Ihab Wahba
University of Pennsylvania, USA
Title: Importance of venous congestion and perfusion pressure in acute kidney injury and the cardiorenal syndrome
Biography
Biography: Ihab Wahba
Abstract
Renal dysfunction is very common in patients with heart failure and is associated with poor longevity and poor overall prognosis.The term “cardiorenal syndrome” has been given to this condition to highlight its importance. The pathophysiology of acute kidney injury (AKI) and chronic kidney disease in the setting of heart failure is complex and poorly understood, and therefore, treatment options are not clearly defined. Recent observational data challenge the long-held hypothesis that renal dysfunction in that setting is mainly due to reduced cardiac output. This presentation will review evidence published both in the older literature and in recent studies that expand our understanding of this complex syndrome, with an emphasis on the role of venous congestion and low perfusion pressure in patients with the cardiorenal syndrome. Real case scenarios will be presented to highlight the pathophysiology and to propose effective treatment strategies. The role of medications and other factors that are usually overlooked yet may be crucial in the pathophysiology AKI and diuretic resistance in the setting of venous congestion and low perfusion will be emphasized.