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J Am Coll Cardiol, 2006; 47:1-8, doi:10.1016/j.jacc.2005.07.067 (Published online 12 December 2005).
© 2006 by the American College of Cardiology Foundation
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STATE-OF-THE-ART PAPER

Role of Diminished Renal Function in Cardiovascular Mortality

Marker or Pathogenetic Factor?

Robert W. Schrier, MD*

University of Colorado School of Medicine, Division of Renal Diseases and Hypertension, Denver, Colorado.

Manuscript received March 31, 2005; revised manuscript received July 7, 2005, accepted July 18, 2005.

* Reprint requests and correspondence: Dr. Robert W. Schrier, University of Colorado School of Medicine, Division of Renal Diseases and Hypertension, 4200 East Ninth Avenue B-173, Denver, Colorado 80262. (Email: robert.schrier{at}uchsc.edu).

The interactions between the heart and the kidney recently have been the focus of intense interest because of epidemiological evidence indicating that even mild deterioration of renal function is an important risk factor for poor outcome in patients with congestive heart failure, myocardial infarction, and cardiovascular surgery. Kidney function deterioration may be a consequence of cardiac and baroreceptor dysfunction or may be primarily caused by intrinsic kidney disease. This review provides a comprehensive analysis of the role of the kidney not only as a marker but also as a pathogenic factor in cardiorenal syndromes, whether primary heart or primary kidney disease or both are the initiators of the subsequent pathophysiological events.

Abbreviations and Acronyms
  BNP = brain natriuretic peptide
  CHF = congestive heart failure
  ECF = extracellular fluid
  GFR = glomerular filtration rate
  HF = heart failure
  LV = left ventricular




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