Heart Failure and Cardiorenal Syndrome
Heart failure and kidney disease often travel together. When one organ struggles, the other is placed under strain, and managing them in isolation rarely works. Cardiorenal syndrome is the term for this combination. It is increasingly common in an ageing population and demands a coordinated approach.
Dr Rory McQuillan provides specialist input for patients with heart failure who also have kidney disease, optimising medical therapy across both systems and avoiding the common pitfalls that arise when treatments for one organ destabilise the other.
What is cardiorenal syndrome?
Cardiorenal syndrome describes the situation where heart disease and kidney disease interact and worsen each other. There are five subtypes, depending on which organ deteriorated first and over what time course. The most common pattern in adults is chronic heart failure causing slowly worsening kidney function over years.
Why integrated care matters
Several medications used in heart failure also affect kidney function. Diuretics may improve symptoms but worsen kidney function. ACE inhibitors and ARBs protect both heart and kidney but can cause acute kidney injury or high potassium. Newer therapies including SGLT2 inhibitors and sacubitril-valsartan have transformed outcomes for both heart and kidney disease, but require careful patient selection and monitoring.
Specialist nephrology input alongside cardiology helps to optimise therapy, manage complications, and keep patients out of hospital.
What specialist nephrology input adds
- Optimising the balance between fluid removal and kidney protection
- Managing electrolyte disturbances that arise from medication
- Identifying and treating contributing causes (sleep apnoea, hypertension, anaemia)
- Co-managing diuretic resistance with cardiology
- Planning for advanced care including kidney replacement therapy in selected cases
Assessment and ongoing care
Specialist assessment includes a detailed cardiovascular and renal review, medication reconciliation, focused investigations, and an individualised treatment plan agreed with the cardiology team. Ongoing care is collaborative and shaped around the patient’s overall condition and goals.
Appointments
Appointments are arranged via GP referral. Joint cardiology-nephrology review is available where appropriate.
Frequently Asked Questions
Yes, and it is common. Around half of patients with heart failure have some degree of kidney impairment, and the combination requires careful coordinated management.
Yes. SGLT2 inhibitors have been shown to reduce hospitalisation and death from heart failure and to slow the progression of kidney disease. They are now standard therapy for many patients with cardiorenal disease.
Heart failure can reduce kidney function over time, particularly when it is poorly controlled. Specialist co-management reduces this risk.
In our practice, yes. Joint communication between cardiology and nephrology is standard, and joint reviews are arranged where the case is complex.
Have a Question?
If you’d like more information about Dr. McQuillan’s services or need assistance from the practice team, please get in touch below.
Please note: Appointments are arranged via GP referral.