Banerjee, D; Ali, MA; Wang, AY-M; Jha, V
(2024)
Acute Kidney Injury in Acute Heart Failure - When to worry and when not to worry?
Nephrol Dial Transplant.
ISSN 1460-2385
https://doi.org/10.1093/ndt/gfae146
SGUL Authors: Banerjee, Debasish
Abstract
Acute kidney injury is common in patients with acute decompensated heart failure. It is more common in patients with acute heart failure who suffer from chronic kidney disease. Worsening renal function is often defined as a rise in serum creatinine of more than 0.3 milligrams per deciliter (26.5 µmol/L), which by definition, is acute kidney injury stage one. Perhaps the term acute kidney injury is more appropriate than worsening renal function as it is used universally by nephrologists, internists, and other medical practitioners. In health, the heart and the kidney support each other to maintain body's homeostasis. In disease, the heart and the kidney can adversely affect each other's function causing further clinical deterioration. In patients presenting with acute heart failure and fluid overload, therapy with diuretics for decongestion often causes a rise in serum creatinine and acute kidney injury. However, in the longer term the decongestion improves survival and prevents hospital admissions despite rising serum creatinine and acute kidney injury. It is important to realize that renal venous congestion due to increased right sided heart pressures in acute heart failure is a major cause of kidney dysfunction and hence decongestion therapy improves kidney function in the longer term. This review provides a perspective on the acceptable acute kidney injury with decongestion therapy which is associated with improved survival; as opposed to acute kidney injury due to tubular injury related to sepsis or nephrotoxic drugs, which is associated with poor survival.
Item Type: |
Article
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Additional Information: |
© The Author(s) 2024. Published by Oxford University Press on behalf of the ERA.
This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
Keywords: |
acute heart failure, acute kidney injury, decongestion, diuretic therapy, fluid overload, 1103 Clinical Sciences, Urology & Nephrology |
SGUL Research Institute / Research Centre: |
Academic Structure > Institute of Medical & Biomedical Education (IMBE) |
Journal or Publication Title: |
Nephrol Dial Transplant |
ISSN: |
1460-2385 |
Language: |
eng |
Dates: |
Date | Event |
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29 June 2024 | Published Online | 6 June 2024 | Accepted |
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Publisher License: |
Creative Commons: Attribution-Noncommercial 4.0 |
Projects: |
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PubMed ID: |
38944413 |
![](http://static.pubmed.gov/portal/portal3rc.fcgi/2745237/img/27842) |
Go to PubMed abstract |
URI: |
https://openaccess.sgul.ac.uk/id/eprint/116730 |
Publisher's version: |
https://doi.org/10.1093/ndt/gfae146 |
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