Bioimpedance and Hand-held Echocardiographay for Clinical Decision-making in Treatment of Cardio-renal Syndrome Type I

Inclusion Criteria: * Patient admitted for acute decompensation of heart failure and developed cardiorenal syndrome (all three criteria below are required): A. Evidence of heart failure defined by either (i) or (ii) and (iii), where: (i) is clinical complaints of dyspnea or leg swelling or fatigue (ii) is clinical findings of pulmonary rales, leg edema, or congestion on chest film (iii) is recent (within 1 year of admission) echocardiographic examination demonstrating heart failure B. Patient as in A (above) whos serum creatinine level on admission is 0.3 mg% greater than patient's baseline. C. Patient capable of submitting informed consent Exclusion Criteria: * Other causes for dyspnea or leg edema (e.g. exacerbation of COPD, pneumonia, liver cirrhosis, hypoalbuminemia, nephrotic syndrome) * other causes for acute renal failure (e.g. contrast media nephropathy 10 days prior to admission, use of NSAIDS or antibiotics (aminoglycosides, quinolones), diarrhea, vomiting, rhabdomyolysis, seizures, sepsis. * Anemia (Hb\<8 gr%) * significant bleeding (upper or lower GI, hemoptysis) * BMI\>40, or BMI\<18 * Signs of a new myocardial infarction by EKG, and increase in troponin levels to levels 1.5 above baseline levels. * Hypothyroidism * Addison's disease * patient on Hemo- or peritoneal dialysis * Mechanical ventillation