Cardiorenal syndrome in decompensated heart failure: prognostic and therapeutic implications.

Various lines of evidence implicate impaired renal function as an important prognostic indicator in patients with congestive heart failure (CHF). Conventional diuretics may aggravate renal dysfunction and can result in neurohumoral activation. Evolving new therapeutic strategies that enhance renal function include administration of B-type natriuretic peptide, adenosine and vasopressin antagonists, and ultrafiltration methods. Prospective studies are needed to evaluate whether these new renal-enhancing strategies will improve patient outcome in CHF.