What Physicians Need to Know About Renal Function in Outpatients with Heart Failure

The majority of outpatients with heart failure (HF) have chronic kidney disease (CKD) as an important comorbidity. Both glomerular filtration rate and abnormal urinary albumin excretion are major predictors of outcome in HF patients. Despite this, patients with renal dysfunction have been systematically excluded from the large randomized HF trials. There is lack of evidence for optimal treatment in these cardiorenal patients and treatment nihilism may account in part for their bad prognosis. Identifying and monitoring the progression of renal disease and making an effort to preserve renal function should be an important task in the management of all patients with HF. In this review, the current understanding of the pathophysiology of renal dysfunction in outpatients with HF will be summarized. Furthermore, important principles of the identification and management of cardiorenal patients will be described in order to make the physician more capable of managing outpatients with HF and renal dysfunction. © 2015 S. Karger AG, Basel Received: March 16, 2014 Accepted after revision: February 16, 2015 Published online: May 6, 2015 Bård Waldum-Grevbo, MD, PhD Department of Nephrology Oslo University Hospital, Ullevål PB 4956 Nydalen, NO–0424 Oslo (Norway) E-Mail bard.waldum @ medisin.uio.no © 2015 S. Karger AG, Basel 0008–6312/15/1312–0130$39.50/0