Two disparate analyses appear in this issue of the Journal: one evaluates hemodynamics associated with worsening renal function (WRF) in 145 patients hospitalized for acutely decompensated heart failure (ADHF) (1), and the other assesses the correlation between hemodynamics, renal function, and mortality in 2,557 patients undergoing right heart catheterization for various cardiovascular disorders (2). Despite the dissimilar patient populations, a strikingly similar message emerges: increased central venous pressure (CVP) is independently associated with renal dysfunction, WRF, and unfavorable outcomes. In the Dutch study, the detrimental effect of CVP on renal function and survival was greatest in those patients with preserved cardiac index (CI) (2).
