It is quite common to see accompanying acute kidney injury during a congestive heart failure exacerbation.
- Renal hypo-perfusion secondary to poor cardiac output.
- Renal venous congestion. Increased central venous pressure (CVP) is transmitted into the efferent arteriole, reducing the pressure gradient and subsequently the GFR.
- Neurohumoral mechanisms (i.e RAAS, ADH) which help acutely but are maladaptive in the long term on the kidneys’ GFR.
- Marlies Ostermann, Heleen M. Oudemans-van Straaten and Lui G. Forni. Fluid overload and acute kidney injury: cause or consequence?. Critical Care 201519:443https://doi.org/10.1186/s13054-015-1163-7
Han SW, Ryu KH. Renal Dysfunction in Acute Heart Failure. Korean Circulation Journal. 2011;41(10):565-574. doi:10.4070/kcj.2011.41.10.565.