{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T23:13:46Z","timestamp":1789773226792,"version":"4.0.1"},"reference-count":64,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2024,6,29]],"date-time":"2024-06-29T00:00:00Z","timestamp":1719619200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000272","name":"NIHR","doi-asserted-by":"publisher","award":["207236"],"award-info":[{"award-number":["207236"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,12,20]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:p>Acute kidney injury is common in patients with acute decompensated heart failure. It is more common in patients with acute heart failure who suffer from chronic kidney disease. Worsening renal function is often defined as a rise in serum creatinine of more than 0.3\u00a0mg\/dL (26.5\u00a0\u00b5mol\/L) which, by definition, is acute kidney injury (AKI) stage 1. Perhaps the term AKI is more appropriate than worsening renal function as it is used universally by nephrologists, internists and other medical practitioners. In health, the heart and the kidney support each other to maintain the body's homeostasis. In disease, the heart and the kidney can adversely affect each other's function, causing further clinical deterioration. In patients presenting with acute heart failure and fluid overload, therapy with diuretics for decongestion often causes a rise in serum creatinine and AKI. However, in the longer term the decongestion improves survival and prevents hospital admissions despite rising serum creatinine and AKI. It is important to realize that renal venous congestion due to increased right-sided heart pressures in acute heart failure is a major cause of kidney dysfunction and hence decongestion therapy improves kidney function in the longer term. This review provides a perspective on the acceptable AKI with decongestion therapy, which is associated with improved survival, as opposed to AKI due to tubular injury related to sepsis or nephrotoxic drugs, which is associated with poor survival.<\/jats:p>","DOI":"10.1093\/ndt\/gfae146","type":"journal-article","created":{"date-parts":[[2024,6,29]],"date-time":"2024-06-29T23:57:23Z","timestamp":1719705443000},"page":"10-18","source":"Crossref","is-referenced-by-count":42,"title":["Acute kidney injury in acute heart failure\u2013when to worry and when not to worry?"],"prefix":"10.1093","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6863-2325","authenticated-orcid":false,"given":"Debasish","family":"Banerjee","sequence":"first","affiliation":[{"name":"Renal and Transplantation Unit, St George's University Hospitals NHS Foundation Trust , London ,","place":["UK"]},{"name":"Molecular and Clinical Sciences Research Institute, St George's, University of London , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4633-452X","authenticated-orcid":false,"given":"Mahrukh Ayesha","family":"Ali","sequence":"additional","affiliation":[{"name":"Renal and Transplantation Unit, St George's University Hospitals NHS Foundation Trust , London ,","place":["UK"]},{"name":"Molecular and Clinical Sciences Research Institute, St George's, University of London , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2508-7117","authenticated-orcid":false,"given":"Angela Yee-Moon","family":"Wang","sequence":"additional","affiliation":[{"name":"Duke-National University of Singapore, Academic Medical Center, Singapore General Hospital ,","place":["Singapore"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vivekanand","family":"Jha","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, School of Public Health, Imperial College London , London ,","place":["UK"]},{"name":"The George Institute of Global Health , Delhi ,","place":["India"]},{"name":"Prasanna School of Public Health, Manipal Academy of Higher Education , Manipal ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,6,29]]},"reference":[{"key":"2025030500281146100_bib1","author":"British Society For Heart Failure","year":".."},{"key":"2025030500281146100_bib2","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1016\/j.mpaic.2021.05.003","article-title":"Renal physiology: blood flow, glomerular filtration and plasma clearance","volume":"22","author":"Leatherby","year":"2021","journal-title":"Anaesth Intensive Care Med"},{"key":"2025030500281146100_bib3","doi-asserted-by":"publisher","first-page":"845","DOI":"10.2174\/15701611113116660149","article-title":"Molecular mechanisms of renal blood flow autoregulation","volume":"12","author":"Burke","year":"2014","journal-title":"Curr Vasc Pharmacol"},{"key":"2025030500281146100_bib4","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1016\/j.jacc.2003.07.031","article-title":"Incidence, predictors at admission, and impact of worsening renal function among patients hospitalized with heart failure","volume":"43","author":"Forman","year":"2004","journal-title":"J Am Coll Cardiol"},{"key":"2025030500281146100_bib5","doi-asserted-by":"publisher","first-page":"190","DOI":"10.1007\/s11886-008-0033-1","article-title":"The cardiorenal connection in heart failure","volume":"10","author":"Rastogi","year":"2008","journal-title":"Curr Cardiol Rep"},{"key":"2025030500281146100_bib6","doi-asserted-by":"crossref","first-page":"1787","DOI":"10.1093\/eurheartj\/ehs104","article-title":"ESC Committee for Practice Guidelines. 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