Right Heart Failure and Cardiorenal Syndrome

Cardiol Clin. 2020 May;38(2):185-202. doi: 10.1016/j.ccl.2020.01.004. Epub 2020 Mar 2.


Cardiorenal syndrome is a complex interplay of dysregulated heart and kidney interaction that leads to multiorgan system dysfunction, which is not an uncommon occurrence in the setting of right heart failure. The traditional concept of impaired perfusion and forward flow recently has been modified to include the recognition of systemic venous congestion as a contributor, with direct and indirect mechanisms, including elevated renal venous pressure, reduced renal perfusion pressure, increased renal interstitial pressure, tubular dysfunction, splanchnic congestion, and neurohormonal and inflammatory activation. Treatment options beyond diuretics and vasoactive drugs remain limited and lack supportive evidence.

Keywords: Cardiorenal syndrome; Diuretics; Right heart failure; Systemic venous congestion.

Publication types

  • Review

MeSH terms

  • Cardio-Renal Syndrome / etiology*
  • Cardio-Renal Syndrome / physiopathology
  • Heart Failure / complications*
  • Heart Failure / physiopathology
  • Humans
  • Ventricular Dysfunction, Right / complications*
  • Ventricular Dysfunction, Right / physiopathology
  • Ventricular Function, Right / physiology*