• Maya Guglin, Abel Rivero, Fadi Matar, and Marcos Garcia.
• Department of Medicine, University of South Florida, Tampa, FL 33620, USA. mguglin@gmail.com
• Clin Cardiol. 2011 Feb 1; 34 (2): 113-6.

BackgroundRenal dysfunction in heart failure is thought to be due to poor perfusion of the kidney.HypothesisWe tested the hypothesis that passive congestion is more important than poor perfusion.MethodsWe retrospectively studied the data on 178 patients who underwent right heart catheterization for evaluation of heart failure and had serum creatinine (Cr) measured on the same day.ResultsSerum Cr and glomerular filtration rate (GFR) correlated with central venous pressure (r = 0.22, P = 0.001 and r = -0.55, P < 0.0001, respectively) and renal perfusion pressure (r = 0.21, P = 0.001 and r = 0.27, P = 0.015, respectively). Neither correlated with cardiac index or left ventricular ejection fraction. Serum Cr was significantly higher and GFR was significantly lower in the upper tertile of central venous pressure, pulmonary capillary wedge pressure as well as in the lower tertile of renal perfusion pressure.ConclusionsRenal dysfunction in heart failure is determined more by passive congestion than by low perfusion.© 2011 Wiley Periodicals, Inc.

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