Table 1. Summary of the Management of Cardiorenal Syndrome.

 ADHF: Acute Decompensated Heart Failure; IV: Intravenous; LVAD: Left Ventricular Assist Device; INTERMACS: Interagency Registry for Mechanically Assisted Circulatory Support; CRS: Cardiorenal Syndrome; RCT: Randomized Controlled Trial; PCWP: Pulmonary Capillary Wedge Pressure

Author	Year	Type of study	No of patients	Purpose of study	Results	Conclusion
Abraham et al. [11]	2005	Observational study	65,180	To compare in-hospital mortality in ADHF in patients receiving IV vasoactive medications.	Decreased mortality in patients receiving nitroglycerine or nesiritide compared to patients receiving dobutamine or milrinone.	The use of natriuretic peptides was associated with a significant reduction in in-hospital mortality compared to positive inotropic therapy in patients with ADHF.
Kirklin et al. [12]	2013	Observational study	4917	To estimate post-implant mortality of LVAD in patients from INTERMACS as per the severity of renal dysfunction.	60% reported mild or no renal dysfunction, 30% with moderate, and 6% with severe renal dysfunction. Increased mortality in severe renal dysfunction.	Pre-implant renal dysfunction was associated with higher mortality. LVAD implants should be considered before CRS advances.
Felker et al. [13]	2011	RCT	308	To assess renal function with administration of diuretics by bolus compared to continuous infusion or at high dose compared to low dose.	No significant difference in change in mean creatinine level. High dose, however, was associated with increased diuresis and favorable outcomes.	No significant difference in patients' assessment of symptoms or change in renal status.
Testani et al. [15]	2010	RCT	336	To study the effect of aggressive decongestion in decompensated heart failure on renal function and survival.	Hemoconcentration was strongly associated with worsening renal status but no change in right atrial pressure and PCWP.	Hemoconcentration was associated with an improved survival rate.
Prosek et al. [16]	2013	Narrative review	-	To assess the role of pharmacologic and extracorporeal methods for hypervolemia in ADHF and CRS.	-	Diuretics and ultrafiltration are effective measures in relieving congestion in ADHF.
Kazory [17]	2013	Narrative review	-	To study the benefits of ultrafiltration in ADHF.	-	Ultrafiltration is an effective measure for the management of ADHF and CRS.
McAlister et al. [19]	2004	Cohort study	754	To study the prevalence of renal insufficiency in heart failure.	Survival outcome was associated with renal status in systolic or diastolic dysfunction.	Renal insufficiency is more prevalent in patients with heart failure and is an independent prognostic factor in diastolic and systolic dysfunction.
Pitts et al. [20]	1999	RCT	822	To study the effect of spironolactone on morbidity and mortality in patients with severe heart failure.	30% reduction in risk of death in patients receiving spironolactone and 35% decrease in hospitalization for heart failure.	In addition to standard therapy, spironolactone reduces the risk of morbidity and mortality in severe heart failure.