ReviewFrontiers in cardiovascular medicine2022
How to interpret serum creatinine increases during decongestion.
Review in Frontiers in cardiovascular medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 19 citations in OpenAlex.
- ΔVExPLUs: prognostic value of integrating serial changes in VExUS score and lung ultrasound in acute decompensated heart failure.European heart journal. Imaging methods and practice · 2026Article
- Acute Kidney Injury in Acute Heart Failure Revisited: Marker of Cardiorenal Disease Severity Rather Than Isolated Renal Injury.Life (Basel, Switzerland) · 2026Review
- Renal congestion syndrome in critically ill patients: a neglected mechanism of acute kidney injury - A narrative review.Annals of intensive care · 2026Review
- Impact of infection on decongestion and kidney outcomes in patients with cardiorenal syndrome type 1.PloS one · 2026Article
- Antidiabetic Effect ofScientifica · 2026Article
- The Intersection of Heart Failure and Chronic Kidney Disease: Challenges in Co-management.Cureus · 2026Review
- Cardiorenal Syndrome in the Elderly: Challenges and Considerations.Geriatrics (Basel, Switzerland) · 2025Review
- Prognostic value of dynamic KDIGO staging in acute kidney injury after acute heart failure: a doubly robust analysis.Scientific reports · 2025Article
- Low levels of adropin are associated with acute kidney injury after decongestion in patients with acutely decompensated heart failure.Journal of molecular and cellular cardiology plus · 2025Article
- VExUS Protocol Along Cardiorenal Syndrome: An Updated Review.Journal of clinical medicine · 2025Review
- Evolving Decongestion Strategies in the Management of Acute Heart Failure.Current treatment options in cardiovascular medicine · 2025Review
- Renal Biomarkers in Cardiovascular Patients with Acute Kidney Injury: A Case Report and Literature Review.Diagnostics (Basel, Switzerland) · 2023Review
- Patient Selection and End Point Definitions for Decongestion Studies in Acute Decompensated Heart Failure: Part 1.Journal of the Society for Cardiovascular Angiography & InterventionsReview
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
During decongestion in acute decompensated heart failure (ADHF), it is common to observe elevations in serum creatinine (sCr) values due to vascular congestion, a mechanism that involves increased central venous pressure that has a negative impact on the nephron, promoting greater absorption of water and sodium, increased interstitial pressure in an encapsulated organ developing "renal tamponade" which is one of main physiopathological mechanism associated with impaired kidney function. For the treatment of this syndrome, it is recommended to use diuretics that generate a high urinary output and natriuresis to decongest the venous system, during this process the sCr values can rise, a phenomenon that may bother some cardiologist and nephrologist, since raise the suspicion of kidney damage that could worsen the prognosis of these patients. It is recommended that increases of up to 0.5 mg/dL from baseline are acceptable, but some patients have higher increases, and we believe that an arbitrary number would be impractical for everyone. These increases in sCr may be related to changes in glomerular hemodynamics and true hypovolemia associated with decongestion, but it is unlikely that they are due to structural injury or truly hypoperfusion and may even have a positive connotation if accompanied by an effective decongestion and be associated with a better prognosis in the medium to long term with fewer major cardiovascular and renal events. In this review, we give a comprehensive point of view on the interpretation of creatinine elevation during decongestion in patients with ADHF.
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