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Type 1 Cardio-Renal Syndrome

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Textbook of Cardiorenal Medicine

Abstract

Patients with heart failure commonly develop organ dysfunction as a consequence of impaired blood perfusion or non-hemodynamic indirect injury, and often subsequent progression of renal dysfunction is associated with poor clinical prognosis. While neurohormonal system activation, systemic inflammatory reaction, and hemodynamic derangement are considered the central pathology in acute (or Type 1) cardio-renal syndrome (CRS), there is growing evidence that intricate networks of mediators participate in the process of cardio-renal injury. However, current treatment strategies are unable to effectively modulate this complex interplay of mediators in order to reverse true cardio-renal injury. The presence of conglomerated cardio-renal mediators in advanced CRS often hampers clinician efforts to recognize proper causal relationships in CRS progress. Either imprecise decongestive treatment or imperfect biomarker-based assessment of renal function can contribute to undesirable outcomes. Hence, there is a pressing need to gain insights into vulnerable cardio-renal substrates during subclinical stages of CRS rather than to overcome such mediators during overt CRS.

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Funding

Dr. Tang is funded by grants from the National Institutes of Health (R01HL103931, R01DK106000, R01HL126827).

Disclosure: All authors have no relationships to disclose.

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Authors and Affiliations

  1. Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH, USA

    Youn-Hyun Kim, Weining Xu, Takeshi Kitai & W. H. Wilson Tang

  2. Cardiovascular Division, Department of Internal Medicine, Korea University Ansan Hospital, Ansan-si, Republic of Korea

    Youn-Hyun Kim

  3. Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Kobe, Japan

    Takeshi Kitai

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  1. Youn-Hyun Kim
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  2. Weining Xu
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  4. W. H. Wilson Tang
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Correspondence to W. H. Wilson Tang .

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  1. Baylor University Medical Center, Texas A&M University, Dallas, TX, USA

    Peter A. McCullough

  2. Director, Department of Nephrology Dialysis and Transplantation, International Renal Research Institute (IRRIV), Ospedale San Bortolo Vicenza, Vicenza, Italy

    Claudio Ronco

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Kim, YH., Xu, W., Kitai, T., Tang, W.H.W. (2021). Type 1 Cardio-Renal Syndrome. In: McCullough, P.A., Ronco, C. (eds) Textbook of Cardiorenal Medicine. Springer, Cham. https://doi.org/10.1007/978-3-030-57460-4_7

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