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Cardio-renal failure: an emerging clinical entity.

The progressive ageing of the population, the extensiveapplication of cardiac interventional procedures andthe improved prognosis of diseases with a so far dismaloutcome have generated several predictable corollaries.Of remarkable importance is the rising number of‘survivors’whohavecombinedheartandkidneyfailure[1,2]. More speciﬁcally, we do not refer to the severecardiovascular disease accompanying chronic renalfailure, nor to the so-called ‘kidney in heart failure’, aconcept which assumes normally functioning kidneysfacing a failing heart. Instead, we draw attention to thefragile equilibrium between simultaneously and oftenseriously compromised renal and cardiac function. Letus deﬁne this condition as cardio-renal failure.By deﬁnition, cardio-renal failure is more thanrenal failure and more than heart failure (HF) alone;therefore, its management may require strategiesdifferent from those for the two entities consideredseparately. The view presented herein is based ontraditional concepts, personal observations and anoriented reading of the literature.