Overview of Cardiorenal Syndrome

Mehmet Şahinbaş

doi:10.7197/cmj.1600386

EN TR

Overview of Cardiorenal Syndrome

Abstract

Cardiorenal syndrome is a complex clinical condition affecting both the kidney and the heart. It is divided into 5 different subgroups according to various clinical features. However, in most clinical settings this is difficult to determine because the pathophysiology is complex and the pathways are poorly understood. Given this complex clinical situation, many challenges arise in the management of both acute and chronic cardiorenal syndrome. In this review, the definition, classification, pathophysiology and treatment of cardiorenal syndrome are examined.

Keywords

References

1. Rangaswami J, Bhalla V, Blair JEA, et al. Cardiorenal Syndrome: Classification, Pathophysiology, Diagnosis, and Treatment Strategies: A Scientific Statement From the American Heart Association. Circulation 2019;139:840-878.
2. Rastogi A, Fonarow GC. The cardiorenal connection in heart failure. CurrCardiol Rep 2008;10:190–197.
3. Ronco C, Haapio M, House AA, Anavekar N, Bellomo R. Cardiorenal syndrome. J Am CollCardiol 2008 Nov 4;52:1527–1539.
4. Ronco C, McCullough P, Anker SD, et al. Cardio-renal syndromes: report from the consensus conference of the acute dialysis quality initiative. Eur Heart J 2010;31:703-711.
5. Kumar U, Wettersten N, Garimella PS. Cardiorenal Syndrome: Pathophysiology. CardiolClin 2019;37:251-265.
6. Rademaker MT, Pilbrow AP, Ellmers LJ, et al. Acute Decompensated Heart Failure and the Kidney: Physiological, Histological and Transcriptomic Responses to Development and Recovery. J Am Heart Assoc 2021;10:e021312.
7. Forrester SJ, Booz GW, Sigmund CD, et al. Angiotensin II Signal Transduction: An Update on Mechanisms of Physiology and Pathophysiology. Physiol Rev 2018;98:1627-1738.
8. Malbrain MLNG, Cheatham ML, Kirkpatrick A, et al. Results from the International Conference of Experts on Intra-abdominal Hypertension and Abdominal Compartment Syndrome. I. Definitions. Intensive Care Med 2006;32:1722–1732.

9. Haase M, Müller C, Damman K, et al. Pathogenesis of cardiorenal syndrome type 1 in acute decompensated heart failure: workgroup statements from the eleventh consensus conference of the Acute Dialysis Quality Initiative (ADQI). ContribNephrol 2013;182:99-116.
10. Dalfino L, Tullo L, Donadio I, Malcangi V, Brienza N. Intra-abdominal hypertension and acute renal failure in critically ill patients. Intensive Care Med 2008;34:707–713.
11. Bradley SE, Bradley GP. THE EFFECT OF INCREASED INTRA-ABDOMINAL PRESSURE ON RENAL FUNCTION IN MAN. J Clin Invest 1947;26:1010–1022.
12. Grune T, Sommerburg O, Siems WG. Oxidative stress in anemia. ClinNephrol 2000;53:18-22.
13. Damman K, Ng KamChuen MJ, MacFadyen RJ, et al. Volume status and diuretic therapy in systolic heart failure and the detection of early abnormalities in renal and tubular function. J Am CollCardiol 2011;57:2233-2241.
14. Colbert G, Jain N, De Lemos JA, Susan Hedayati S. Utility of traditional circulating and imaging-based cardiac biomarkers in patients with predialysis CKD. Clin J Am SocNephrol2015;10:515–529.
15. Yancy CW, Jessup M, Bozkurt B, et al. 2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America. Circulation 2017;136:137-161.
16. McCullough PA, Olobatoke A, Vanhecke TE. Galectin-3: a novel blood test for the evaluation and management of patients with heart failure. Rev Cardiovasc Med 2011;12:200–210.
17. Shlipak MG, Katz R, Fried LF, et al. Cystatin-C and mortality in elderly persons with heart failure [published correction appears in J Am CollCardiol J Am CollCardiol 2005;45:268-271.
18. Arimoto T, Takeishi Y, Niizeki T, et al. Cystatin C, a novel measure of renal function, is an independent predictor of cardiac events in patients with heart failure. J Card Fail. 2005;11:595-601.
19. Kashani K, Al-Khafaji A, Ardiles T, et al. Discovery and validation of cell cycle arrest biomarkers in human acute kidney injury. Crit Care 2013;17:R25.
20. Mortara A, Bonadies M, Mazzetti S, et al. Neutrophil gelatinase-associated lipocalin predicts worsening of renal function in acute heart failure: methodological and clinical issues. J Cardiovasc Med (Hagerstown) 2013;14:629-634.
21. Beigel R, Cercek B, Siegel RJ, Hamilton MA. Echo-Doppler hemodynamics: an important management tool for today’s heart failure care. Circulation 2015;131:1031–1034.
22. Cowie B, Kluger R, Rex S, Missant C. Noninvasive estimation of left atrial pressure with transesophageal echocardiography. Ann Card Anaesth 2015;18:312–316.
23. Park JH, Marwick TH. Use and Limitations of E/e’ to Assess Left Ventricular Filling Pressure by Echocardiography. J Cardiovasc Ultrasound2011;19:169.
24. Mavrakanas TA, Khattak A, Singh K, Charytan DM. Epidemiology and Natural History of the Cardiorenal Syndromes in a Cohort with Echocardiography. Clin J Am SocNephrol 2017;12:1624–1633.
25. Iida N, Seo Y, Sai S, et al. Clinical Implications of Intrarenal Hemodynamic Evaluation by Doppler Ultrasonography in Heart Failure. JACC Heart Fail 2016;4:674-682.
26. Faubel S, Patel NU, Lockhart ME, Cadnapaphornchai MA. Renal relevant radiology: use of ultrasonography in patients with AKI. Clin J Am SocNephrol 2014;9:382–394.
27. Gallo G, Lanza O, Savoia C. New Insight in Cardiorenal Syndrome: From Biomarkers to Therapy. Int J MolSci 2023;24:5089.
28. Rubinstein J, Sanford D. Treatment of Cardiorenal Syndrome. CardiolClin 2019;37:267-273.
29. McDonagh TA, Metra M, Adamo M, et al. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J 2021;42:3599-3726.
30. Felker GM, Lee KL, Bull DA, et al. Diuretic strategies in patients with acute decompensated heart failure. N Engl J Med 2011;364:797-805.
31. Doukky R, Avery E, Mangla A, et al. Impact of Dietary Sodium Restriction on Heart Failure Outcomes. JACC Heart Fail 2016;4:24-35.
32. Suri SS, Pamboukian SV. Optimal diuretic strategies in heart failure. Ann Transl Med 2021;9:517.
33. Gilotra NA, Princewill O, Marino B, et al. Efficacy of Intravenous Furosemide Versus a Novel, pH-Neutral Furosemide Formulation Administered Subcutaneously in Outpatients With Worsening Heart Failure. JACC Heart Fail 2018;6:65-70.
34. DiNicolantonio JJ. Should torsemide be the loop diuretic of choice in systolic heart failure?. Future Cardiol 2012;8:707-728.
35. Felker GM, Ellison DH, Mullens W, Cox ZL, Testani JM. Diuretic Therapy for Patients With Heart Failure: JACC State-of-the-Art Review. J Am CollCardiol 2020;75:1178-1195.
36. Damman K, Valente MA, Voors AA, O'Connor CM, van Veldhuisen DJ, Hillege HL. Renal impairment, worsening renal function, and outcome in patients with heart failure: an updated meta-analysis. Eur Heart J 2014;35:455-469.
37. Palazzuoli A, Pellegrini M, Ruocco G, et al. Continuous versus bolus intermittent loop diuretic infusion in acutely decompensated heart failure: a prospective randomized trial. Crit Care 2014;18:R134.
38. Grodin JL, Stevens SR, de las Fuentes L, et al. Intensification of Medication Therapy for Cardiorenal Syndrome in Acute Decompensated Heart Failure. J Card Fail 2016;22:26-32.
39. terMaaten JM, Valente MA, Damman K, Hillege HL, Navis G, Voors AA. Diuretic response in acute heart failure-pathophysiology, evaluation, and therapy. Nat Rev Cardiol 2015;12:184-192.
40. Costanzo MR. The Cardiorenal Syndrome in Heart Failure. Heart Fail Clin 2020;16:81-97.
41. Butler J, Anstrom KJ, Felker GM, et al. Efficacy and Safety of Spironolactone in Acute Heart Failure: The ATHENA-HF Randomized Clinical Trial. JAMA Cardiol 2017;2:950-958.
42. Bart BA, Goldsmith SR, Lee KL, et al. Ultrafiltration in decompensated heart failure with cardiorenal syndrome. N Engl J Med 2012;367:2296-2304.
43. Costanzo MR, Guglin ME, Saltzberg MT, et al. Ultrafiltration versus intravenous diuretics for patients hospitalized for acute decompensated heart failure. J Am CollCardiol 2007;49:675-683.
44. Elkayam U, Hatamizadeh P, Janmohamed M. The challenge of correcting volume overload in hospitalized patients with decompensated heart failure. J Am CollCardiol 2007;49:684-686.
45. Chen HY, Chou KJ, Fang HC, et al. Effect of ultrafiltration versus intravenous furosemide for decompensated heart failure in cardiorenal syndrome: a systematic review with meta-analysis of randomized controlled trials. Nephron 2015;129:189-196.
46. Friedrich JO, Adhikari N, Herridge MS, Beyene J. Meta-analysis: low-dose dopamine increases urine output but does not prevent renal dysfunction or death. Ann Intern Med 2005;142:510-524.
47. Rangaswami J, Bhalla V, Blair JEA, et al. Cardiorenal Syndrome: Classification, Pathophysiology, Diagnosis, and Treatment Strategies: A Scientific Statement From the American Heart Association. Circulation 2019;139:840-878.
48. Gheorghiade M, Böhm M, Greene SJ, et al. Effect of aliskiren on postdischarge mortality and heart failure readmissions among patients hospitalized for heart failure: the ASTRONAUT randomized trial. JAMA 2013;309:1125-1135.
49. Solomon SD, Claggett B, McMurray JJ, Hernandez AF, Fonarow GC. Combined neprilysin and renin-angiotensin system inhibition in heart failure with reduced ejection fraction: a meta-analysis. Eur J Heart Fail 2016;18:1238-1243.
50. Mc Causland FR, Lefkowitz MP, Claggett B, et al. Angiotensin-Neprilysin Inhibition and Renal Outcomes in Heart Failure With Preserved Ejection Fraction. Circulation 2020;142:1236-1245.
51. Rossing P, Caramori ML, Chan JCN, et al. Executive summary of the KDIGO 2022 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease: an update based on rapidly emerging new evidence. Kidney Int 2022;102:990-999.
52. Anker SD, Butler J, Filippatos G, et al. Empagliflozin in Heart Failure with a Preserved Ejection Fraction. N Engl J Med 2021;385:1451-1461.
53. Felker GM, Mentz RJ, Cole RT, et al. Efficacy and Safety of Tolvaptan in Patients Hospitalized With Acute Heart Failure. J Am CollCardiol 2017;69:1399-1406.
54. Konstam MA, Kiernan M, Chandler A, et al. Short-Term Effects of Tolvaptan in Patients With Acute Heart Failure and Volume Overload. J Am CollCardiol 2017;69:1409-1419.
55. Hauptman PJ, Burnett J, Gheorghiade M, et al. Clinical course of patients with hyponatremia and decompensated systolic heart failure and the effect of vasopressin receptor antagonism with tolvaptan. J Card Fail 2013;19:390-397.
56. Richette P, Latourte A, Bardin T. Cardiac and renal protective effects of urate-lowering therapy. Rheumatology (Oxford) 2018;57:47-50.
57. Robbins N, Gilbert M, Kumar M, et al. Probenecid Improves Cardiac Function in Patients With Heart Failure With Reduced Ejection Fraction In Vivo and Cardiomyocyte Calcium Sensitivity In Vitro. J Am Heart Assoc 2018;7:e007148.
58. Kiage JN, Latif Z, Craig MA, Mansour N, Khouzam RN. Implantable Cardioverter Defibrillators and Chronic Kidney Disease. CurrProblCardiol 2021;46:100639.

Details

Primary Language

English

Subjects

Multimorbidity

Journal Section

Review

Authors

Mehmet Şahinbaş ^*
0000-0001-6498-7252
Türkiye

Publication Date

December 31, 2024

Submission Date

December 12, 2024

Acceptance Date

December 23, 2024

Published in Issue

Year 2024 Volume: 46 Number: 4

DOI

https://doi.org/10.7197/cmj.1600386

IZ

https://izlik.org/JA44EM49UZ

Cite

RIS / Bibtex

APA

Şahinbaş, M. (2024). Overview of Cardiorenal Syndrome. Cumhuriyet Medical Journal, 46(4), 234-239. https://doi.org/10.7197/cmj.1600386

AMA

1.Şahinbaş M. Overview of Cardiorenal Syndrome. CMJ. 2024;46(4):234-239. doi:10.7197/cmj.1600386

Chicago

Şahinbaş, Mehmet. 2024. “Overview of Cardiorenal Syndrome”. Cumhuriyet Medical Journal 46 (4): 234-39. https://doi.org/10.7197/cmj.1600386.

EndNote

Şahinbaş M (December 1, 2024) Overview of Cardiorenal Syndrome. Cumhuriyet Medical Journal 46 4 234–239.

IEEE

[1]M. Şahinbaş, “Overview of Cardiorenal Syndrome”, CMJ, vol. 46, no. 4, pp. 234–239, Dec. 2024, doi: 10.7197/cmj.1600386.

ISNAD

Şahinbaş, Mehmet. “Overview of Cardiorenal Syndrome”. Cumhuriyet Medical Journal 46/4 (December 1, 2024): 234-239. https://doi.org/10.7197/cmj.1600386.

JAMA

1.Şahinbaş M. Overview of Cardiorenal Syndrome. CMJ. 2024;46:234–239.

MLA

Şahinbaş, Mehmet. “Overview of Cardiorenal Syndrome”. Cumhuriyet Medical Journal, vol. 46, no. 4, Dec. 2024, pp. 234-9, doi:10.7197/cmj.1600386.

Vancouver

1.Mehmet Şahinbaş. Overview of Cardiorenal Syndrome. CMJ. 2024 Dec. 1;46(4):234-9. doi:10.7197/cmj.1600386

Overview of Cardiorenal Syndrome

Abstract

Keywords

Kardiyorenal Sendroma Genel Bakış

Abstract

Keywords

References

Details

Primary Language

Subjects

Journal Section

Authors

Publication Date

Submission Date

Acceptance Date

Published in Issue

DOI

IZ

Cite