kidney function changes in acute heart failure: a practical approach to interpretation and management

Grupos y Plataformas de I+D+i

• Grupo de Enfermedad Renal

  

  Leading Researcher

  Jose Luis Górriz Teruel

• Grupo de Investigación en Insuficiencia Cardiaca

  

  Established Researcher

  Julio Nuñez Villota

Abstract

Worsening kidney function (WKF) is common in patients with acute heart failure (AHF) syndromes. Although WKF has traditionally been associated with worse outcomes on a population level, serum creatinine concentrations vary greatly during episodes of worsening heart failure, with substantial individual heterogeneity in terms of their clinical meaning. Consequently, interpreting such changes within the appropriate clinical context is essential to unravel the pathophysiology of kidney function changes and appropriately interpret their clinical meaning. This article aims to provide a critical overview of WKF in AHF, aiming to provide physicians with some tips and tricks to appropriately interpret kidney function changes in the context of AHF. In this article we thoroughly review the literature on a debatable topic in cardiorenal medicine. We aimed to provide physicians with some tips and tricks for interpreting kidney function changes in patients with acute heart failure syndromes.

© The Author(s) 2023. Published by Oxford University Press on behalf of the ERA.

Keywords

• decongestion; diuretic therapy; heart failure; intrarenal venous flow pattern; kidney venous congestion