Mechanical strategies to improve fluid over load in patients with cardiorenal syndrome

Murthy AS

Pdf Page Numbers :- 45-51

Murthy AS^1,*

¹Consultant Nephrologist, Krishna Institute of Medical Sciences, Minister Road, Secunderabad - 500003, AP, India

*Corresponding author: Dr. A. S. Murthy, MD, DM (Nephrology), Consultant Nephrologist, Krishna Institute of Medical Sciences, Minister Road, Secunderabad - 500003, AP, India, Mobile: +91 9000789665; E-mail: smthy85@yahoo.co.in

Received 10 December 2012; Revised 17 February 2013; Accepted 27 February 2013

Citation: Murthy AS. Mechanical strategies to improve fluid over load in patients with cardiorenal syndrome. J Med Sci Res 2013; 1(1): 45-51. http://dx.doi.org/10.17727/JMSR.2013/1-010

Copyright: © 2013 Murthy AS. Published by KIMS Foundation and Research Center. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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Abstract

Treatment of acute deterioration in cardiac function traditionally involved diuretics, inotropes, and vasodilators. Usage of diuretics to reduce volume overload and pulmonary edema is often slow and many times accompanied by activation of RAAS and sympathetic nervous system with resultant increase in serum creatinine and heart rate. Other therapies that have been used in this setting include natriuretics and aquareticsalthough with limited success. To address this problem, mechanical removal of fluid (ultrafiltration/ aquapheresis) in volume overloaded patients is increasingly being done with lesser incidence of activation of RAAS and SNS. Both traditional dialysis machines and dedicated machines for isolated ultrafiltration have been employed.

Keywords: Ultrafiltration; Aquapheresis; Diuretics; Sympathetic nervous system (SNS); Renin angiotensin Aldosterone system (RAAS); Cardiorenal syndrome