Venous congestion and the kidney in cardiorenal syndrome

Hypervolemia is associated with deterioration of renal function and poor prognosis of patients with cardiorenal syndrome. The term congestive nephropathy is related to a disorder of renal function that occur as a result of venous congestion and poor renal perfusion during cardiorenal interaction. The mechanism of congestive nephropathy is multifactorial and complex. It is not possible to fully assess the true intravascular volume by clinical examination. In the assessment of hypervolemia, various markers are used, which are interpreted carefully and in the context of the clinical picture. Of the visualization methods, the most interesting is Doppler ultrasound for assessing volemia and venous circulation in different clinical circumstances. The Doppler index was created as a sum of points obtained by Doppler examination of the inferior vena cava, portal vein, hepatic and renal veins as a means of assessing the degree of hypervolemia and the burden of kidney congestion. One of the goals in the treatment of congestive nephropathy is the control of kidney function, water and electrolyte homeostasis, and hemodynamic disturbance. Future research will resolve doubts about the criteria for the diagnosis of congestive nephropathy, the mechanism of the disease, its recognition, diagnosis and treatment.