Renal adaptation to the failing heart

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In patients with congestive heart failure, a diversity of neurohumoral and renal responses are involved in the maintenance of effective circuiting blood volume. The major clinical consequences of these responses are edema formation and, ultimately, decreased renal perfusion. In this article, the authors review the mechanisms that affect renal function in patients with systolic heart failure. A companion article on page 153 discusses use of therapeutic agents that modify these pathophysiologic sequelae.

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Notes on contributors

Daniel J. Riley

Daniel J. Riley, MD Dr Riley is senior renal fellow, department of medicine, division of nephrology, University of Texas Health Science Center at San Antonio.

Matthew Weir

Matthew Weir, MD Dr Weir is associate professor of medicine, division of nephrology, University of Maryland Medical Center, Baltimore.

George L. Bakris

George L. Bakris, MD Dr Bakris is assistant professor, departments of preventive and internal medicine, divisions of nephrology and endocrinology, Rush-Presbyterian-St Luke's Medical Center, Chicago. He is also director of the Hypertension Research Fellowship Program at Rush University Hypertension Center.