What are the 3 major ways that BP is regulated that involve the kidney?
Epinephrine & norepinephrine (from adrenal medulla)
Renin-angiotensin-aldosterone system (renin from kidney, aldosterone from adrenal cortex)
Vasopressin (ADH-- from posterior pituitary)
What is the effect of vasopressin?
Increased H2O retention, Increased vasoconstriction
How do you distinguish heart failure from kidney failure?
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
What is cardiorenal syndrome?
1. Decreased kidney function
2. Therapy-resistant heart failure with congestion -- diuretic resistance
3. Worsening kidney function during heart failure therapy