Acute cardiorenal syndrome: Mechanisms and clinical implications

Abstract

Cardiac and renal dysfunction often coexist, and one begets the other. The association is referred to as cardiorenal syndrome. One subtype, acute cardiorenal syndrome, is often described as a clinical scenario in which acute worsening of cardiac function leads to acute kidney injury. Though this definition covers the basic pathophysiologic framework, a robust clinical definition is still lacking. Acute cardiorenal syndrome is common and often leads to emergency room visits and hospitalization. Our understanding of the hemodynamic mechanisms of acute cardiorenal syndrome is advancing. Correction of hypervolemia is the mainstay of therapy.

Intestinal fatty acid-binding protein as a predictor of prognosis in postoperative cardiac surgery patients

“…Both reduced cardiac output (CO) and increased central venous pressure (CVP) are crucial in describing the organ-to-organ crosstalk between the damaged cardiac function and other organs, and vice versa, cardiorenal syndrome is a typically example in cardiology. [ 1 ] While accumulating evidence shows that organ crosstalk occurs between the heart and the gut. [ 2 – 5 ] Severe cardiac diseases, such as severe cardiac valve disease or coronary artery disease, at the preoperation, it manifested as intestinal hypoperfusion or congestion, and during the operation, some other factors furtherly cause gut injury, such as cardiopulmonary bypass, vasoactive drugs usage, and surgical stress.…”

Nomogram Model to Predict Cardiorenal Syndrome Type 1 in Patients with Acute Heart Failure

“…The adverse clinical outcomes make the identification of patients at high risk for developing CRS1 very critical. Currently, the diagnosis of CRS1 mainly relies on serum creatinine change and urine output which has been found to be too insensitive and too late to detect CRS1 and make beneficial interventions, leading to poor clinical outcomes [8,9].…”

“…Many recent efforts have been made to identify the clinical variables, such as estimated glomerular filtration rate (eGFR), albumin, urinary neutrophil gelatinaseassociated lipocalin (uNGAL) and urinary angiotensionogen (uAGT) for the early diagnosis of CRS1 [9][10][11][12][13][14]. However, their effectiveness for predicting CRS1 is still controversial.…”

Cardiorenal relationships in the focus of risks of atrial fibrillation in patients after acute ST-elevated myocardial infarction (observational program FAKEL)

“…В исследованиях показано, что кардиоренальный синдром является серьезным клиническим состоянием у пациентов с острой сердечной недостаточностью и обуславливает высокую частоту развития неблагоприятных клинических исходов [15][16][17]. Показано, что для ранней диагностики кардиореналь-ного синдрома у пациентов с острой сердечной недостаточностью альбумин, скорость клубочковой фильтрации, С-реактивный белок могут быть эффективны в прогнозе тяжести состояния [18][19][20]. В 2010 г. опубликованы результаты исследования, в которое было включено 841 пациентов (600 мужчин и 241 женщина), поступивших в стационар в период с января 2008 по май 2008 гг., у которых были оценены уровни NT-ProBNP и креатинина во время госпитализации.…”