Pathophysiology of the cardiorenal syndrome in acute heart failure

Heart failure is a common disease which, despite progress in medical and device-based therapies, continues to be associated with substantial morbidity and mortality. Heart failure is primarily characterized by impairment in cardiac function, which compromises the function of other organ systems and becomes a multisystem disorder. The kidney is the major organ in the control of body fluid and electrolyte homeostasis, and it is of particular importance in the pathogenesis of heart failure. While renal sodium and water retention are an attempt to maintain blood pressure and cardiac output, this can result in a vicious cycle by further increasing the load on an already failing heart.