Cardiovascular Consequences of Acute Kidney Injury: Treatment Options

Abstract

Soon after haemodialysis was introduced into clinical practice, a high risk of cardiac death was noted in end-stage renal disease. However, only in the last decade has it become clear that any renal injury, acute or chronic, is associated with high overall and cardiovascular lethality. The need for early recognition of kidney damage in cardiovascular pathology to assess risk and develop tactics for patient management contributed to the emergence of the concept of the “cardiorenal syndrome” (CRS). CRS is a pathophysiological disorder of the heart and kidneys in which acute or chronic dysfunction of one of these organs leads to acute or chronic dysfunction of the other. The beneficial effect of ultrafiltration as a component of renal replacement therapy (RRT) is due to the elimination of hyperhydration, which ultimately affects the improvement in cardiac contractile function. This review considers the theoretical background, current status of CRS, and future potential of RRT, focusing on the benefits of ultrafiltration as a therapeutic option.

Plasma B-type natriuretic peptide is independently associated with cardiovascular events and mortality in patients with chronic kidney disease

“…In the heart-kidney hemodynamic model, the kidneys control the extracellular uid volume by regulating sodium excretion and reabsorption, and the heart controls systemic hemodynamics. When one of these organs fails, a vicious circle develops in which the RAAS, the nitric oxide-reactive oxygen species balance, the sympathetic nervous system, and in ammation interact and synergize, thereby leading to an increase in morbidity and mortality 24,25 . Cardiorenal syndrome (CRS) is de ned as a pathophysiologic disorder of the heart and kidneys, whereby acute or chronic dysfunction in one organ induces acute or chronic dysfunction in the other.…”

Plasma B-type natriuretic peptide is independently associated with cardiovascular events and mortality in patients with chronic kidney disease

“…In the heart–kidney hemodynamic model, the kidneys control the extracellular fluid volume by regulating sodium excretion and reabsorption, and the heart controls systemic hemodynamics. When one of these organs fails, a vicious circle develops in which the RAAS, the nitric oxide-reactive oxygen species balance, the sympathetic nervous system, and inflammation interact and synergize, thereby leading to an increase in morbidity and mortality 26 , 27 . Cardiorenal syndrome (CRS) is defined as a pathophysiologic disorder of the heart and kidneys, whereby acute or chronic dysfunction in one organ induces acute or chronic dysfunction in the other.…”

Perioperative Management of Valvular Heart Disease in Patients Undergoing Non-Cardiac Surgery

“…Patients with CKD have a higher prevalence of AS, and AS severity correlates with CKD [ 12 , 18 ]. Pre-existing CKD is the most significant risk factor for the development of acute kidney injury (AKI), and the baseline estimated glomerular filtration rate (eGFR) is an important variable in preprocedural risk calculation [ 12 , 19 ].…”