Effect of the Adenosine A1 Receptor Antagonist, KW-3902, on Diuresis and Renal Function in Patients with Acute Decompensated Heart Failure Refractory to Maximum Doses of Conventional Diuretics: A Randomized, Double-Blind, Placebo Controlled, Dose Escalation Study

2006 ◽  
Vol 12 (6) ◽  
pp. S82-S83 ◽  
Author(s):  
Michael M. Givertz ◽  
Michael Tansey ◽  
Leeanne L. Pearson ◽  
Tara K. Fields ◽  
Howard C. Dittrich
Keyword(s):  
Heart Failure ◽  
Renal Function ◽  
Dose Escalation ◽  
Acute Decompensated Heart Failure ◽  
Decompensated Heart Failure ◽  
Dose Escalation Study ◽  
Double Blind ◽  
Double Blind Placebo ◽  
Adenosine A1 ◽  
A1 Receptor

scholarly journals Therapeutic Options for the Management of the Cardiorenal Syndrome

2011 ◽  
Vol 2011 ◽  
pp. 1-10 ◽  
Author(s):  
Katerina Koniari ◽  
Marinos Nikolaou ◽  
Ioannis Paraskevaidis ◽  
John Parissis
Keyword(s):  
Heart Failure ◽  
Renal Function ◽  
Acute Decompensated Heart Failure ◽  
Clinical Success ◽  
Decompensated Heart Failure ◽  
Cardiorenal Syndrome ◽  
Patients With Heart Failure ◽  
Adenosine A1 ◽  
A1 Receptor

Patients with heart failure often present with impaired renal function, which is a predictor of poor outcome. The cardiorenal syndrome is the worsening of renal function, which is accelerated by worsening of heart failure or acute decompensated heart failure. Although it is a frequent clinical entity due to the improved survival of heart failure patients, still its pathophysiology is not well understood, and thus its therapeutic approach remains controversial and sometimes ineffective. Established therapeutic strategies, such as diuretics and inotropes, are often associated with resistance and limited clinical success. That leads to an increasing concern about novel options, such as the use of vasopressin antagonists, adenosine A1 receptor antagonists, and renal-protective dopamine. Initial clinical trials have shown quite encouraging results in some heart failure subpopulations but have failed to demonstrate a clear beneficial role of these agents. On the other hand, ultrafiltration appears to be a more promising therapeutic procedure that will improve volume regulation, while preserving renal and cardiac function. Further clinical studies are required in order to determine their net effect on renal function and potential cardiovascular outcomes. Until then, management of the cardiorenal syndrome remains quite empirical.

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