Biomarkers in kidney and heart disease

Abstract

There is much symptomatic similarity between acute kidney disease and acute heart disease. Both may present with shortness of breath and chest discomfort, and thus it is not surprising that biomarkers of acute myocardial and renal disease often coexist in many physicians' diagnostic work-up schedules. In this review we explore the similarities and differences between current and future tests of myocardial and renal injury and function, with particular emphasis on the diagnostic utility of currently available biomarkers to assist with the diagnosis of cardiorenal syndromes. Imaging studies have not traditionally been viewed as clinical biomarkers, but as tests of structure and function; they contribute to the diagnostic process, and we believe that they should be considered alongside more traditional biomarkers such as blood and urine measurements of circulating proteins and metabolites. We discuss the place of natriuretic peptides, novel tests of kidney damage as well as kidney function and conclude with a discussion of their place in guiding future research studies whose goals must include better characterization of the degree of dysfunction imposed on one organ system by failure of the other.

The Role of Congestion in Cardiorenal Syndrome Type 2: New Pathophysiological Insights into an Experimental Model of Heart Failure

“…It suggests that a congestion-induced increase in kidney intravenous pressure is responsible for the tubular damage and NGAL release [16,20,21]. …”

Pathophysiology of the Cardiorenal Syndromes: Executive Summary from the Eleventh Consensus Conference of the Acute Dialysis Quality Initiative (ADQI)

“…In refractory patients, hyponatremia as a physiologic reflection of marked neurohormonal activation in CRS type 1 heralds a very poor prognosis [19]. Recent studies suggest individuals with greater levels of natriuretic peptides as baseline and evidence of pulmonary congestion, in addition to increased central venous pressure, have the greatest risk for CRS type 1 [20]. The end result of these hemodynamic perturbations of the kidney result in a loss of autoregulation and the onset of worsened salt and water retention, reduction in renal filtration, and oliguria.…”

Effect of Renal Dysfunction on the Cardiacvascular System. The Possibili Ties of Early Diagnosis of the Renal Dysfunction

“…Безусловно, все эти вазоактивные субстанции и раз-нонаправленные патологические сдвиги препятству-ют нормальной эндотелиальной функции [39,40]. Также у пациентов с ХБП заметно увеличивается концентрация натрийуретического пептида B-типа (BNP) и неактивного пептида NT-proBNP по срав-нению с пациентами соответствующего возраста и пола с нормальной функцией почек [41]. С прогрессированием стадий ХБП, кульминацией которого является наступление диализпотребного состояния (одного из составляющих ХБП 5 стадии), связи между почечной дисфункцией и поражением сердца становятся комплексными и многоуровне-выми.…”