Chronic Heart Failure and Comorbid Renal Dysfunction - A Focus on Type 2 Cardiorenal Syndrome

Jois, Preeti; Mebazaa, Alexandre; Iyngkaran, Pupalan; Thomas, Merlin C.; Ronco, Claudio

doi:10.2174/1573403x12666160606120958

Cited by 16 publications

(13 citation statements)

References 74 publications

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“…The cardiovascular system and the kidneys are intimately related to each other. Thus impairment in the functioning of either system deteriorates the functioning of the other, giving rise to cardiorenal syndromes [200,201]. Basically, CKD can distort cardiovascular functions through uremic toxin retention, abnormalities in renal calcium/phosphate handling, overactivation of the SNS and RAS, anemia, and increased oxidative stress, resulting in the development of chronic renocardiac syndrome [200] and fluid overload.…”

Section: Cardiovascular-renal Crosstalk Cardiorenal Syndromes and Tmentioning

confidence: 99%

Gut microbiota and inflammation in chronic kidney disease and their roles in the development of cardiovascular disease

et al. 2018

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The health and proper functioning of the cardiovascular and renal systems largely depend on crosstalk in the gut-kidney-heart/vessel triangle. Recent evidence suggests that the gut microbiota has an integral function in this crosstalk. Mounting evidence indicates that the development of chronic kidney and cardiovascular diseases follows chronic inflammatory processes that are affected by the gut microbiota via various immune, metabolic, endocrine, and neurologic pathways. Additionally, deterioration of the function of the cardiovascular and renal systems has been reported to disrupt the original gut microbiota composition, further contributing to the advancement of chronic cardiovascular and renal diseases. Considering the interaction between the gut microbiota and the renal and cardiovascular systems, we can infer that interventions for the gut microbiota through diet and possibly some medications can prevent/stop the vicious cycle between the gut microbiota and the cardiovascular/renal systems, leading to a decrease in chronic cardiovascular and renal diseases.

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Section: Cardiovascular-renal Crosstalk Cardiorenal Syndromes and Tmentioning

confidence: 99%

Gut microbiota and inflammation in chronic kidney disease and their roles in the development of cardiovascular disease

et al. 2018

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“…In acute HF, WRF usually occurs as a consequence of intensive, sudden or rapid changes in fluid balance. In contrast, WRF in chronic HF is more likely to be over weeks or months [ 5 ] which may have considerably different prognostic implications, but here the evidence is limited.…”

Section: Introductionmentioning

confidence: 99%

Chronic kidney disease, worsening renal function and outcomes in a heart failure community setting: A UK national study

Lawson

Testani

Mamas

et al. 2018

International Journal of Cardiology

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BackgroundRoutine heart failure (HF) monitoring and management is in the community but the natural course of worsening renal function (WRF) and its influence on HF prognosis is unknown. We investigated the influence of routinely monitored renal decline and related comorbidities on imminent hospitalisation and death in the HF community population.MethodsA nested case-control study within an incident HF cohort (N = 50,114) with 12-years follow-up. WRF over 6-months before first hospitalisation and 12-months before death was defined by >20% reduction in estimated glomerular filtration rate (eGFR). Additive interactions between chronic kidney disease (CKD) and comorbidities were investigated.ResultsPrevalence of CKD (eGFR<60 ml/min/1.73m2) in the HF community was 63%, which was associated with an 11% increase in hospitalisation and 17% in mortality. Both risk associations were significantly worse in the presence of diabetes. Compared to HF patients with eGFR,60–89, there was no or minimal increase in risk for mild to moderate CKD (eGFR,30–59) for both outcomes. Adjusted risk estimates for hospitalisation were increased only for severe CKD(eGFR,15–29); Odds Ratio 1.49 (95%CI;1.36,1.62) and renal failure(eGFR,<15); 3.38(2.67,4.29). The relationship between eGFR and mortality was U-shaped; eGFR, ≥90; 1.32(1.17,1.48), eGFR,15–29; 1.68(1.58,1.79) and eGFR,<15; 3.04(2.71,3.41). WRF is common and associated with imminent hospitalisation (1.50;1.37,1.64) and mortality (1.92;1.79,2.06).ConclusionsIn HF, the risk associated with CKD differs between the community and the acute HF setting. In the community setting, moderate CKD confers no risk but severe CKD, WRF or CKD with other comorbidities identifies patients at high risk of imminent hospitalisation and death.

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“…In acute heart failure it is estimated that up to 64% of patients may show some degree of renal dysfunction and in patients with Chronic Heart Failure the prevalence is around 30%. 158,159 From a pathophysiological point of view, it can be supported that patients with renal impairment may develop heart failure, while patients with heart failure are a source of renal dysfunction creating a vicious cycle. 160,161 Mechanisms involved include neurohumoral over-expression, increased central venous pressure, low cardiac output, increased oxidative stress, increased apoptosis (cardiac and renal), the coexistence of morbid factors (i.e.…”

Section: Hf and Chronic Kidney Disease Are Entities That Often Co-exist And Overshadow The Prognosis Of Patients With Hfmentioning

confidence: 99%

Primera declaración Mexicana en materia de Insuficiencia Cardiaca

Serrano¹,

López²,

Mendoza³

et al. 2021

Cardiovasc Metab Sci

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Chronic Heart Failure and Comorbid Renal Dysfunction - A Focus on Type 2 Cardiorenal Syndrome

Cited by 16 publications

References 74 publications

Gut microbiota and inflammation in chronic kidney disease and their roles in the development of cardiovascular disease

Gut microbiota and inflammation in chronic kidney disease and their roles in the development of cardiovascular disease

Chronic kidney disease, worsening renal function and outcomes in a heart failure community setting: A UK national study

Primera declaración Mexicana en materia de Insuficiencia Cardiaca

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