Cardiorenal Syndrome

Abstract

The term cardiorenal syndrome (CRS) increasingly has been used without a consistent or well-accepted definition. To include the vast array of interrelated derangements, and to stress the bidirectional nature of heart-kidney interactions, we present a new classification of the CRS with 5 subtypes that reflect the pathophysiology, the time-frame, and the nature of concomitant cardiac and renal dysfunction. CRS can be generally defined as a pathophysiologic disorder of the heart and kidneys whereby acute or chronic dysfunction of 1 organ may induce acute or chronic dysfunction of the other. Type 1 CRS reflects an abrupt worsening of cardiac function (e.g., acute cardiogenic shock or decompensated congestive heart failure) leading to acute kidney injury. Type 2 CRS comprises chronic abnormalities in cardiac function (e.g., chronic congestive heart failure) causing progressive chronic kidney disease. Type 3 CRS consists of an abrupt worsening of renal function (e.g., acute kidney ischemia or glomerulonephritis) causing acute cardiac dysfunction (e.g., heart failure, arrhythmia, ischemia). Type 4 CRS describes a state of chronic kidney disease (e.g., chronic glomerular disease) contributing to decreased cardiac function, cardiac hypertrophy, and/or increased risk of adverse cardiovascular events. Type 5 CRS reflects a systemic condition (e.g., sepsis) causing both cardiac and renal dysfunction. Biomarkers can contribute to an early diagnosis of CRS and to a timely therapeutic intervention. The use of this classification can help physicians characterize groups of patients, provides the rationale for specific management strategies, and allows the design of future clinical trials with more accurate selection and stratification of the population under investigation.

B-type natriuretic peptide and renal function in Japanese patients with type 2 diabetes mellitus: The Dogo Study

“…Cardio-renal syndrome has received widespread attention [2]. However, the mechanism of the association between BNP and albuminuria among patients with type 2 diabetes mellitus is still not clear.…”

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THE LEADING CAUSE OF THE DEATH among patients with renal dysfunction is cardiovascular diseases [1], and the importance of the interaction between the heart and kidneys is widely note [2]. Plasma B-type natriuretic peptide (BNP) releases from the ventricles in response to hemodynamic stress, and BNP is one of the predictive markers for cardiovascular events [3,4].

Among patients with type 2 diabetes mellitus, sev- Abstract.

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Relationship of the American Heart Association's Impact Goals (Life's Simple 7) With Risk of Chronic Kidney Disease: Results From the Atherosclerosis Risk in Communities (ARIC) Cohort Study

“…The shared underlying pathophysiology leading to the development of cardiovascular and kidney disease suggests that cardioprotective recommendations might also be effective for kidney disease prevention 10. Two studies have investigated Life's Simple 7 and kidney disease progression among individuals with impaired kidney function 11, 12.…”

Incidencia e importancia pronóstica del deterioro de la función renal en pacientes hospitalizados con insuficiencia cardiaca

“…En la IC aguda, el deterioro de la función renal parece ser más acentuado en aquellos pacientes con mayor deterioro de la función sistólica del VI, que en aquellos con FE preservada, alcanzando una incidencia de hasta 70% en los pacientes en shock cardiogénico [29][30] . No se encontraron diferencias en la incidencia de falla renal en pacientes con FE preservada o disminuida.…”