Kidney and Heart

Question 1

What are the 3 major ways that BP is regulated that involve the kidney?

Answer 1

Epinephrine & norepinephrine (from adrenal medulla)

Renin-angiotensin-aldosterone system (renin from kidney, aldosterone from adrenal cortex)

Vasopressin (ADH– from posterior pituitary)

Question 2

What is the effect of vasopressin?

Answer 2

Increased H2O retention, Increased vasoconstriction

Question 3

How do you distinguish heart failure from kidney failure?

Answer 3

On a physical exam you can’t distinguish! Salt/water retention, congestion, edema, neck vein distention

Kidney failure: you’ll have uremic toxins, anemia

Heart failure: you’ll have low cardiac output

BUT– heart failure leads to kidney failure and vice versa = cardiorenal syndrome so you can think of them as the same thing

Question 4

What is cardiorenal syndrome?

Answer 4

1. Decreased kidney function
2. Therapy-resistant heart failure with congestion – diuretic resistance
3. Worsening kidney function during heart failure therapy