%0 Journal Article
%T Cardiorenal Signaling Pathways in Heart Failure: Good and Bad News - Cardiorenal Signaling Pathways in Heart Failure: Good and Bad News - Open Access Pub
%A Gabriela Borrayo S¨¢nchez
%A Gilberto P¨¦rez Rodr¨ªguez
%A Jos¨¦ Ram¨®n Paniagua-Sierra
%A Martin Rosas-Peralta
%A Silvia Palomo-Pi£¿¨®n
%J OAP | Home | Journal of Hypertension and Cardiology | Open Access Pub
%D 2017
%X DOI10.14302/issn.2329-9487.jhc-15-864 During the past half-century, the advances in the prevention, diagnosis, and management of cardiovascular disease (CVD) have been nothing short of spectacular. Age-adjusted CVD related deaths have declined by about two-thirds in industrialized nations1 however, in developing countries still increasing. Nevertheless, Heart failure (HF) is a notable exception to these encouraging trends. Indeed, after normal delivery, it is the most common cause of hospitalization. Annual hospital discharges in patients with a primary diagnosis of HF have risen steadily since 1975, and now exceed 1 million discharges per year, although they may at last be leveling off or actually decreasing, in the United States. In Europe, hospitalizations for HF are clearly declining. HF is primarily a disease of the elderly that affects about 10% of men and 8% of women over the age of 60 years, and its prevalence rises with age and has risen overall. In the United States, patients with a primary diagnosis of HF now make >3 million physician visits per year. The direct and indirect costs of HF in the United States are staggering; in 2010 they were estimated to be US $39.2 billion. The estimated lifetime cost of HF per individual patient is $110,000/year (2008 US dollars), with more than three-fourths of this cost consumed by in-hospital care1 Survival after a diagnosis of HF has improved during the past 30 years; the age-adjusted death rate has declined, and the mean age at death from HF has risen. However, despite these modest improvements, the 5-year mortality is still approximately 50% worse than that of many cancers. Among Medicare patients, 30-day mortality is 10% to 12%, and the 30-day readmission rate after hospital discharge is 20% to 25%1 Cardiorenal syndrome (CRS) is the umbrella term used to describe clinical conditions in which cardiac and renal dysfunctions coexist. Much has been written on this subject, but underlying pathophysiological mechanisms continue to be unraveled and implications for management continue to be debated. Mortality is increased in patients with heart failure (HF) who have a reduced glomerular filtration rate (GFR).Patients with chronic kidney disease have an increased risk of both atherosclerotic cardiovascular disease and HF, and cardiovascular disease is responsible for up to 50 percent of deaths in patients with renal failure1, 2, 3. Acute or chronic systemic disorders can cause both cardiac and renal dysfunction. The pathophysiological pathways have common neurohormonal links such as
%U https://www.openaccesspub.org/jhc/article/250