{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T05:14:44Z","timestamp":1768886084813,"version":"3.49.0"},"reference-count":92,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2008,2,19]]},"abstract":"<jats:p>Heart failure and chronic kidney disease share a number of risk factors and pathophysiological pathways. These 2 pathological processes coexist in large numbers of patients. Whereas the presence of chronic kidney disease in patients with heart failure adversely influences their survival, cardiovascular disease is the major cause of mortality in individuals with chronic kidney disease. The management of heart failure by cardiologists has recently expanded from pharmacological treatment to extracorporeal strategies; the interaction between (and concurrent use of) these approaches traditionally has been part of nephrology care and training. The purpose of this review is to explore these management strategies from a nephrologic standpoint and cover the pathophysiology of diuretic resistance, new pharmaceutical strategies to induce natriuresis or aquaresis, and the physiological basis and theoretical advantages of fluid removal by nontraditional peritoneal or hemofiltration approaches. This review also focuses on the technical features, safety, and potential risks of dedicated ultrafiltration devices that do not require dialysis staff or facilities and that are now readily available to nonnephrologists.<\/jats:p>","DOI":"10.1161\/circulationaha.107.742270","type":"journal-article","created":{"date-parts":[[2008,2,19]],"date-time":"2008-02-19T21:52:14Z","timestamp":1203457934000},"page":"975-983","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":70,"title":["Contemporary Trends in the Pharmacological and Extracorporeal Management of Heart Failure"],"prefix":"10.1161","volume":"117","author":[{"given":"Amir","family":"Kazory","sequence":"first","affiliation":[{"name":"From the Division of Nephrology, Hypertension, and Transplantation, University of Florida, Gainesville."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edward A.","family":"Ross","sequence":"additional","affiliation":[{"name":"From the Division of Nephrology, Hypertension, and Transplantation, University of Florida, Gainesville."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_2_1_2","unstructured":"American Heart Association. Heart Disease and Stroke Statistics: 2006 Update. Dallas Tex; American Heart Association; 2006."},{"key":"e_1_3_2_2_2","first-page":"S107","volume":"13","year":"1994","unstructured":"O\u2019Connell JB, Bristow MR. Economic impact of heart failure in the United States: time for a different approach. J Heart Lung Transplant. 1994; 13: S107\u2013S112.","journal-title":"J Heart Lung Transplant"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2005.074393"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2006101159"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(00)00582-9"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10741-005-6129-4"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehi696"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.102.2.203"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1159\/000099012"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199908193410806"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(07)00488-2"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2005.02.095"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1210\/jcem.82.4.3900"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1053\/gast.2003.50143"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa065181"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.73.2.3002660"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.0000165065.82609.3d"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.297.12.1319"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.297.12.1332"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.297.12.1374"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1177\/1074248406291155"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1988.00380020030006"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0030-6665(20)30770-2"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1159\/000047397"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1067\/mhj.2002.123144"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.0306-5251.2003.02054.x"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(03)00765-4"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1136\/pgmj.2003.010835"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2007.03.059"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cardfail.2007.08.006"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1159\/000168356"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1291\/hypres.22.17"},{"key":"e_1_3_2_33_2","unstructured":"Frierdich G Schuh J Brown M Blehm D Delyani JA. Effect of selective mineralocorticoid receptor antagonist eplerenone in a model of aldosterone-induced hypertension and cardiac fibrosis. In: Program and abstracts of the 13th Scientific Meeting of the American Society of Hypertension; May 13\u201316 1998; New York NY."},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.hyp.0000193502.77417.17"},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199909023411001"},{"key":"e_1_3_2_36_2","first-page":"650","volume":"240","year":"1987","unstructured":"de Gasparo, Joss U, Ramjoue HP, Whitebread SE, Haenni H, Schenkel L, Kraehenbuehl C, Biollaz M, Grob J, Schmidlin J. Three new epoxy-spirolactone derivatives: characterization in vivo and in vitro. J Pharmacol Exp Ther. 1987; 240: 650\u2013656.","journal-title":"J Pharmacol Exp Ther"},{"key":"e_1_3_2_37_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa030207"},{"key":"e_1_3_2_38_2","doi-asserted-by":"publisher","DOI":"10.1038\/ki.1992.172"},{"key":"e_1_3_2_39_2","doi-asserted-by":"publisher","DOI":"10.1172\/JCI115146"},{"key":"e_1_3_2_40_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0889-8529(18)30497-3"},{"key":"e_1_3_2_41_2","doi-asserted-by":"publisher","DOI":"10.1152\/ajpheart.00085.2003"},{"key":"e_1_3_2_42_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehl337"},{"key":"e_1_3_2_43_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(99)00184-9"},{"key":"e_1_3_2_44_2","first-page":"1531","volume":"287","year":"2002","unstructured":"Publication Committee for the VAMC Investigators. Intravenous nesiritide vs. nitroglycerin for treatment of decompensated congestive heart failure: a randomized controlled trial. JAMA. 2002; 287: 1531\u20131540.","journal-title":"JAMA"},{"key":"e_1_3_2_45_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2006.10.048"},{"key":"e_1_3_2_46_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.0000159340.93220.e4"},{"key":"e_1_3_2_47_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.293.15.1900"},{"key":"e_1_3_2_48_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.0000141829.04031.25"},{"key":"e_1_3_2_49_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2007.03.071"},{"key":"e_1_3_2_50_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2004.05.022"},{"key":"e_1_3_2_51_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2007.02.004"},{"key":"e_1_3_2_52_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2362.1992.tb01427.x"},{"key":"e_1_3_2_53_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2005.01.022"},{"key":"e_1_3_2_54_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2005.05.098"},{"key":"e_1_3_2_55_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cardfail.2003.12.003"},{"key":"e_1_3_2_56_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2005.07.067"},{"key":"e_1_3_2_57_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.72.6.534"},{"key":"e_1_3_2_58_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(01)01479-6"},{"key":"e_1_3_2_59_2","doi-asserted-by":"publisher","DOI":"10.1159\/000047404"},{"key":"e_1_3_2_60_2","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfm004"},{"key":"e_1_3_2_61_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2006.07.073"},{"key":"e_1_3_2_62_2","first-page":"820.","volume":"50","year":"2007","unstructured":"Kazory A, Ejaz AA, Ross EA. The UNLOAD trial: a nephrologic standpoint. J Am Coll Cardiol. 2007; 50: 820.","journal-title":"J Am Coll Cardiol"},{"key":"e_1_3_2_63_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cardfail.2006.01.011"},{"key":"e_1_3_2_64_2","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfg590"},{"key":"e_1_3_2_65_2","doi-asserted-by":"crossref","unstructured":"Polaschegg HD Levin N. Hemodialysis machines and monitors. In: H\u00f6rl WH Koch KM Lindsay RM Ronco C Winchester JF eds. Replacement of Renal Function by Dialysis. 5th ed. Dordrecht The Netherlands. Kluwer Academic Publishers; 2004: 323\u2013447.","DOI":"10.1007\/978-1-4020-2275-3_14"},{"key":"e_1_3_2_66_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.ki.5001508"},{"key":"e_1_3_2_67_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0272-6386(04)01078-9"},{"key":"e_1_3_2_68_2","doi-asserted-by":"publisher","DOI":"10.1038\/ki.1996.399"},{"key":"e_1_3_2_69_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-70-5-931"},{"key":"e_1_3_2_70_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.ki.5001918"},{"key":"e_1_3_2_71_2","doi-asserted-by":"publisher","DOI":"10.1159\/000047401"},{"key":"e_1_3_2_72_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1959.03010080025004"},{"key":"e_1_3_2_73_2","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfh1105"},{"key":"e_1_3_2_74_2","first-page":"141","volume":"22","year":"2006","unstructured":"Takane H, Nakamoto H, Arima H, Shoda J, Moriwaki K, Ikeda N, Kobayashi K, Kanno Y, Sugahara S, Okada H, Suzuki H. Continuous ambulatory peritoneal dialysis is effective for patients with severe congestive heart failure. Adv Perit Dial. 2006; 22: 141\u2013146.","journal-title":"Adv Perit Dial"},{"key":"e_1_3_2_75_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1523-1755.2003.00165.x"},{"key":"e_1_3_2_76_2","doi-asserted-by":"publisher","DOI":"10.1002\/hep.21355"},{"key":"e_1_3_2_77_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(94)90142-2"},{"key":"e_1_3_2_78_2","first-page":"2093","volume":"22","year":"2007","unstructured":"Kazory A, Ejaz AA. Removal of BNP and inflammatory cytokines by haemodiafiltration in refractory heart failure. Nephrol Dial Transplant. 2007; 22: 2093\u20132094.","journal-title":"Nephrol Dial Transplant"},{"key":"e_1_3_2_79_2","first-page":"IV77","volume":"87","year":"1993","unstructured":"Horl WH, Riegel W. Cardiac depressant factors in renal disease. Circulation. 1993; 87 (suppl 5): IV77\u2013IV82.","journal-title":"Circulation"},{"key":"e_1_3_2_80_2","doi-asserted-by":"publisher","DOI":"10.1038\/ki.1994.414"},{"key":"e_1_3_2_81_2","first-page":"16","volume":"5","year":"1989","unstructured":"Fincher ME, Campbell HT, Sklar AH, Caruana RJ, Lightfoot BO, Cheek PL, Smith KL, Hess CP. Atrial natriuretic peptide (ANP) is removed by peritoneal dialysis in humans. Adv Perit Dial. 1989; 5: 16\u201319.","journal-title":"Adv Perit Dial"},{"key":"e_1_3_2_82_2","first-page":"377","volume":"87","year":"2003","unstructured":"Cromie N, Lee C, Struthers AD. Anemia in chronic heart failure: what is its frequency in the UK and its underlying causes? Heart. 2003; 87: 377\u2013378.","journal-title":"Heart"},{"key":"e_1_3_2_83_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000052622.51963.FC"},{"key":"e_1_3_2_84_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(02)01854-5"},{"key":"e_1_3_2_85_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.0000044914.42696.6a"},{"key":"e_1_3_2_86_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(01)01248-7"},{"key":"e_1_3_2_87_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2006.11.024"},{"key":"e_1_3_2_88_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2005.10.014"},{"key":"e_1_3_2_89_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199808273390903"},{"key":"e_1_3_2_90_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa065485"},{"key":"e_1_3_2_91_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa062276"},{"key":"e_1_3_2_92_2","unstructured":"FDA Drug Safety Podcasts: Erythropoiesis-Stimulating Agents (ESAs). US Food and Drug Administration Web site. Available at: http:\/\/www.fda.gov\/cder\/drug\/podcast\/20070313_02_full.htm. Accessed March 22 2007."}],"container-title":["Circulation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCULATIONAHA.107.742270","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T06:20:31Z","timestamp":1715581231000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCULATIONAHA.107.742270"}},"subtitle":["A Nephrologic Perspective"],"short-title":[],"issued":{"date-parts":[[2008,2,19]]},"references-count":92,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2008,2,19]]}},"alternative-id":["10.1161\/CIRCULATIONAHA.107.742270"],"URL":"https:\/\/doi.org\/10.1161\/circulationaha.107.742270","relation":{},"ISSN":["0009-7322","1524-4539"],"issn-type":[{"value":"0009-7322","type":"print"},{"value":"1524-4539","type":"electronic"}],"subject":[],"published":{"date-parts":[[2008,2,19]]},"assertion":[{"value":"2008-02-19","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}