New Insight in Cardiorenal Syndrome: From Biomarkers to Therapy

Gallo, Giovanna; Lanza, Oreste; Savoia, Carmine

doi:10.3390/ijms24065089

Cited by 11 publications

(13 citation statements)

References 193 publications

(243 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Renal disease is present in up to 91% of patients admitted for acute heart failure, and the presence of HU is considered an independent risk factor for renal dysfunction [ 34 , 35 ]. Systemic congestion is one of the main causes of CRS, with congestive nephropathy (CN) being the term that denotes renal involvement in congestion [ 36 ]. There is some similarity between CN in CRS and the uric acid nephropathy of TLS.…”

Section: Discussionmentioning

confidence: 99%

Treatment with Rasburicase in Hospitalized Patients with Cardiorenal Syndrome: Old Treatment, New Scenario

Melero,

Torroba-Sanz,

Goicoechea

et al. 2024

IJMS

View full text Add to dashboard Cite

Cardiorenal syndrome (CRS) involves joint dysfunction of the heart and kidney. Acute forms share biochemical alterations like hyperuricaemia (HU) with tumour lysis syndrome (TLS). The mainstay treatment of acute CRS with systemic overload is diuretics, but rasburicase is used in TLS to prevent and treat hyperuricaemia. An observational, retrospective study was performed to assess the effectiveness and safety of a single dose of rasburicase in hospitalized patients with cardiorenal syndrome, worsening renal function and uric acid levels above 9 mg/dL. Rasburicase improved diuresis and systemic congestion in the 35 patients included. A total of 86% of patients did not need to undergo RRT, and early withdrawal was possible in the remaining five. Creatinine (Cr) decreased after treatment with rasburicase from a peak of 3.6 ± 1.27 to 1.79 ± 0.83 mg/dL, and the estimated glomerular filtration rate (eGFR) improved from 17 ± 8 to 41 ± 20 mL/min/1.73 m2 (p = 0.0001). The levels of N-terminal type B Brain Natriuretic Peptide (Nt-ProBNP) and C-reactive protein (CRP) were also significantly reduced. No relevant adverse events were detected. Our results show that early treatment with a dose of rasburicase in patients with CRS and severe HU is effective to improve renal function and systemic congestion, avoiding the need for sustained extrarenal clearance, regardless of comorbidities and ventricular function.

show abstract

Section: Discussionmentioning

confidence: 99%

Treatment with Rasburicase in Hospitalized Patients with Cardiorenal Syndrome: Old Treatment, New Scenario

Melero,

Torroba-Sanz,

Goicoechea

et al. 2024

IJMS

View full text Add to dashboard Cite

show abstract

“…Damman et al showed that, in HF patients on diuretic treatment, KIM-1 is superior to other markers for unveiling subclinical tubular injury. Also, in patients with chronic HF or myocardial infarction, urinary KIM-1 is associated with an increased risk of death or hospitalization, independent of GFR [33,34].…”

Section: Kidney Injury Molecule-1 (Kim-1)mentioning

confidence: 99%

Cardiac and Renal Fibrosis, the Silent Killer in the Cardiovascular Continuum: An Up-to-Date

Chiuariu,

Șalaru,

Ureche

et al. 2024

JCDD

View full text Add to dashboard Cite

Cardiovascular disease (CVD) and chronic kidney disease (CKD) often coexist and have a major impact on patient prognosis. Organ fibrosis plays a significant role in the pathogenesis of cardio-renal syndrome (CRS), explaining the high incidence of heart failure and sudden cardiac death in these patients. Various mediators and mechanisms have been proposed as contributors to the alteration of fibroblasts and collagen turnover, varying from hemodynamic changes to the activation of the renin–angiotensin system, involvement of FGF 23, and Klotho protein or collagen deposition. A better understanding of all the mechanisms involved has prompted the search for alternative therapeutic targets, such as novel inhibitors of the renin–angiotensin–aldosterone system (RAAS), serelaxin, and neutralizing interleukin-11 (IL-11) antibodies. This review focuses on the molecular mechanisms of cardiac and renal fibrosis in the CKD and heart failure (HF) population and highlights the therapeutic alternatives designed to target the responsible pathways.

show abstract

“…Acute or chronic involvement of one can lead to acute or chronic alteration of the other; this relationship is bidirectional and further worsens the clinical situation. The risk of adverse events increases, with high morbidity and mortality having been reported [11][12][13][14][15][16]. The pathophysiology of CRS is complex, multifactorial, and dynamic and includes bidirectional hemodynamic changes associated with heart and kidney failure, neurohormonal abnormalities, and an increased oxidative and inflammatory response (Fig.…”

Section: Introductionmentioning

confidence: 99%

“…The pathophysiology of CRS is complex, multifactorial, and dynamic and includes bidirectional hemodynamic changes associated with heart and kidney failure, neurohormonal abnormalities, and an increased oxidative and inflammatory response (Fig. 1) [11][12][13][14][15][16]. Consequently, it is necessary to move from the old concept of renal dysfunction or kidney failure due to low cardiac output, and vice versa, to the current concept of heartkidney interaction in the setting of HF.…”

Section: Introductionmentioning

confidence: 99%

Practical requirements for the development of an advanced cardiorenal unit

Almenar-Bonet,

Sánchez-Lázaro,

Soldevila

et al. 2024

Cardiorenal Med

View full text Add to dashboard Cite

Background: Heart failure is frequently associated with kidney disease, and patients with kidney disease are at increased risk of heart failure. The co-occurrence of both entities not only significantly increases morbidity and mortality, but also complicates therapy. Summary: Cardiorenal syndrome often requires a broad, comprehensive, and multidisciplinary approach. As a result, a need has arisen to create specialized cardiorenal units that allow for rigorous and personalized management of this condition. Moreover, in some cases, cardiorenal syndrome is more complex owing to an acute and critical situation that requires the concept of cardiorenal unit to be extended towards advanced diagnostic and therapeutic positions, thus confirming the need for an advanced cardiorenal unit. The creation of these units constitutes a real challenge, necessitating a specific multilevel action plan, covering governance and management, type of patient, personnel requirements, service portfolio, care process, information systems, and other resources. Specific lines of action must be proposed for each of the relevant points in order to facilitate development of these units, together with continuous evaluation of unit activity through specific indicators, and to detect areas for improvement.

show abstract

New Insight in Cardiorenal Syndrome: From Biomarkers to Therapy

Cited by 11 publications

References 193 publications

Treatment with Rasburicase in Hospitalized Patients with Cardiorenal Syndrome: Old Treatment, New Scenario

Treatment with Rasburicase in Hospitalized Patients with Cardiorenal Syndrome: Old Treatment, New Scenario

Cardiac and Renal Fibrosis, the Silent Killer in the Cardiovascular Continuum: An Up-to-Date

Practical requirements for the development of an advanced cardiorenal unit

Contact Info

Product

Resources

About