Cardiorenal syndrome in children with heart failure

Abstract

Concomitant cardiac and renal dysfunction has been termed the cardiorenal syndrome (CRS). This clinical condition usually manifests as heart failure with worsening renal function and occurs frequently in the acute care setting. A consistent definition of CRS has not been universally agreed upon, although a recent classification of CRS describes several subtypes depending on the primary organ injured and the chronicity of the injury. CRS may develop in adults and children and is a strong predictor of morbidity and mortality in hospitalized and ambulatory patients. The underlying physiology of CRS is not well understood, creating a significant challenge for clinicians when treating heart failure patients with renal insufficiency. This review summarizes recent data characterizing the incidence, physiology, and management of children who have heart failure and acute kidney injury.

Fluid overload and fluid removal in pediatric patients on extracorporeal membrane oxygenation requiring continuous renal replacement therapy*

“…We included a large pediatric cardiac patient population in this study, in whom FO may be of particular importance given the complex interplay between renal and cardiac dysfunction in the cardiorenal syndrome (26–29). The finding that initiation FO was not significantly predictive of mortality in non-cardiac patients further highlights the cardiac subgroup as a potentially high-yield target population.…”

An update and review of acute kidney injury in pediatrics

“…AKI is seen in conjunction with pulmonary, hepatic, and cardiac failure (26,27). The increased mortality reported with these dual-axis syndromes underscores the kidney's centrality to host survival.…”

Acute Kidney Injury – An Underestimated Problem In Pediatric Intensive Care / Akûts Nieru Bojâjums — Nenovçrtçta Problçma Bçrnu Intensîvajâ Terapijâ

“…Therefore, all children with any of these risks factors should be monitored closely for the development of AKI. Early AKI detection is crucial, as even small increases in SCr may be associated with paediatric patient morbidity and mortality (Price et al, 2009). …”