Targeting the kidney in acute decompensated heart failure: Conventional diuretics and renal-acting vasodilators

Fernando L. Martin, Horng Haur Chen, Alessandro Cataliotti, John C Jr. Burnett

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

A mainstay of therapy for congestive heart failure has been the use of potent diuretic agents, such as furosemide, that target the kidney to enhance sodium and water excretion. Although furosemide is widely used to treat the symptoms of acute decompensated heart failure (ADHF), the consequent activation of the renin-angiotensin-aldosterone system may limit the natriuretic response by reducing the glomerular filtration rate. In addition, excessive diuresis may reduce cardiac preload and result in systemic hypotension, which reduces renal perfusion pressure and prerenal azotemia and raises levels of blood urea nitrogen. In order to preserve and/or enhance renal function in ADHF, especially with agents such as conventional diuretics and vasodilators, an understanding of intrarenal factors that may protect the kidney may provide a direction for optimal use of current therapies and also lead to newer therapeutic strategies. Vasodilators, especially those that are linked to cGMP activation, may provide an alternative approach.

Original languageEnglish (US)
Pages (from-to)39-45
Number of pages7
JournalReviews in Cardiovascular Medicine
Volume9
Issue number1
StatePublished - Dec 2008

Fingerprint

Vasodilator Agents
Diuretics
Heart Failure
Kidney
Furosemide
Azotemia
Blood Urea Nitrogen
Diuresis
Renin-Angiotensin System
Glomerular Filtration Rate
Hypotension
Therapeutics
Perfusion
Sodium
Pressure
Water

Keywords

  • Acute decompensated heart failure
  • Diuretics
  • Renal function
  • Renin-angiotensin-aldosterone system
  • Vasodilators

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Targeting the kidney in acute decompensated heart failure : Conventional diuretics and renal-acting vasodilators. / Martin, Fernando L.; Chen, Horng Haur; Cataliotti, Alessandro; Burnett, John C Jr.

In: Reviews in Cardiovascular Medicine, Vol. 9, No. 1, 12.2008, p. 39-45.

Research output: Contribution to journalArticle

@article{06d7e822fcd0478598be9299d59124f0,
title = "Targeting the kidney in acute decompensated heart failure: Conventional diuretics and renal-acting vasodilators",
abstract = "A mainstay of therapy for congestive heart failure has been the use of potent diuretic agents, such as furosemide, that target the kidney to enhance sodium and water excretion. Although furosemide is widely used to treat the symptoms of acute decompensated heart failure (ADHF), the consequent activation of the renin-angiotensin-aldosterone system may limit the natriuretic response by reducing the glomerular filtration rate. In addition, excessive diuresis may reduce cardiac preload and result in systemic hypotension, which reduces renal perfusion pressure and prerenal azotemia and raises levels of blood urea nitrogen. In order to preserve and/or enhance renal function in ADHF, especially with agents such as conventional diuretics and vasodilators, an understanding of intrarenal factors that may protect the kidney may provide a direction for optimal use of current therapies and also lead to newer therapeutic strategies. Vasodilators, especially those that are linked to cGMP activation, may provide an alternative approach.",
keywords = "Acute decompensated heart failure, Diuretics, Renal function, Renin-angiotensin-aldosterone system, Vasodilators",
author = "Martin, {Fernando L.} and Chen, {Horng Haur} and Alessandro Cataliotti and Burnett, {John C Jr.}",
year = "2008",
month = "12",
language = "English (US)",
volume = "9",
pages = "39--45",
journal = "Reviews in Cardiovascular Medicine",
issn = "1530-6550",
publisher = "MedReviews LLC",
number = "1",

}

TY - JOUR

T1 - Targeting the kidney in acute decompensated heart failure

T2 - Conventional diuretics and renal-acting vasodilators

AU - Martin, Fernando L.

AU - Chen, Horng Haur

AU - Cataliotti, Alessandro

AU - Burnett, John C Jr.

PY - 2008/12

Y1 - 2008/12

N2 - A mainstay of therapy for congestive heart failure has been the use of potent diuretic agents, such as furosemide, that target the kidney to enhance sodium and water excretion. Although furosemide is widely used to treat the symptoms of acute decompensated heart failure (ADHF), the consequent activation of the renin-angiotensin-aldosterone system may limit the natriuretic response by reducing the glomerular filtration rate. In addition, excessive diuresis may reduce cardiac preload and result in systemic hypotension, which reduces renal perfusion pressure and prerenal azotemia and raises levels of blood urea nitrogen. In order to preserve and/or enhance renal function in ADHF, especially with agents such as conventional diuretics and vasodilators, an understanding of intrarenal factors that may protect the kidney may provide a direction for optimal use of current therapies and also lead to newer therapeutic strategies. Vasodilators, especially those that are linked to cGMP activation, may provide an alternative approach.

AB - A mainstay of therapy for congestive heart failure has been the use of potent diuretic agents, such as furosemide, that target the kidney to enhance sodium and water excretion. Although furosemide is widely used to treat the symptoms of acute decompensated heart failure (ADHF), the consequent activation of the renin-angiotensin-aldosterone system may limit the natriuretic response by reducing the glomerular filtration rate. In addition, excessive diuresis may reduce cardiac preload and result in systemic hypotension, which reduces renal perfusion pressure and prerenal azotemia and raises levels of blood urea nitrogen. In order to preserve and/or enhance renal function in ADHF, especially with agents such as conventional diuretics and vasodilators, an understanding of intrarenal factors that may protect the kidney may provide a direction for optimal use of current therapies and also lead to newer therapeutic strategies. Vasodilators, especially those that are linked to cGMP activation, may provide an alternative approach.

KW - Acute decompensated heart failure

KW - Diuretics

KW - Renal function

KW - Renin-angiotensin-aldosterone system

KW - Vasodilators

UR - http://www.scopus.com/inward/record.url?scp=42249104540&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=42249104540&partnerID=8YFLogxK

M3 - Article

C2 - 18418308

AN - SCOPUS:42249104540

VL - 9

SP - 39

EP - 45

JO - Reviews in Cardiovascular Medicine

JF - Reviews in Cardiovascular Medicine

SN - 1530-6550

IS - 1

ER -