Heart failure mortality is significantly increased in patients with baseline renal impairment and those with underlying heart failure who subsequently develop renal dysfunction. This accelerated progression occurs independent of the cause or grade of renal dysfunction and baseline risk factors. Recent large prospective databases have highlighted the depth of the current problem, while longitudinal population studies support an increasing disease burden. We have extensively reviewed the epidemiological and therapeutic data among these patients. The evidence points to a progression of heart failure early in renal impairment, even in the albuminuric stage. The data also support poor prescription of prognostic therapies. As renal function is the most important prognostic factor in heart failure, it is important to establish the current understanding of the disease burden and the therapeutic implications.

1.
Lindner A, Charra B, Sherrard DJ, Scribner BH: Accelerated atherosclerosis in prolonged maintenance hemodialysis. N Eng J Med 1974;290:697–701.
2.
Ronco C, Haapio M, House AA, Anavekar N, Bellomo R: Cardiorenal syndrome. J Am Coll Cardiol 2008;52:1527–1539.
3.
Bock JS, Gottlieb SS: Cardiorenal syndrome: new perspectives. Circulation 2010;121:2592–2600.
4.
Schiffrin EL, Lipman ML, Mann JF: Chronic kidney disease – effects on the cardiovascular system. Circulation 2007;116:85–97.
5.
Sarnak MJ, Levey AS, Schoolwerth AC, Coresh J, Culleton B, Hamm LL, McCullough PA, Kasiske BL, Kelepouris E, Klag MJ, Parfray P, Pfeffer M, Raij L, Spinosa DJ, Wilson PW: Kidney disease as a risk factor for development of cardiovascular disease: a statement from the American Heart Association Councils on Kidney in Cardiovascular Disease, High Blood Pressure Research, Clinical Cardiology and Epidemiology and Prevention. Circulation 2003;108:2154–2169.
6.
Solomon R, Segal A: Defining acute kidney injury: what is the most appropriate metric? Nat Clin Pract Nephrol 2008;4:208–215.
7.
Iyngkaran P, Schneider H, Devarajan P, Anavekar N, Krum H, Ronco C: Cardio-renal syndrome: new perspective in diagnostics. Semin Nephrol 2012;32:3–17.
8.
Ahmed A, Campbell RC: Epidemiology of chronic kidney disease in heart failure. Heart Fail Clin 2008;4:387–399.
9.
Heywood JT: The cardiorenal syndrome: lessons from the ADHERE database and treatment options. Heart Fail Rev 2004;9:195–201.
10.
Adams KF, Fonarrow GC, Emerman CL, LeJemtel TH, Costanzo MR, Abraham WT, Berkowitz, Galvao M, Horton DP; ADHERE Scientific Advisory Committee and Investigators: Characteristics and outcomes of patients hospitalized for heart failure in the United States: rationale, design and preliminary observations from the first 100,000 cases in the Acute Decompensated Heart Failure National Registry (ADHERE). Am Heart J 2005;149:209–216.
11.
Fonarow GC, Abraham WT, Albert NM, Gattis Stough W, Gheorghiade M, Greenberg BH, O’Connor CM, Pieper K, Sun JL, Yancy CW, Young JB; OPTIMIZE-HF Investigators and Hospitals: Influence of a performance-improvement initiative on quality of care for hospitalized patients with heart failure: results of the Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients With Heart Failure (OPTIMIZE-HF). Arch Intern Med 2007;167:1493–1502.
12.
Cleland JG, Swedberg K, Follath F, Komajda, Cohen-Solal A, Aguilar JC, Dietz R, Gavazzi A, Hobbs R, Korewicki J, Madeira HC, Moiseyev VS, Preda I, van Gilst WH, Widimsky J, Freemantle N, Eastaugh J, Mason J; Study Group on Diagnosis of the Working Group on Heart Failure of the European Society of Cardiology: The EuroHeart Failure survey programme – a survey on the quality of care among patients with heart failure in Europe. Part 1: patient characteristics and diagnosis. Eur Heart J 2003;24:442–463.
13.
Smith GL, Lichtman JH, Bracken MB, Shlipak MG, Phillips CO, DiCapua P, Krumholz HM: Renal impairment and outcomes in heart failure: systematic review and meta-analyisis. J Am Coll Cardiol 2006;47:1987–1996.
14.
Levey AS, Coresh J, Balk E, Kausz AT, Levin S, Steffes MW, Hogg RJ, Perrone RD, Lau J, Eknoyan G; National Kidney Foundation: National Kidney Foundation practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Ann Intern Med 2003;139:137–147.
15.
Heywood JT, Fonarow GC, Costanzo MR, Mathur VS, Wigneswaran JR, Wynne J, et al: High prevalence of renal dysfunction and its impact on outcome in 118,465 patients hospitalized with acute decompensated heart failure: a report from the ADHERE database. J Card Fail 2007;13:422–430.
16.
Zocalli C: Cardiorenal risk as a new frontier of nephrology: research needs and areas for intervention. Nephrol Dial Transplant 2002;17:50–54.
17.
Parfrey PS, Foley R: The clinical epidemiology of cardiac disease in chronic renal failure. J Am Soc Nephrol 1999;10:1606–1615.
18.
Ruilope LM, van Veldhuisen DJ, Ritz E, Luscher TF: Renal function: the Cinderella of cardiovascular risk profile. J Am Coll Cardiol 2001;38:1782–1787.
19.
Go AS, Chertow GM, Fan D, McCulloch CE, Hsu CY: Chronic kidney disease and the risks of death, cardiovascular events and hospitalization. N Engl J Med 2004;351:1296–1305.
20.
Kearney MT, Fox KA, Lee AJ, et al: Predicting death due to progressive heart failure in patients with mild to moderate heart failure. J Am Coll Cardiol 2002;40:1801–1808.
21.
Hilleage HL, Girbes ARJ, de Kam PJ, Boomsma F, de Zeeuw D, Charlesworth A, et al: Renal function, neurohormonal activation, and survival in patients with chronic heart failure. Circulation 2000;102:203–210.
22.
Miyagishima K, Hiramitsu S, Kimura H, Mori K, Ueda T, Kato S, Kato Y, Ishikawa S, Iwase M, Morimoto Shin-ichiro, Hishida H, Ozaki Y: Long term prognosis of chronic heart failure: reduced versus preserved left ventricular ejection fraction. Circ J 2009;73:92–99.
23.
Dries DL, Exner DV, Domanski MJ, Greenberg B, Stevenson LW: The prognostic implications of renal insufficiency in asymptomatic and symptomatic patients with left ventricular systolic dysfunction. J Am Coll Cardiol 2000;35:681–689.
24.
Effect of enalapril on survival in patients with reduced left ventricular ejection fractions and congestive heart failure. The SOLVD Investigators. N Engl J Med 1991;325:293–302.
25.
McAlister FA, Ezekowitz J, Tonelli MR, Armstrong PW: Renal insufficiency and heart failure: prognostic and therapeutic implications from a prospective cohort study. Circulation 2004;109:1004–1009.
26.
Mahon NG, Blackstone EH, Francis GS, Starling RC, Young JB, Lauer MS: The prognostic value of estimated creatinine clearance alongside functional capacity in ambulatory patients with mild to moderate chronic heart failure. J Am Coll Cardiol 2002;40:1106–1113.
27.
Gottlieb SS, Abraham W, Butler J, et al: The prognostic importance of different definitions of worsening renal function in congestive heart failure. J Card Fail 2002;8:136–141.
28.
Hilleage HL, Nitsch D, Pfeffer MA, Swedberg K, McMurray JJ, Yusuf S, Granger CB, Michelson EL, Ostergen J, Cornel JH, de Zeeuw D, Pocock S, van Veldhuisen DJ; Candersartan in Heart Failure: Assessment of Reduction in Mortality and Morbidity (CHARM) Investigators: Renal function as a predictor of outcome in a broad spectrum of patients with heart failure. Circulation 2006;113:671–678.
29.
Schrier RW: Role of diminished renal function in cardiovascular mortality: marker or pathogenetic factor? J Am Coll Cardiol 2006;47:1–8.
30.
Smith GL, Vaccarino V, Kosiborod M, et al: Worsening renal function: what is a clinically meaningful change in creatinine during hospitalization with heart failure? J Card Fail 2003;9:13–25.
31.
Klein L, Massie BM, Leimberger JD, O’Connor CM, Pina Il, Adams KF, Califf RM, Gheorgide M; OPTIME-CHF Investigators: Admission or changes in renal function during hospitalizations for worsening heart failure predict postdischarge survival: results from the Outcomes of a Prospective Trial of Intravenous Milrinone for Exacerbations of Chronic Heart Failure (OPTIME-CHF). Circ Heart Fail 2008;1:25–33.
32.
Forman DE, Butler J, Wang Y, Abraham WT, O’Connor CM, Gottlieb SS, Loh E, Massie BM, Rich MW, Stevenson LW, Young JB, Krumholz HM: Incidence, predictors at admission and impact of worsening renal function among patients hospitalized with heart failure. J Am Coll Cardiol 2004;43:61–67.
33.
Damman K, Navis G, Voors AA, Asselbergs FW, Smilde TD, Cleland JG, Veldhuisen DJ, Hillege HL: Worsening renal function and prognosis in heart failure: systematic review and meta-analysis. J Card Fail 2007;13:599–608.
34.
Henry RMA, Kostense PJ, Bos G, Dekker JM, Nijpels G, Heine RJ, Bouter LM, Stehouwer CD: Mild renal insufficiency is associated with increased cardiovascular mortality: The Hoorn Study. Kidney Int 2002;62:1402–1407.
35.
Ritz E, McClellan WM: Overview: increased risk in patients with minor renal dysfunction: an emerging issue with far reaching consequences. J Am Soc Nephrol 2004;15:513–516.
36.
Ritz E: Minor renal dysfunction: an emerging independent cardiovascular risk factor. Heart 2003;89:963–964.
37.
Ismailov RM, Goldberg RJ, Lessard D, Spencer FA: Decompensated heart failure in the setting of kidney dysfunction: a community-wide perspective. Nephron Clin Pract 2007;107:c147–c155.
38.
Wilson AC, Mitsnefes MM: Cardiovascular disease in CKD in children: update on risk factors, risk assessment and management. Am J Kidney Dis 2009;54:3345–3360.
39.
Krumholz HM, Chen YT, Vaccarino V, Wang Y, Radford MJ, Bradford WD, Horwitz RI: Correlates and impact of worsening renal function in patients ≥65 years of age with heart failure. Am J Cardiol 2000;85:1110–1113.
40.
Fonarrow GC, Adams, KF, Abraham WT, Yancy CW, Boscardin WJ: Risk stratification for in-hospital mortality in acutely decompensated heart failure: classification and regression tree analysis. JAMA 2005;293:572–580.
41.
McClellan WM, Langston RD, Presley R: Medicare patients with cardiovascular disease have a high prevalence of chronic kidney disease and a high rate of progression to end-stage renal disease. J Am Soc Nephrol 2004;15:1912–1919.
42.
Shlipak MG, Fried LF, Stehman-Breen C, Siscovick D, Newman AB: Chronic renal insufficiency and cardiovascular events in the elderly: findings from the Cardiovascular Health Study. Am J Geriatr Cardiol 2004;13:81–90.
43.
Ezekowitz J, McAlister FA, Humphries KH, Norris CM, Tonelli M, Ghali WA, Knudston ML; APPRAOCH Investigators: The association among renal insufficiency, pharmacotherapy, and outcomes in 6,247 patients with heart failure and coronary artery disease. J Am Coll Cardiol 2004;44:1587–1592.
44.
Chang TI, Chertow GM: Chronic kidney disease and cardiovascular therapeutics: time to close the gaps. J Am Coll Cardiol 2011;58:1162–1163.
45.
Tardiff JC: Slowing heart rate with ivabradine: new treatment options. Eur Heart J 2011;13(suppl C):C19–C24.
46.
Al-Ahmad A, Rand WM, Manjunath G, Konstam MA, Salem DN, Levey AS, Sarnak MJ: Reduced kidney function and anemia as risk factors for mortality in patients with left ventricular dysfunction. J Am Coll Cardiol 2001;38:955–962.
47.
McClellan WM, Flanders WD, Langston RD, Jurkovitz C, Presley R: Anemia and renal insufficiency are independent risk factors for death among patients with congestive heart failure admitted to community hospitals: a population based study. J Am Soc Nephrol 2002;13:1928–1936.
48.
Go AS, Yang J, Ackerson LM, Lepper K, Robbins S, Massie BM, Shlipak MG: Hemoglobin level, chronic kidney disease, and the risks of death and hospitalization in adults with chronic heart failure: the Anemia in Chronic Heart Failure: Outcomes and Resource Utilization (ANCHOR) Study. Circulation 2006;113:2713–2723.
49.
Gaddam KK, Ventura HO, Lavie CJ: Metabolic syndrome and heart failure – the risk, paradox, and treatment. Curr Hypertens Rep 2011;13:142–148.
50.
van Melle JP, Bot M, de Jonge P, de Boer RA, van Veldhuisen DJ, Whooley MA: Diabetes, glycemic control, and new-onset heart failure in patients with stable coronary artery disease: data from the heart and soul study. Diabetes Care 2010;33:2084–2089.
51.
Opie LH, Yellon DM, Gersh BJ: Controversies in the cardiovascular management of type 2 diabetes. Heart 2011;97:6–14.
52.
Aguilar D, Bozkurt B, Ramasubbu K, Deswal A: Relationship of hemoglobin A1C and mortality in heart failure patients with diabetes. J Am Coll Cardiol 2009;54:422–428.
53.
Eshaghian S, Horwich TB, Fonarrow GC: An unexpected inverse relationship between HbA1c levels and mortality in patients with diabetes and advanced systolic heart failure. Am Heart J 2006;151:91.e1–91.e6.
54.
Ascione R, Rogers CA, Rajakurana C, Angelini GD: Inadequate blood glucose is associated with in-hospital mortality and morbidity in diabetic and non-diabetic patients undergoing cardiac surgery. Circulation 2008;118:113–123.
55.
Kosiborod M, Inzucchi SE, Spertus JA, Wang Y, Masoudi FA, Havranek EP, et al: Elevated admission glucose and mortality in elderly patients hospitalized with heart failure. Circulation 2009;119:1899–1907.
56.
Zhang CY, Sun AJ, Zhang SN, Wu CN, Fu MQ, Xia G, et al: Effects of intensive glucose control on incidence of cardiovascular events in patients with type 2 diabetes: A meta-analysis. Ann Med 2010;42:305–315.
57.
Boussageon R, Bejan-Angoulvant T, Saadatian-Elahi M, Lafont S, Bergeonneau C, Kassai B, et al: Effect of intensive glucose lowering treatment on all cause mortality, cardiovascular death, and microvascular events in type 2 diabetes: meta-analysis of randomised controlled trials. BMJ 2011;343:d4169.
58.
Goodarzi MO, Psaty BM: Glucose lowering to control macrovascular disease in type 2 diabetes: treating the wrong surrogate end point? JAMA 2008;300:2051–2053.
59.
Tonelli M, Moye L, Sacks FM, Kiberd B, Curhan G; CARE Trial Investigators: Pravastatin for secondary prevention of cardiovascular events in persons with mild chronic renal insufficiency. Ann Intern Med 2003;138:98–104.
60.
McCullough PA, Rocher LR: Statin therapy in renal disease: harmful or protective? Curr Atheroscler Rep 2007;9:18–24.
61.
Baber U, Toto RD, de Lemos JA: Statin and cardiovascular risk reductions in patients with chronic kidney disease and end-stage renal failure. Am Heart J 2007;153:471–477.
62.
Jardine MJ, Ninomiya T, Perkovic V, Cass A, Turnbull F, Gallagher MP, et al: Aspirin is beneficial in hypertensive patients with chronic kidney disease: a post-hoc subgroup analysis of a randomized controlled trial. J Am Coll Cardiol 2010;56:956–965.
63.
Evans M, Fored CM, Bellocco R, Fitzmaurice G, Fryzek JP, McLaughlin JK, Nyren O, Elinder CG: Acetominophen, aspirin and progression of advanced chronic kidney disease. Nephrol Dial Transplant 2009;24:1908–1918.
64.
Wali RK: Aspirin and the prevention of cardiovascular disease in chronic kidney disease: time to move forward? J Am Coll Cardiol 2010;56:966–968.
65.
Chade AR, Brosh D, Higano ST, Lennon RJ, Lerman LO, Lerman A: Mild renal insufficiency is associated with reduced coronary flow in patients with non-obstructive coronary artery disease. Kidney Int 2006;69:266–271.
66.
Foley RN, Parfrey PS, Kent GM, Harnett JD, Murray DC, Barre PE: Serial change in echocardiographic parameters and cardiac failure in end-stage renal disease. J Am Soc Nephrol 2000;11:912–916.
67.
Chittineni H, Miyawaki N, Gulipelli S, Fishbane S: Risk for acute renal failure in patients hospitalized for decompensated congestive heart failure. Am J Nephrol 2007;27:55–62.
68.
Knight EL, Glynn RJ, McIntyre KM, Mogun H, Avorn J, Mass B: Predictors of decreased renal function in patients with heart failure during angiotensin-converting enzyme inhibitor therapy: results from the studies of left ventricular dysfunction (SOLVD). Am Heart J 1999;138:849–855.
69.
Kittleson M, Hurwitz S, Shah MR, Nohria A, Lewis E, Givertz M, Fang J, Jarcho J, Mudge G, Stevenson LW: Development of circulatory-renal limitations to angiotensin converting enzyme inhibitors identifies patients with severe heart failure and early mortality. J Am Coll Cardiol 2003;41:2029–2035.
70.
Gotsman I, Rubonivich S, Azaz-Livshits T: Use of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers in patients with congestive heart failure: an observational study of treatment rates and clinical outcomes. Isr Med Assoc J 2008;10:214–218.
71.
Glowinska I, Grochowski J, Malyszko J: Cardiovascular complication in patients with diabetic nephropathy receiving pharmacological versus renal replacement therapy. Pol Arch Medy Wewn 2008;118:404–411.
72.
Bart BA: Concern for azotemia with angiotensin-converting enzyme inhibitors: public health implications and clinical relevance. Am Heart J 1999;138:801–803.
73.
de Silva R, Nikitin NP, Bhandari S, Nicholson A, Clark AL, Cleland JG: Atherosclerotic renovascular disease in chronic heart failure: should we intervene? Eur Heart J 2005;26:1596–1605.
74.
Barkis GL, Weir MR: Angiotensin-converting enzyme inhibitor associated elevations in serum creatinine: is this a cause for concern? Arch Intern Med 2000;160:685–693.
75.
Pinkau T, Hilgers KF, Veelken R, Mann JF: How does minor renal dysfunction influence cardiovascular risk and the management of cardiovascular disease? J Am Soc Nephrol 2004;15:517–523.
76.
Mann JF, Gerstein HC, Pogue J, Bosch J, Yusuf S: Renal insufficiency as a predictor of cardiovascular outcomes and the impact of ramipril: the HOPE randomized trial. Ann Intern Med 2001;134:629–636.
77.
Mann JF, Gerstein HC, Dulau-Florea I, Lonn E: Cardiovascular risk in patients with mild renal insufficiency. Kidney Int Suppl 2003;84:s192–s196.
78.
Mann JF, Yi QL, Sleight P, Dagenais GR, Probstfield J, Gerstein HC, Lonn EM, Bosch J, Yusuf S; HOPE investigators: New trial data on prevention: potassium and CV risk in HOPE. Pacing Clin Electrophysiol 2003;26:1565–1568.
79.
Saltzman HE, Sharma K, Mather PJ, Rubin S, Adams S, Whellan DJ: Renal dysfunction in heart failure patients: what is the evidence? Heart Fail Rev 2007;12:37–47.
80.
Lakhdar R, Al-Mallah MH, Lanfear DE: Safety and tolerability of angiotensin-converting enzyme inhibitor versus the combination of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker in patients with left ventricular dysfunction: a systematic review and metaanalysis of randomized controlled trials. J Card Fail 2008;14:181–188.
81.
Ljungman S, Kjekshus J, Swedberg K: Renal function in severe congestive heart failure during treatment with enalapril (the Cooperative North Scandinavian Enalapril Survival Study [CONSENSUS] Trial). Am J Cardiol 1992;70:479–487.
82.
Schoolwerth AC, Sica DA, Ballermann BJ, Wilcox CS: Renal consideration in angiotensin converting enzyme inhibitor therapy: a statement for healthcare professionals from the council on the Kidney in Cardiovascualr Disease and the council for High Blood Pressure Research of the American Heart Association. Circulation 2001;104:1985–1991.
83.
Abdo AS, Basu A, Geraci SA: Managing chronic heart failure patient in chronic kidney disease. Am J Med 2011;124:26–28.
84.
Ruilope LM: Safety aspects of aldosterone-blocking drugs. Eur Heart J 2011;13(suppl B):840–842.
85.
Maron BA, Leopold JA: Aldosterone receptor antagonists: effective but often forgotten. Circulation 2010;121:934–939.
86.
Edwards NC, Ferro CJ, Kirkwood H, Chue CD, Young AA, Stewart PM, Steeds RP, Townend JN: Effects of spironolactone on left ventricular systolic and diastolic function in patients with early chronic kidney disease. Am J Cardiol 2010;106:1505–1511.
87.
Navaneethan SD, Nigwekar SU, Sehgal AR, Strippoli FM: Aldosterone antagonist for preventing the progression of chronic kidney disease: a systematic review and meta-analysis. Clin J Am Soc Nephrol 2009;4:542–551.
88.
Malek F, Havrda M, Fruhaufova Z, Vranova J: Short-term effect of evidence-based medicine heart failure therapy on glomerular filtration rate in elderly patients with chronic cardiorenal syndrome. J Am Geriatr Soc 2009;57:2385–2386.
89.
Ludovit P, Unger T: Novel therapeutic targets for hypertension. Nat Rev Cardiol 2010;7:431–441.
90.
McMurray JJ, Pitt B, Latini R, Maggioni AP, Solomon SD, Keefe DL, et al: Effects of the oral direct renin inhibitor aliskiren in patients with symptomatic heart failure. Circ Heart Fail 2008;1:17–24.
91.
Pitt B, Latini R, Maggioni AP, Solomon SD, Smith BA, Wright M, et al: Neurohumoral effects of aliskiren in patients with symptomatic heart failure receiving a mineralocorticoid receptor antagonist: the Aliskiren Observation of Heart Failure Treatment study. Eur J Heart Fail 2011;13:755–764.
92.
Krum H, Iyngkaran P, Lekawanvijit S: Pharmacologic management of the cardiorenal syndrome in heart failure. Curr Heart Fail Rep 2009;6:105–111.
93.
Boerrigter G, Burnett JC: Cardiorenal syndrome in decompensated heart failure: prognostic and therapeutic implications. Curr Heart Fail Rep 2004;1:113–120.
94.
Petrie CJ, Mark PB, Weir RA: Broken pump or leaky filter? Renal dysfunction in heart failure a contemporary review. Int J Cardiol 2008;128:154–165.
95.
Rastogi A, Fonarow GC: The cardiorenal connection in heart failure. Curr Cardiol Rep 2008;10:190–197.
96.
Liu PP: Cardiorenal syndrome in heart failure: a cardiologist’s perspective. Can J Cardiol 2008;24(Suppl B):25B–29B.
97.
Shlipak MG: Pharmacotherapy for heart failure on patients with renal insufficiency. Ann Intern Med 2003:138:917–924.
98.
Shlipak MG, Browner WS, Noguchi H, et al: Comparison of the effects of angiotensin converting-enzyme inhibitors and beta-blockers on survival in elderly patients with reduced left ventricular function after myocardial infarction. Am J Med 2001;110:425–433.
99.
Khan W, Deepak SM, Coppinger T, et al: Beta blocker treatment is associated with improvement in renal function and anaemia in patients with heart failure. Heart 2006;92:1856–1857.
100.
Cice G, Ferrara L, D’Andrea A, et al: Carvedilol increases two-year survival in dialysis patients with dilated cardiomyopathy. J Am Coll Cardiol 2003;41:1438–1444.
101.
Sweileh WM, Sawalha AF, Jayousi HM, Zyoud SH, Al-Jabi SW: Predictors of ‘worsening renal function’ in patients hospitalized in internal medicine department. Curr Drug Saf 2009;4:113–118.
102.
Triposkiadis T, Karayannis G, Giamouzis G, Skoularigis J, Louridas G, Butler J: The sympathetic nervous system in heart failure physiology, pathophysiology, and clinical implications. J Am Coll Cardiol 2009;54:1747–1762.
103.
Zech P, Pozet N, Labeeuw M, et al: Acute renal effects of beta-blockers. Am J Nephrol 1986;6(suppl 2):15–19.
104.
Cice G, Ferrara L, D’Andrea A, et al: Dilated cardiomyopathy in dialysis patients – beneficial effects of carvedilol: a double-blind, placebo-controlled trial. J Am Coll Cardiol 2001;37:407–411.
105.
Abraham WT, Tsvetkova T, Lowes BD, et al: Carvedilol improves renal hemodynamics in patients with chronic heart failure. Circulation 1998;98:I-378–I-379.
106.
Sanderson JE, Chan SKW, Yip G, Yeung LYC, Chan KW, Raymond K, Woo KS: Beta-blockade in heart failure: a comparison of carvedilol with metoprolol. J Am Coll Cardiol 1999;34:1522–1528.
107.
Cohen-Solal A, Kotecha D, van Veldhuisen DJ, Babalis D, Böhm M, Coats AJ, Roughton M, Poole-Wilson P, Tavazzi L, Flather M; SENIORS Investigators: Efficacy and safety of nebivolol in elderly heart failure patients with impaired renal function: insights from the SENIORS trial. Eur J Heart Fail 2009;11:872–880.
108.
Munzel T, Gori T: Nebivilol: the somewhat-different beta-adrenergic receptor blocker. J Am Coll Cardiol 2009;54:1491–1499.
109.
Badve SV, Roberts MA, Hawley CM, Cass A, Garg AX, Krum H, Tonkin A, Perkovic V: Effects of beta-adrenergic antagonists in patients with chronic kidney disease: a systematic review and meta-analysis. J Am Coll Cardiol 2011;58:1152–1161.
110.
Phillips HR, O’Connor CM, Rogers J: Revascularization for heart failure. Am Heart J 2007;153:65–73.
111.
Tarakji KG, Brunken R, McCarthy PM, Al-Chekakie MO, Abdel-Latif A, Pothier CE, et al: Myocardial viability and the effects of early intervention in patients with advanced left ventricular systolic dysfunction. Circulation 2006;113:230–237.
112.
The BARI 2D Study Group: A randomized trial of therapies for type 2 diabetics and coronary artery disease. N Engl J Med 2009;360:2503–2515.
113.
Chan MY, Becker RC, Harrington RA, Peterson ED, Armstrong PW, White H, et al: Non-invasive, medical management for non-ST-elevation acute coronary syndromes. Am Heart J 2008;155:397–407.
114.
van Straten AH, Soliman Hamad MA, van Zundert AA, Martens EJ, Schonberger JP, de Wolf AM: Risk factors for deterioration of renal function after coronary artery bypass grafting. Eur J Cardiothorac Surg 2010;37:106–111.
115.
Hillis GS, Croal BL, Buchan KG, El-shafei H, Gibson G, Jeffrey RR, et al: Renal function and outcome from coronary artery bypass grafting. Circulation 2006;113:1056–1062.
116.
Nishida H, Uchikawa S, Chikazawa G, Kurihara H, Kihara S, Uwabe K, et al: Coronary artery bypass grafting in 105 patients with hemodialysis-dependent renal failure. Artif Organs 2001;25:268–272.
117.
Hillis GS, Cuthbertson BH, Croal BL: Renal function, revascularization and risk. Eur Heart J 2007;28:782–784.
118.
Goldenberg I, Moss AJ, McNitt S, Zareba W, Andrews ML, Hall WJ, Greenberg H, Case RB; Multicenter Automatic Defibrillator Implantation Trial-II Investigators: Relations among renal function, risk of sudden cardiac death, and benefit of the implanted cardiac defibrillator in patients with ischemic left ventricular dysfunction. Am J Cardiol 2006;98:485–490.
119.
Choncol M, Goldenberg I, Moss AJ, McNitt S, Cheung AK: Risk factors for sudden cardiac death in patients with chronic renal insufficiency and left ventricular dysfunction. Am J Nephrol 2007;27:7–14.
120.
Velavan P, Khan NK, Goode K, Rigby AS, Loh PH, Komajda M, Follath F, Swedberg K, Madeira H, Cleland JG: Predictors of short term mortality in heart failure – insights from the Euro Heart Failure survey. Int J Cardiol 2010;138:63–69.
121.
Patel UD, Hernandez AF, Liang L, Peterson ED, LaBresh KA, Yancy CW, Albert NM, Ellrodt G, Fonarow GC: Quality of care and outcomes among patients with heart failure and chronic kidney disease: A Get With the Guidelines – Heart Failure Program study. Am Heart J 2008;156:674–681.
122.
Coca SG, Peixoto AJ, Garg AX, Krumholz HM, Parikh CR: The prognostic importance of a small acute decrement in kidney function in hospitalized patients: a systematic review and meta-analysis. Am J Kidney Dis 2007;50:712–720.
123.
Smith GL, Shlipak MG, Havranek EP, et al: Race and renal impairment in heart failure: mortality in blacks versus whites. Circulation 2005;111:1270–1277.
124.
Lewis EF, Velazquez EJ, Solomon SD, Hellkamp AS, McMurray JJ, Mathias J, Rouleau JL, Maggioni AP, Swedberg K, Kober L, White H, Dalby AJ, Francis GS, Zannad F, Califf RM, Pfeffer MA: Predictors of the first heart failure hospitalization in patients who are stable survivors of myocardial infarction complicated by pulmonary congestion and/or left ventricular dysfunction: a VALIANT study. Eur Heart J 2008;29:748–756.
125.
Shlipak MG, Heidenreich PA, Naguchi H, Chertow GM, Browner WS, McClellan MB: Association of renal insufficiency with treatment and outcomes after myocardial infarction in elderly patients. Ann Int Med 2002;137:555–562.
126.
Stevens LA, Li S, Wang C, Huang C, Becker BN, Bomback AS, Brown WW, Burrows NR, Jurkovitz CT, McFarlane SI, Norris KC, Shlipak M, Whaley-Connell AT, Chen SC, Bakris GL, McCullough PA: Prevalence of CKD and comorbid illness in elderly patients in the United States: results from the Kidney Early Evaluation Program (KEEP). Am J Kidney Dis 2010;55(3 suppl 2):S23–S33.
127.
Bertoni AG, Hundley WG, Massing MW, Bonds MW, Burke GL, Goff DC: Heart failure prevalence, incidence, and mortality in the elderly with diabetes. Diabetes Care 2004;27:699–703.
128.
Nichols GA, Gullion CM, Koro CE, Ephross SA, Brown JB: The incidence of congestive heart failure in type 2 diabetes: an update. Diabetes Care 2004;27:1879–1884.
129.
Baigent C, Landray MJ, Reith C, Emberson J, Wheeler DC, Tomson C, Wanner C, et al: The effects of lowering LDL cholesterol with simvastatin plus ezetemibe in patients with chronic kidney disease (Study of Heart and Renal Protection): a randomised placebo-controlled trial. Lancet 2011;377:2181–2192.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.