Systemic inflammation in acute cardiorenal syndrome: an observational pilot study

Linhart, Christoph; Ulrich, Christof; Greinert, Daniel; Dambeck, Stefanie; Wienke, Andreas; Girndt, Matthias; Pliquett, Rainer U.

doi:10.1002/ehf2.12327

Cited by 16 publications

(12 citation statements)

References 38 publications

(69 reference statements)

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“…Therefore, these emerging evidence supporting systemic inflammation as a connector for crosstalk between heart and kidney in CRS4, as previous literatures report.. [24][25][26][27][28] In addition, the results indicate systemic inflammation activates wnt/β-signalling in heart that supports the intrinsic interplay between inflammation and Wnt/β-catenin. 11 It is well known that wnt/βcatenin signalling is involved in heart injury under diverse pathophysiology condition.…”

Section: Discussionsupporting

confidence: 84%

Wnt/β‐catenin signalling mediates cardiac hypertrophy in type 4 cardiorenal syndrome

Zhao

Lei

et al. 2021

Nephrology

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Aim: Cardiorenal syndrome type 4 (CRS4) is characterized by the condition that chronic kidney disease (CKD) causes sustainable injury to heart. This study focuses on exploring the mechanism underlying CRS4 and potential treatment for CRS4.Methods: In the present study, Sprague Dawley (SD) rats were subjected to 5/6 subtotal nephrectomy (5/6NX) for generating animal model of CKD. Cardiac hypertrophy, kidney injury, Wnt/β-catenin signalling and serum TNF-α were tested at eighth week after 5/6NX.Results: Cardiac hypertrophy and kidney injury were prominent and accompanied by Wnt/β-catenin activation in rats at eighth week after 5/6NX. Blockade of Wnt/βcatenin by ICG-001 reduced 5/6NX-stimulated fibronectin and podocalyxin in remnant kidney. Interestingly, ICG-001 also inhibited hypertrophic markers β-MHC and α-actin and reduced cardiac hypertrophy. In addition, TNF-α, as a systemic inflammation factor in blood circulation, was suggested to connect CKD to cardiac hypertrophy. It was demonstrated in vitro and in vivo studies that ICG-001 is sufficient to counteract TNF-α-induced cardiac hypertrophy by sequestration of β-catenin. Conclusion:These results demonstrate that Wnt/β-catenin to be a unified pathogenic pathway of heart disorder and kidney disease in CRS4. Based on that, Wnt/βcatenin signalling could be a target of promising therapy for protecting both heart and kidney organs in CRS4.

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Section: Discussionsupporting

confidence: 84%

Wnt/β‐catenin signalling mediates cardiac hypertrophy in type 4 cardiorenal syndrome

Zhao

Lei

et al. 2021

Nephrology

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“…A relação entre o sistema nervoso simpático e o neuro-hormonal ocorre pela redução da função cardíaca leva à hipoperfusão renal, o que resulta em retenção de sódio para preservar o volume plasmático por meio da ativação do sistema renina-angiotensina-aldosterona (SRAA). O aumento dos níveis de sódio causa a vasoconstricção das arteríolas glomerulares, o que reduz a taxa de filtração glomerular (TFG) (Ng et al, 2017;Siegenthaler et al, 2017;Linhart et al, 2018;Virzì et al, 2019).…”

Section: Discussionunclassified

“…O aumento de lipopolissacarídeo (LPS) também desempenha função importante, recrutando as citocinas inflamatórias, induzindo inflamação, estresse oxidativo e lesão renal. Essa ativação em longo prazo pode resultar em fibrose tecidual patológica e comprometimento endotelial, agravando a vasoconstricção renal e piora da função cardíaca (Linhart et al, 2018;Virzì et al, 2019).…”

Section: Discussionunclassified

“…Parâmetros de inflamação sistêmica estão aumentados em pacientes com síndrome cardiorrenal aguda, independentemente do volume plasmático médio. Na síndrome cardiorrenal, a sobrecarga de volume e congestão venosa são os dois principais mecanismos fisiopatológicos que resultam em inflamação, evento no qual a hiperativação do SRAA e sistema nervoso simpático são os principais fatores desencadeantes (García-Blas et al, 2017;Siegenthaler et al, 2017;Linhart et al, 2018;Zhang et al, 2018).…”

Section: Discussionunclassified

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Fatores preditivos para o desenvolvimento da síndrome cardiorrenal em pacientes com insuficiência cardíaca

Gonçalves

Sousa

Farias

2021

RSD

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Objetivo: analisar, a partir de uma revisão sistemática da literatura, quais são os fatores preditivos para o desenvolvimento da síndrome cardiorrenal em pacientes com insuficiência cardíaca. Métodos: efetuou-se uma revisão sistemática da literatura a partir da questão de pesquisa “Quais os fatores preditivos para o desenvolvimento da síndrome cardiorrenal em pacientes com insuficiência cardíaca?”. Para a seleção dos artigos que compõem este estudo, realizou-se uma busca nas seguintes bases de dados: Medical Publisher (PUBMED), Biblioteca Virtual em Saúde (BVS), Science Direct (SD) e Semantic Scholar utilizando-se como critérios de elegibilidade apenas estudos observacionais ou ensaios clínicos randomizados, que contemplassem a questão de pesquisa, que fossem relevantes e atuais para abordar o tema. A amostra final é composta por 25 publicações. Resultados: os principais fatores preditivos para o desenvolvimento da síndrome cardiorrenal se associam com os fatores de risco cardiovasculares e às manifestações geradas a partir do comprometimento renal. Conclusão: a junção de comorbidades do paciente, com fatores de risco para desenvolvimento de doença cardiovascular, de injúria renal aguda associado com marcadores laboratoriais de injúria miocárdica e de lesão renal podem atuar como fatores preditivos confiáveis para o desenvolvimento da síndrome cardiorrenal.

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“…Animal models of CRS demonstrated the bidirectional nature, where the failure of the one organ system adversely affects the function of the other [ 7 ]. The consideration of hypo- and hypervolemic states may further differentiate CRS on clinical grounds [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Diabetes prevalence and outcomes in hospitalized cardiorenal-syndrome patients with and without hyponatremia

et al. 2020

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Background Hyponatremia is known to be associated with a worse patient outcome in heart failure. In cardiorenal syndrome (CRS), the prognostic role of concomitant hyponatremia is unclear. We sought to evaluate potential risk factors for hyponatremia in patients with CRS presenting with or without hyponatremia on hospital admission. Methods In a retrospective study, we investigated 262 CRS patients without sepsis admitted to the University Hospital Halle over a course of 4 years. CRS diagnosis was derived from an electronic search of concomitant diagnoses of acute or chronic (NYHA 3–4) heart failure and acute kidney injury (AKIN 1–3) or chronic kidney disease (KDIGO G3-G5nonD). A verification of CRS diagnosis was done based on patient records. Depending on the presence (Na < 135 mmol/L) or absence (Na ≥ 135 mmol/L) of hyponatremia on admission, the CRS patients were analyzed for comorbidities such as diabetes, presence of hypovolemia on admission, need for renal replacement therapy and prognostic factors such as in-hospital and one-year mortality. Results Two hundred sixty-two CRS patients were included in this study, thereof, 90 CRS patients (34.4%) with hyponatremia (Na < 135 mmol/L). The diabetes prevalence among CRS patients was high (> 65%) and not related to the serum sodium concentration on admission. In comparison to non-hyponatremic CRS patients, the hyponatremic patients had a lower serum osmolality, hypovolemia was more prevalent (41.1% versus 16.3%, p < 0.001). As possible causes of hypovolemia, diarrhea, a higher number of diuretic drug classes and higher diuretic dosages were found. Hyponatremic and non-hyponatremic CRS patients had a comparable need for renal-replacement therapy (36.7% versus 31.4%) during the hospital stay. However, after discharge, relatively more hyponatremic CRS patients on renal replacement therapy switched to a non-dialysis therapy regimen (50.0% versus 22.2%). Hyponatremic CRS patients showed a trend for a higher in-hospital mortality (15.6% versus 7.6%, p = 0.054), but no difference in the one-year mortality (43.3% versus 40.1%, p = 0.692). Conclusions All CRS patients showed a high prevalence of diabetes mellitus and a high one-year mortality. In comparison to non-hyponatremic CRS patients, hyponatremic ones were more likely to have hypovolemia, and had a higher likelihood for temporary renal replacement therapy.

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Systemic inflammation in acute cardiorenal syndrome: an observational pilot study

Cited by 16 publications

References 38 publications

Wnt/β‐catenin signalling mediates cardiac hypertrophy in type 4 cardiorenal syndrome

Wnt/β‐catenin signalling mediates cardiac hypertrophy in type 4 cardiorenal syndrome

Fatores preditivos para o desenvolvimento da síndrome cardiorrenal em pacientes com insuficiência cardíaca

Diabetes prevalence and outcomes in hospitalized cardiorenal-syndrome patients with and without hyponatremia

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