Renal Dysfunction in Heart Failure Is Due to Congestion but Not Low Output
Version of Record online: 6 FEB 2011
© 2011 Wiley Periodicals, Inc.
Volume 34, Issue 2, pages 113–116, February 2011
How to Cite
Guglin, M., Rivero, A., Matar, F. and Garcia, M. (2011), Renal Dysfunction in Heart Failure Is Due to Congestion but Not Low Output. Clin Cardiol, 34: 113–116. doi: 10.1002/clc.20831
- Issue online: 4 FEB 2011
- Version of Record online: 6 FEB 2011
- Manuscript Accepted: 20 JUL 2010
- Manuscript Received: 15 MAY 2010
Renal dysfunction in heart failure is thought to be due to poor perfusion of the kidney.
We tested the hypothesis that passive congestion is more important than poor perfusion.
We retrospectively studied the data on 178 patients who underwent right heart catheterization for evaluation of heart failure and had serum creatinine (Cr) measured on the same day.
Serum Cr and glomerular filtration rate (GFR) correlated with central venous pressure (r = 0.22, P = 0.001 and r = −0.55, P < 0.0001, respectively) and renal perfusion pressure (r = 0.21, P = 0.001 and r = 0.27, P = 0.015, respectively). Neither correlated with cardiac index or left ventricular ejection fraction. Serum Cr was significantly higher and GFR was significantly lower in the upper tertile of central venous pressure, pulmonary capillary wedge pressure as well as in the lower tertile of renal perfusion pressure.
Renal dysfunction in heart failure is determined more by passive congestion than by low perfusion. Copyright © 2011 Wiley Periodicals, Inc.
The authors have no funding, financial relationships, or conflicts of interest to disclose.