Effects of the Adenosine A1 Receptor Antagonist, KW-3902, Alone and in Combination with Furosemide, on Diuresis and Renal Function in Hospitalized Acutely Decompensated Heart Failure Patients with Renal Impairment: A Randomized, Double-Blind, Placebo-Controlled, Dose-Ranging Study

2006 ◽  
Vol 12 (6) ◽  
pp. S70
Author(s):  
Howard C. Dittrich ◽  
Michael Tansey ◽  
Gadi Cotter ◽  
Tara K. Fields ◽  
Leeanne L. Pearson ◽  
...  
Keyword(s):  
Heart Failure ◽  
Renal Function ◽  
Decompensated Heart Failure ◽  
Double Blind ◽  
Double Blind Placebo ◽  
Heart Failure Patients ◽  
Acutely Decompensated Heart Failure ◽  
Adenosine A1 ◽  
Dose Ranging ◽  
A1 Receptor

scholarly journals Worsening of renal function in patients hospitalized with acutely decompensated heart failure

2018 ◽  
Vol 75 (11) ◽  
pp. 1083-1088
Author(s):  
Marko Lazovic ◽  
Sonja Radenkovic ◽  
Dijana Stojanovic ◽  
Jelena Radovic ◽  
Miodrag Stojanovic ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Renal Function ◽  
Total Cholesterol ◽  
Significant Risk ◽  
Decompensated Heart Failure ◽  
Clinical Group ◽  
Heart Failure Patients ◽  
Acutely Decompensated Heart Failure ◽  
Patients With Heart Failure

Background/Aim. A predictor of a poor prognosis, renal dysfunction often manifests in patients with heart failure, and is associated with an increased mortality in these patients. The aim of the parent study was to determine risk factors associated with worsening renal function (WRF) in patients hospitalized for acutely decompensated heart failure. Methods. The study included 330 patients with acutely decompensated heart failure. Patients who developed WRF (n = 215, mean age 72.4 ? 9.8 years) were in the clinical group, and patients without WRF (n = 115, mean age 59.8 ? 11.7 years) were in the control group. Patients in the clinical group were observed according to: the age, gender, lipids, electrolytes, smoking, hypertension, and type of heart failure, with reduced or preserved left ventricle ejection fraction (HFrEF or HFpEF). We used logistic regression to calculate non-adjusted odds ratio (OR) and 95% confidence intervals for occurrence of WRF. Results. WRF was determined in 65.2% of patients with heart failure. Non-adjusted OR showed that there was a significant risk for development of WRF with age (OR = 4.3; p < 0.01), total cholesterol > 5.2 mmol/L (OR = 1.6; p < 0.05), hyponatremia < 135 mmol/L, (OR = 2.8; p < 0.01), smoking (OR = 3.9; p < 0.01), hypertension (OR = 2.0; p < 0.05), and with the presence of HFrEF (OR = 1.3; p < 0.01). Presence of HFpEF, hypokalemia, < 3.5 mmol/L, plasma triglycerides, > 1.7 mmol/L, and gender, did not have any significance for the development of renal damage. Conclusion. Patients? age, total cholesterol, hyponatremia, smoking, hypertension, and HFrEF were significant risk factors for worsening renal function in heart failure patients. Comparing predictive values, age could be the best prognostic tool for early identification of patients at risk for WRF.

scholarly journals Therapeutic Options for the Management of the Cardiorenal Syndrome

2011 ◽  
Vol 2011 ◽  
pp. 1-10 ◽  
Author(s):  
Katerina Koniari ◽  
Marinos Nikolaou ◽  
Ioannis Paraskevaidis ◽  
John Parissis
Keyword(s):  
Heart Failure ◽  
Renal Function ◽  
Acute Decompensated Heart Failure ◽  
Clinical Success ◽  
Decompensated Heart Failure ◽  
Cardiorenal Syndrome ◽  
Patients With Heart Failure ◽  
Adenosine A1 ◽  
A1 Receptor

Patients with heart failure often present with impaired renal function, which is a predictor of poor outcome. The cardiorenal syndrome is the worsening of renal function, which is accelerated by worsening of heart failure or acute decompensated heart failure. Although it is a frequent clinical entity due to the improved survival of heart failure patients, still its pathophysiology is not well understood, and thus its therapeutic approach remains controversial and sometimes ineffective. Established therapeutic strategies, such as diuretics and inotropes, are often associated with resistance and limited clinical success. That leads to an increasing concern about novel options, such as the use of vasopressin antagonists, adenosine A1 receptor antagonists, and renal-protective dopamine. Initial clinical trials have shown quite encouraging results in some heart failure subpopulations but have failed to demonstrate a clear beneficial role of these agents. On the other hand, ultrafiltration appears to be a more promising therapeutic procedure that will improve volume regulation, while preserving renal and cardiac function. Further clinical studies are required in order to determine their net effect on renal function and potential cardiovascular outcomes. Until then, management of the cardiorenal syndrome remains quite empirical.

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