Cardiorenal Syndrome: New Pathways and Novel Biomarkers

Abstract

Cardiorenal syndrome (CRS) is a multi-organ disease characterized by the complex interaction between heart and kidney during acute or chronic injury. The pathogenesis of CRS involves metabolic, hemodynamic, neurohormonal, and inflammatory mechanisms, and atherosclerotic degeneration. In the process of better understanding the bi-directional pathophysiological aspects of CRS, the need to find precise and easy-to-use markers has also evolved. Based on the new pathophysiological standpoints and an overall vision of the CRS, the literature on renal, cardiac, metabolic, oxidative, and vascular circulating biomarkers was evaluated. Though the effectiveness of different extensively applied biomarkers remains controversial, evidence for several indicators, particularly when combined, has increased in recent years. From new aspects of classic biomarkers to microRNAs, this review aimed at a 360-degree analysis of the pathways that balance the kidney and the heart physiologies. In this delicate system, different markers and their combination can shed light on the diagnosis, risk, and prognosis of CRS.

Identification and external validation of the hub genes associated with cardiorenal syndrome through time-series and network analyses

“…POSTN was further significantly correlated with LVEF (R = 0.54, P < 0.05, Figure 5I ) and BUN (R = 0.41, P < 0.05, Figure 5J ), while no significant association was observed between POSTN and Scr (R = 0.33, P = 0.16, Figure 5K ), NT-proBNP (R = 0.43, P = 0.063, Figure 5L ), and UA (R = 0.35, P = 0.13, Figure 5M ). The association of CRS with LVEF [ 30 ], NTproBNP [ 31 ], Scr [ 32 ], and BUN [ 33 ] has been verified in multiple studies, which strengthens the reliability of FN1 and POSTN.…”

“…The advancement and popularization of gene sequencing technology has provided an opportunity to further elucidate the pathological processes of this disease. Recently, many novel biomarkers associated with CRS have been reported, including cystatin 3, galectin 3, NGAL, and KIM1 [ 31 , 41 ]. These biomarkers not only provide the clinical guidelines for CRS diagnosis and prognosis, but also suggest the underlying cut-in points for mechanistic studies.…”

Risk Factors and Outcome Variables of Cardiorenal Syndrome Type 1 in Acute Myocardial Infarction Patients

“…4 Until recently, there have been few studies on the risk factors of and prediction methods for the short-term prognosis of CRS1. 5 The goal of this study was to explore the risk factors that affect the short-term prognosis of CRS1 in AMI patients and to understand the predictive value of three scoring methods-Sequential Organ Failure Assessment (SOFA), Acute Physiology and Chronic Health Evaluation (APACHE) II, and Simplified Acute Physiology Scores (SAPS) II-on the mortality of AMI patients with CRS1 within 28 days after the onset of AMI, in order to provide clinical guidance.…”

Modulation of cardiometabolic risk and CardioRenal syndrome by oral vitamin D3supplementation in Black and White Southern Sahara residents with chronic kidney disease Stage 3: focus on racial and ethnic disparities

“…The recent meta-analysis have demonstrated that CKD deterioration is related to alteration of bone and mineral metabolism as novel risk factors emerged for cardiovascular disease mortality in patients with CKD and CRenal. This relationship is explained by strongly linked with hyperphosphatemia and vascular calcification [ 8 ]. The RAAS play a central factor contributing to end-stage kidney disease (ESKD), particularly in black individuals [ 9 ].…”