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Challenges for the Basis of Practice

How Should We Modify Recommended Renin–Angiotensin–Aldosterone System Inhibition When Facing the Cardiorenal Syndrome?

Donal J. Sexton
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https://doi.org/10.1161/CIRCHEARTFAILURE.113.000843
Circulation: Heart Failure. 2014;7:536
Originally published May 20, 2014
Donal J. Sexton
From the HRB Clinical Research Facility, National University of Ireland Galway, Galway, Ireland.
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  • cardio-renal syndrome
  • heart failure

Introduction

In the advent of the characterization of the cardiorenal syndrome,1 nephrologists and cardiologists alike frequently toil with the conceptualization of the balance between cardiac and kidney function. This is particularly pertinent in the setting of newly diagnosed left ventricular failure (LVF) in patients with pre-existing chronic kidney disease (CKD), for example, post–myocardial infarction or nonischemic cardiomyopathy. Another common dilemma is the patient with progressive deterioration of both heart and kidney function leading to refractory congestive symptoms despite recurrent heart failure hospitalizations.

Renin–angiotensin–aldosterone system (RAAS) blockade with angiotensin-converting enzyme inhibitors2 or mineralocorticoid receptor antagonists3 is associated with reduced mortality in LVF. …

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Circulation: Heart Failure
May 2014, Volume 7, Issue 3
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    How Should We Modify Recommended Renin–Angiotensin–Aldosterone System Inhibition When Facing the Cardiorenal Syndrome?
    Donal J. Sexton
    Circulation: Heart Failure. 2014;7:536, originally published May 20, 2014
    https://doi.org/10.1161/CIRCHEARTFAILURE.113.000843

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    How Should We Modify Recommended Renin–Angiotensin–Aldosterone System Inhibition When Facing the Cardiorenal Syndrome?
    Donal J. Sexton
    Circulation: Heart Failure. 2014;7:536, originally published May 20, 2014
    https://doi.org/10.1161/CIRCHEARTFAILURE.113.000843
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