Cardiorenal syndrome
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate-Editor(s)-in-Chief: Yazan Dabboul; Rim Halaby
Overview
Cardiorenal Syndrome (CRS) comprises a group of disease states that involve simultaneous kidney and heart failure or disorder. Because the kidney and the heart lead a “symbiotic” bi-directional relationship; the vitality of one organ ultimately and inevitably depends on the vitality of the other [1]. Cardiorenal syndromes have recently earned major clinical significance because of their complex management challenges and their profound prognostic indication of mortality in patients suffering from concomitant heart and kidney diseases [2]. The term “cardiorenal syndromes” has only been recently clearly defined in the literature; where prior use of the term had witnessed several misconceptions and wrongful utilization in the past. Cardiorenal syndromes are a unique disease entity of complex and poorly understood pathophysiology, etiology, and management. Perhaps the greatest challenge a clinician faces with cardiorenal syndromes is the therapeutic approach and pharmacological intervention required in favor of a CRS patient with known poor prognosis. Today’s management approaches, despite proven efficacy, remain notorious for their injurious effects on the target organs of CRS. Individualized treatment remains up till now an optimal modality of approach pending the understanding of CRS, pathophysiology, and effective prevention.
Classification
Five subgroups have been identified and further approved by the Acute Dialysis Quality Initiative (ADQI) in 2010 on the basis of the following:
- Pathophysiology
- Acute vs. Chronic
- Concomitance of cardiac and renal dysfunction
For descriptive purposes, the five cardiorenal syndromes have also been named differently [1] as shown in the table below:
| Type | Name |
| Type 1 | Acute cardiorenal syndrome |
| Type 2 | Chronic cardiorenal syndrome |
| Type 3 | Acute renocardiac syndrome |
| Type 4 | Chronic renocardiac syndrome |
| Type 5 | Secondary cardiorenal syndrome |
Causes
Pathophysiology
Diagnosis
Treatment
References
{Reflist|2}
- ↑ 1.0 1.1 Ronco, C., Haapio, M., House, A., Anavekar, N., & Bellomo, R. (2008). Cardiorenal Syndrome. Journal of the American College of Cardiology, 52(19):1527-1539.
- ↑ Heywood, J. (2004). The cardiorenal syndrome: Lessons from the ADHERE database and treatment options. Heart Failure Review, 9:195–201