Biomarkers in Cardiorenal Syndromes

Fu, Shihui; Zhao, Shaopan; Luo, Li

doi:10.1155/2018/9617363

Cited by 25 publications

(17 citation statements)

References 74 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Previous valid papers aimed to enlighten the usefulness of classical CRS [ 90 , 91 , 92 , 93 ]. The purpose of our work was to underline the pathophysiological processes at the basis of CRS and how the most recent cardiorenal biomarkers can take place in the treatment strategy of this condition.…”

Section: Discussionmentioning

confidence: 99%

Cardiorenal Syndrome: New Pathways and Novel Biomarkers

et al. 2021

View full text Add to dashboard Cite

Cardiorenal syndrome (CRS) is a multi-organ disease characterized by the complex interaction between heart and kidney during acute or chronic injury. The pathogenesis of CRS involves metabolic, hemodynamic, neurohormonal, and inflammatory mechanisms, and atherosclerotic degeneration. In the process of better understanding the bi-directional pathophysiological aspects of CRS, the need to find precise and easy-to-use markers has also evolved. Based on the new pathophysiological standpoints and an overall vision of the CRS, the literature on renal, cardiac, metabolic, oxidative, and vascular circulating biomarkers was evaluated. Though the effectiveness of different extensively applied biomarkers remains controversial, evidence for several indicators, particularly when combined, has increased in recent years. From new aspects of classic biomarkers to microRNAs, this review aimed at a 360-degree analysis of the pathways that balance the kidney and the heart physiologies. In this delicate system, different markers and their combination can shed light on the diagnosis, risk, and prognosis of CRS.

show abstract

Section: Discussionmentioning

confidence: 99%

Cardiorenal Syndrome: New Pathways and Novel Biomarkers

et al. 2021

View full text Add to dashboard Cite

show abstract

“…We combined the use of elevated serum cTnI, B-type natriuretic peptide (BNP), N-terminal pro-BNP (NT-proBNP), and the KDIGO definition of AKI. AKI is defined by (1) elevated SCr ≥0.3 mg/dL (≥26.5 μmol/L) within 48 h, or (2) elevated SCr ≥1.5 times of baseline SCr within 7 days, or (3) urine volume <0.5 mL/(kg/h) for 6 h. Acute cardiac injury in CRS [ 22 ] is indicated by at least one of the following changes within 48 h: (1) increase in BNP ≥100 pg/mL; (2) increase in NT-proBNP ≥300 pg/mL; and (3) increase in cTnI ≥0.03 ng/mL.…”

Section: Methodsmentioning

confidence: 99%

Development and Validation of a Prognostic Nomogram to Predict 30-Day Mortality Risk in Patients with Sepsis-Induced Cardiorenal Syndrome

Liu

Zhang

et al. 2022

Kidney Dis

View full text Add to dashboard Cite

Introduction: Sepsis-induced cardiorenal syndrome (sepsis-induced CRS) is a devastating medical condition that is frequently associated with a high fatality rate. In this study, we aimed to develop an individualized nomogram that may help clinicians assess 30-day mortality risk in patients diagnosed with sepsis-induced CRS. Methods: A total of 340 patients with sepsis-induced CRS admitted from January 2015 to May 2019 in Shanghai Tongji Hospital were used as a training cohort to develop a nomogram prognostic model. The model was constructed using multivariable logistic analyses and was then externally validated by an independent cohort of 103 patients diagnosed with sepsis-induced CRS from June 2019 to December 2020. The prognostic ability of the nomogram was assessed through discrimination, calibration, and accuracy. Results: Five prognostic factors were determined and included in the nomogram: age, Sequential (sepsis-related) Organ Failure Assessment (SOFA) score, vasopressors, baseline serum creatinine, and the rate of change in myoglobin. Our prognostic nomogram showed well-fitted calibration curves and yielded strong discrimination power with the area under the curve of 0.879 and 0.912 in model development and validation, respectively. In addition, the nomogram prognostic model exhibited an evidently higher predictive accuracy than the SOFA score. Conclusions: We developed a prognostic nomogram model for patients with sepsis-induced CRS and externally validated the model in another independent cohort. The nomogram exhibited greater strength in predicting 30-day mortality risk than the SOFA score, which may help clinicians estimate short-term prognosis and modulate therapeutic strategies.

show abstract

“…The use of biomarkers has expanded during the last decades in HF and CKD, being used as diagnostic, prognostic and therapy response tools. This field has been rapidly expanding and many biomarkers have been proposed such as B-type natriuretic peptide (BNP), Troponin I and T(cTnI, cTnT) and Carbohydrate antigen 125 (CA125) [ 1 , 36 ].…”

Section: Diagnosis Of Crs From Biomarkers To Clinical Image Toolsmentioning

confidence: 99%

New aspects in cardiorenal syndrome and HFpEF

Méndez

Azancot

Olivella

et al. 2022

Clinical Kidney Journal

View full text Add to dashboard Cite

Cardiorenal syndrome (CRS) is a complex disease in which the heart and kidney are simultaneously affected, and subsequently the malfunction of one organ promotes the deterioration of the other. Heart failure (HF) with preserved ejection fraction (HFpEF) is the most common form of HF. The pathophysiology of CRS is not well known and several mechanisms have been involved. An elevation of central venous pressure seems to be one of the key points to consider, among others such an increase of intraabdominal pressure. Several diagnostic tools have been identified to establish the diagnosis of CRS in patients with HFpEF. Currently, the availability of biomarkers of renal and cardiac injury, the use of pulmonary ultrasound (LUS), the monitoring of the size of the inferior vena cava and the study of the renal venous pattern offer a new dimension in accurately diagnosing and quantifying organ damage in CRS. Beyond the symptomatic treatment of congestion, until recently specific therapeutic tools for patients with CRS and HFpEF were not available. Interestingly, the development of new drugs such as the angiotensin/neprilysin inhibitors and sodium-glucose cotransporter-2 (SGLT-2) inhibitors offer new therapeutic strategies with potential benefits in reduction of cardio-renal adverse outcomes in this population. Randomized clinical trials focused on patients with HFpEF are currently ongoing to delineate optimal new treatments that may be able to modify their prognosis. In addition, multidisciplinary teamwork (nephrologist, cardiologist and nurse) is expected to decrease the number of visits and the rate of hospitalizations, with a subsequent patient benefit.

show abstract

Biomarkers in Cardiorenal Syndromes

Cited by 25 publications

References 74 publications

Cardiorenal Syndrome: New Pathways and Novel Biomarkers

Cardiorenal Syndrome: New Pathways and Novel Biomarkers

Development and Validation of a Prognostic Nomogram to Predict 30-Day Mortality Risk in Patients with Sepsis-Induced Cardiorenal Syndrome

New aspects in cardiorenal syndrome and HFpEF

Contact Info

Product

Resources

About