Q&A: Vasodilator therapy and cardiorenal syndrome

Q: I’ve been told that vasodilator therapy can be used to preserve renal function, but I’m having trouble understanding how. Could to explain it to me?

A: You’ve likely heard people refer to vasodilator therapy in the context of cardiorenal syndrome—an umbrella term used to define disorders of the heart and kidneys where an acute or chronic dysfunction in one organ may lead to an acute or chronic dysfunction in the other. It’s a tricky condition to treat due to the fact that treatment of the heart failure can also cause decline in the function of the kidneys.

Vasodilators are used in treating heart failure and can help with lowering of blood pressure by opening up the blood vessels and allowing the blood to flow more easily. When the heart no longer pumps blood efficiently, it becomes congested with blood causing pressure to build up in the main vein connected to the kidneys also leading to congestion in the kidneys. Because of this, the kidneys may not be getting enough oxygenated blood. When the kidneys become impaired, the hormone system goes into overdrive trying to increase the amount of blood to the kidneys, which ultimately causes the heart to have to work harder.

I suggest having a conversation with either nephrology or cardiology to better explain this condition and the common clinical indicators necessary for validation within your facility. Also be sure to touch base with your CDI and coding colleagues for additional insight and common conundrums they’ve faced to help provide context for your own record review activities.

Editor’s Note: Sharme Brodie, RN, CCDS, CDI education specialist and CDI Boot Camp instructor for HCPro in Middleton, Massachusetts, answered this question. For information, contact her at sbrodie@hcpro.com. For information regarding CDI Boot Camps, click here.