Bidirectional pathways linking heart failure, renal dysfunction, and congestion in cardiorenal syndrome. Bidirectional pathways linking heart failure,

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Bidirectional pathways linking heart failure, renal dysfunction, and congestion in cardiorenal syndrome. Bidirectional pathways linking heart failure, renal dysfunction, and congestion in cardiorenal syndrome. Decompensation of heart failure can lead to deterioration in renal function via exacerbated neurohormonal activity (i.e., low forward flow) or through fluid overload and renal venous congestion (i.e., high backward pressure). Ultrafiltration could counter these maladaptive interactions mainly through correction of congestion. LVEDP, left ventricular end diastolic pressure. Amir Kazory CJASN 2016;11:1463-1471 ©2016 by American Society of Nephrology