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.
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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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