{"id":"fe96f657349e","type":"article","url":"https://hartvaat.nl/2024/10/15/aha-scientific-statement-nierdisfunctie-bij-gevorderd-hartfalen/","title":"AHA Scientific Statement: nierdisfunctie bij gevorderd hartfalen","title_en":"Evaluation and Management of Kidney Dysfunction in Advanced Heart Failure: A Scientific Statement From the American Heart Association.","category":"hartfalen","category_label":"Hartfalen","professions":["cardioloog","internist"],"tags":["nt-probnp"],"journal":"Circulation","doi":"10.1161/CIR.0000000000001273","source_url":"https://doi.org/10.1161/CIR.0000000000001273","authors":["W H Wilson Tang","Marie A Bakitas","Xingxing S Cheng","James C Fang","Savitri E Fedson","Amy G Fiedler","Pieter Martens","Wendy I McCallum","Modele O Ogunniyi","Janani Rangaswami","Nisha Bansal"],"significance":7,"published":"2024-10-15","source_date":"2024-10-15","image":"","kennis":["https://hartvaat.nl/kennis/hartfalen/hartfalen-en-nierfunctie/"],"congress":"","summary_en":"This AHA scientific statement provided a comprehensive framework for evaluating and managing kidney dysfunction in advanced heart failure, addressing the complex cardiorenal interactions that drive morbidity in this population.","created":"2026-07-03T10:31:14Z","updated":"2026-07-03T13:30:16Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"AHA scientific statement geeft een gestructureerd kader voor evaluatie en management van nierdisfunctie bij gevorderd hartfalen. Het document integreert cardiorenale pathofysiologie met praktische behandelaanbevelingen.","abstract_original":"Early identification of kidney dysfunction in patients with advanced heart failure is crucial for timely interventions. In addition to elevations in serum creatinine, kidney dysfunction encompasses inadequate maintenance of sodium and volume homeostasis, retention of uremic solutes, and disrupted endocrine functions. Hemodynamic derangements and maladaptive neurohormonal upregulations contribute to fluctuations in kidney indices and electrolytes that may recover with guideline-directed medical therapy. Quantifying the extent of underlying irreversible intrinsic kidney disease is crucial in predicting whether optimization of congestion and guideline-directed medical therapy can stabilize kidney function. This scientific statement focuses on clinical management of patients experiencing kidney dysfunction through the trajectory of advanced heart failure, with specific focus on (1) the conceptual framework for appropriate evaluation of kidney dysfunction within the context of clinical trajectories in advanced heart failure, including in the consideration of advanced heart failure therapies; (2) preoperative, perioperative, and postoperative approaches to evaluation and management of kidney disease for advanced surgical therapies (durable left ventricular assist device/heart transplantation) and kidney replacement therapies; and (3) the key concepts in palliative care and decision-making processes unique to individuals with concomitant advanced heart failure and kidney disease."}