Reviews

Acute cardiorenal syndrome: Mechanisms and clinical implications

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Preventive strategies

Various strategies can be used to prevent acute cardiorenal syndrome. An optimal outpatient diuretic regimen to avoid hypervolemia is essential. Patients with advanced congestive heart failure should be followed up closely in dedicated heart failure clinics until their diuretic regimen is optimized. Patients should be advised to check their weight on a regular basis and seek medical advice if they notice an increase in their weight or a reduction in their urine output.

TAKE-HOME POINTS

  • A robust clinical definition of cardiorenal syndrome is lacking. Hence, recognition of this condition can be challenging.
  • Volume overload is central to its pathogenesis, and accurate assessment of volume status is critical.
  • Renal venous congestion is the major mechanism of type 1 cardiorenal syndrome.
  • Misdiagnosis can have devastating consequences, as it may lead to an opposite therapeutic approach.
  • Fluid removal by various strategies is the mainstay of treatment.
  • Temporary inotropic support should be saved for the last resort.

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