Cardiorenal Syndrome, Hemodynamics, and Noninvasive Evaluation

Abstract

Cardiorenal syndrome is a group of disorders resulting from the pathological interaction between the heart and the kidneys. The most accepted classification of cardiorenal syndrome differentiates the types based on the temporal sequence of organ involvement. Although many mechanisms seem to be involved in the pathogenesis, cardiac hemodynamic changes are still considered one of the major parameters that affect the cross talk between these organs. As heart failure and chronic kidney disease reach endemic proportions, the necessity to understand the pathophysiology, hemodynamics, and effective therapy of cardiorenal syndrome becomes fundamental. The aim of this review is to identify and explain the hemodynamic changes behind the syndrome and evaluate potential noninvasive methods that can help develop a practical tool for managing the cardiorenal patient.

Kidney function changes in acute heart failure: a practical approach to interpretation and management

“…First, it can estimate the patient's CO and subsequently help to diagnose a hypoperfusion state. Second, it can evaluate systemic venous congestion by estimating haemodynamic parameters such as the CVP, systolic pulmonary artery pressure or pulmonary capillary wedge pressure and by measuring the size and collapsibility of the inferior vena cava [ 49 ]. A dilated inferior vena cava (defined as a diameter >2.1 cm) with <50% collapsibility during inspiration estimates a right atrial pressure of 15 mmHg [ 50 , 51 ].…”