New approaches to detect and manage edema and renal insufficiency in heart failure.

Earlier detection of edema and renal insufficiency, before overt decompensation, is fundamental to further advances in altering the natural history of heart failure. Progress is being made in the earlier detection of these complications through the use of new devices that monitor for hemodynamic compromise and through monitoring of select cardiac and renal biomarkers. In addition, diuretic-sparing approaches to heart failure management, novel drug classes, new devices, and nonpharmacologic therapies are emerging to reduce reliance on diuretic therapy and manage edema with less renal compromise.