Worsening Renal Function in Elderly Patients with Heart Failure and Chronic Kidney Disease: An Update Alice Bãlãceanu 1,2 , Carmen Bogeanu 3,4 , Rãzvan Dragomirescu 3,4 , Camelia Diaconu 5,6 , Gheorghiåa Aron 1,2 , Ion Dina 1,2 1 Clinical Department No 1, “Carol Davila” University of Medicine and Pharmacy Bucharest, Romania 2 Department of Internal Medicine, “St. John” Emergency Clinical Hospital, Bucharest, Romania 3 Clinical Department No 3, “Carol Davila” University of Medicine and Pharmacy Bucharest, Romania 4 Department of Nephrology and Dialysis, “St. John” Emergency Clinical Hospital, Bucharest, Romania 5 Clinical Department No 5, “Carol Davila” University of Medicine and Pharmacy Bucharest, Romania 6 Department of Internal Medicine and Gastroenterology, Emergency Clinical Hospital Bucharest, Romania Modern Medicine. 2016, Vol. 23, No. 1 : 60-63 Copyright© Celsius Review REZUMAT Agravarea funcåiei renale la pacienåii vârstnici cu insuficienåã cardiacã æi boalã cronicã de rinichi: update Boala cronicã de rinichi (BCR) este factor de risc independent æi factor agravant pentru afectarea cardiacã. Insuficienåa cardiacã decompensatã agraveazã BCR, determinând o evoluåie defavorabilã æi o mortalitate crescutã. Dacã cele douã patologii apar la pacientul vârstnic, prognosticul este æi mai grav. Rinichiul vârstnic este vulnerabil la declinul funcåional, atât prin scãderea fiziologicã a ratei filtrãrii glomerulare, cât æi prin asocierea de morbiditãåi multiple (nefropatie diabeticã sau hipertensivã, nefrotoxicitate medicamentoasã). Agravarea funcåiei renale este definitã ca æi creæterea creatininei serice cu ≥ 0,3 mg/dL æi corespunde stadiului Risk din clasificarea RIFLE a insificienåei renale acute. Deteriorarea funcåiei renale are un prognostic rezervat în ambele tipuri de insuficienåã cardiacã - acutã æi cronicã. Cuvinte cheie: insuficienåã cardiacã, boalã cronicã de rinichi, agravarea funcåiei renale Corresponding author: Lecturer Alice Bãlãceanu, MD, PhD Department of Internal Medicine, “St. John” Emergency Clinical Hospital 13 th Vitan-Bîrzeæti Road, 42122, Sector 4, Bucharest, Romania e-mail: alicebalaceanu@yahoo.com ABSTRACT Chronic kidney disease (CKD) is both an independent risk factor and an aggravating factor for the cardiovascular disease. Decompensated heart failure worsens CKD with adverse outcome and higher mortality. If the two diseases occur in elderly patients the prognosis is even more serious. Kidney function in the elderly is altered both physiologically and through the multiple morbidities (diabetic or hypertensive nephropathy, drug nephrotoxicity). Worsening renal function (WRF) is defined as serum creatinine increase ≥ 0.3 mg/dL.WRF has a poor prognosis in acute and in chronic heart failure. Key words: heart failure, CKD, worsening renal function