Causes of development and progression of cardiorenal syndrome in heart failure patients. Prevention methods

Abstract

The review includes data on the pathogenesis of cardiorenal syndrome (CRS) in patients with heart failure (HF). Renal hypertension has been identified as an important cause of its development and progression. The mechanisms of its formation in patients with low cardiac output are considered. In this setting, renal vasoconstriction, due to neuroendocrine activation, and external parenchymal compression, due to increased intra-abdominal pressure, developed. Both mechanisms were responsible for the decreased glomerular filtration rate. Hypokalemia has often accompanied by CRS. Potassium deficiency aggravated the decrease in cardiac output and provoked arrhythmias. This increased renal hypertension. High doses of furosemide in the treatment of acute decompensated HF sometimes damaged the kidneys due to hypovolemia and hypokalemia. Such side effects of furosemide as a neuroendocrine activation with subsequent vasoconstriction and the development of endothelial dysfunction due to oxidative stress are considered. Two directions of prevention of nephrotoxic effects of the drug are proposed. The proposed prevention methods have shown encouraging results.

Keywords

• cardiorenal syndrome
• heart failure