Abstract
Cardiac dysfunction is an essential part of the definition of heart failure but renal dysfunction may also cause most of the clinical features of heart failure. Altered renal physiology due to cardiac dysfunction plays a central role in the salt and water retention and neuro-endocrine activation characteristic of heart failure. Reno-vascular disease is also common in heart failure. The ASTRAL study, which included many such patients, failed to show that renal angioplasty reduced mortality or end-stage renal disease but suggested a reduction in heart failure hospitalisation.
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