A comprehensive review of acute cardio-renal syndrome: need for novel biomarkers

Abstract

Cardiorenal syndrome represents a wide-spectrum disorder involving the heart and kidneys as the primary affected organs. India has an increasingly high burden of acute CRS, coinciding with the rise in global statistics. Up to 2022, approximately 46.1% of all cardiorenal patients have been diagnosed with acute CRS in India. Acute CRS involves a sudden deterioration of kidney functionalities, referred to as acute kidney injury (AKI) in acute heart failure patients. The pathophysiology of CRS involves hyperactivation of the sympathetic nervous system (SNS) and the renin-angiotensin-aldosterone system (RAAS) following acute myocardial stress. The pathological phenotype of acute CRS is associated with perturbed inflammatory, cellular, and neurohormonal markers in circulation. These complications increase the risk of mortality in clinically diagnosed acute CRS patients, making it a worldwide healthcare burden. Hence, effective diagnosis and early prevention are crucial to prevent the progression of CRS in AHF patients. Present biomarkers, such as serum creatinine (sCr), cystatin C (CysC), glomerular filtration rate (GFR), blood urea nitrogen (BUN), serum and/or urine neutrophil gelatinase-associated lipocalin (NGAL), B-type natriuretic peptide (BNP), and NT-proBNP, are clinically used to diagnose AKI stages in CRS patients but are limitedly sensitive to the early detection of the pathology. Therefore, the need for protein biomarkers is emerging for early intervention in CRS progression. Here, we summarized the cardio-renal nexus in acute CRS, with an emphasis on the present clinicopathological biomarkers and their limitations. The objective of this review is to highlight the need for novel proteomic biomarkers that will curb the burgeoning concern and direct future research trials.

XBP1 Modulates the Aging Cardiorenal System by Regulating Oxidative Stress

“…The hypoperfusion of peripheral tissue in heart failure induces over-activity of SNS, thus resulting in the increased release of renin from the juxtamedullary apparatus. The synthesis of renin is also stimulated by the reduction of hydrostatic pressure in the glomerular afferent arterioles and a reduction in the amount of sodium delivered to the macula densa [7,145]. Subsequently, angiotensinogen (AGT) is converted into the decapeptide angiotensin I (AT1) by renin or the chymase enzyme.…”

Highly Efficient Photoelectrochemical Detection of Cystatin C Based on a Core–Shell MOF Nanocomposite with Biomimetic-Catalysis Amplification

“…Therefore, it is extremely urgent to develop a sensitive and rapid method for detecting CysC. The photoelectrochemical (PEC) biosensor is a newly emerged electroanalytical tool . Compared with traditional detection methods, PEC has the advantages of high sensitivity, fast response, low equipment cost, and convenient operation .…”

“…The photoelectrochemical (PEC) biosensor is a newly emerged electroanalytical tool. 7 Compared with traditional detection methods, PEC has the advantages of high sensitivity, fast response, low equipment cost, and convenient operation. 8 Thus, the PEC biosensor is an ideal means of detecting CysC.…”