Skip to main content

Cardiorenal Syndrome: What Basic Research Can Contribute

  • Chapter
  • First Online:
Introduction to Translational Cardiovascular Research
  • 1173 Accesses

Abstract

Cardiorenal syndrome is defined as the coexistence of heart failure and renal failure. Under this term, several syndromes with distinct etiology and pathophysiology can be discriminated. This short review focuses on what we have learned from basic research approaches, using animal models. The use of animal models, albeit useful, should always be followed with reservations about extrapolation of results. Two models are presented in detail, one where heart dysfunction is caused by ligation of the left anterior descending artery and another where renal dysfunction is caused by subtotal nephrectomy; in both cases, anatomical and functional alterations in the other organ are presented. Next, future directions in this field are proposed, focused mainly on the need to use system biology approaches for gaining a more holistic understanding and on the promise that interventions on histone deacetylases holds for generating specific and effective pharmaceuticals.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

Abbreviations

ANP:

Atrial Natriuretic Peptide

αSMA:

Alpha Smooth Muscle Actin

BiP:

Binding immunoglobulin Protein

βΜΗC:

Beta-Myosin Heavy Chain

CKD:

Chronic Kidney Disease

GFR:

Glomerular Filtration Rate

GRP78:

Glucose Responsive Protein 78

IL-6:

Interleukine-6

IS:

Indoxyl Sulfate

KIM-1:

Kidney Injury Molecule-1

MAPK:

Mitogen-Activated Protein Kinase

MI:

Myocardial Infarction

NFκB:

Nuclear Factor κΒ

NGAL:

Neutrophil Gelatinase Associated Lipocalin

RAAS:

Rennin-Angiotensin-Aldosterone System

SMAD:

Similar to Mothers Against Decapentaplegic protein

STN:

Subtotal Nephrectomy

TGF-β:

Transforming Growth Factor-beta

UPR:

Unfolded Protein Response

References

  1. Ronco C, House AA, Haapio M. Cardiorenal syndrome: refining the definition of a complex symbiosis gone wrong. Intensive Care Med. 2008;34:957–62.

    Article  PubMed  Google Scholar 

  2. Parikh CR, Coca SG, Wang Y, Masudi FA, Krumholz HM. Long-term prognosis of acute kidney injury after acute myocardial infarction. Arch Intern Med. 2008;168:987–95.

    Article  PubMed  Google Scholar 

  3. Sarnak MJ, Levey AS, Schoolwerth AC, Coresh J, Culleton B, et al. Kidney disease as a risk factor for development of cardiovascular disease: a statement from the American Heart Association Councils on Kidney in cardiovascular Disease, High Blood Pressure Research, Clinical Cardiology and Epidemiology and Prevention. Circulation. 2003;108:2154–69.

    Article  PubMed  Google Scholar 

  4. Ronco C. Cardiorenal Syndromes: Definition and Classification. In: Ronco C, Costanzo MR, Bellomo R, Maisel AS, editors. Fluid overload: diagnosis and management, vol. 64. Basel: Karger; 2010. p. 33–8.

    Chapter  Google Scholar 

  5. Bongartz LG, Braam B, Gaillard CA, Cramer MJ, Goldschmeding R, Verhaar MC, et al. Target organ cross talk in cardiorenal syndrome: animal models. Am J Physiol Renal Physiol. 2012;303:F1253–63.

    Article  CAS  PubMed  Google Scholar 

  6. Lekawanvijit S, Kompa AR, Zang Y, Wang BH, Kelly DJ, Krum H. Myocardial infarction impairs renal function, induces renal interstitial fibrosis, and increases renal KIM-1 expression: implications for cardiorenal syndrome. Am J Physiol Heart Circ Physiol. 2012;302:H1884–93.

    Article  CAS  PubMed  Google Scholar 

  7. Tzanidis A, Lim S, Hannan RD, See F, Ugoni AM, Krum H. Combined angiotensin and endothelin receptor blockade attenuates adverse cardiac remodeling post-myocardial infarction in the rat: possible role of transforming growth factor beta. J Mol Cell Cardiol. 2001;33:969–81.

    Article  CAS  PubMed  Google Scholar 

  8. Wolf G. Renal injury due to rennin-angiotensin-aldosterone system activation of the transforming growth factor-beta pathway. Kidney Int. 2006;70:1914–9.

    CAS  PubMed  Google Scholar 

  9. Lekawanvijit S, Kompa AR, Manabe M, Wang BH, Langham RG, Nishijima F, et al. Chronic kidney disease-induced cardiac fibrosis is ameliorated by reducing circulating levels of a non-dialysable uremic toxin, indoxyl sulfate. PLoS One. 2012;7:e41281.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  10. Niwa T. Uremic toxicity of indoxyl sulfate. Nagoya J Med Sci. 2010;72:1–11.

    CAS  PubMed  Google Scholar 

  11. Lekawanvijit S, Adrahtas A, Kelly DJ, Kompa AR, Wang BH, Krum H. Does indoxyl sulfate, a uraemic toxin, have direct effects on cardiac fibroblasts and myocytes? Eur Heart J. 2010;31:1771–9.

    Article  CAS  PubMed  Google Scholar 

  12. Ben-Shoshan J, Entin-Meer M, Guzner-Gur H, Keren G. The cardiorenal syndrome: a mutual approach to concomitant cardiac and renal failure. Isr Med Assoc J. 2012;14:570–6.

    PubMed  Google Scholar 

  13. Xu C, Bailly-Maitre B, Reed JC. Endoplasmic reticulum stress: cell life and death decisions. J Clin Invest. 2005;115:2656–64.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  14. Kim I, Xu W, Reed JC. Cell death and endoplasmic reticulum stress: diseases relevance and therapeutic opportunities. Nat Rev Drug Discov. 2008;7:1013–30.

    Article  CAS  PubMed  Google Scholar 

  15. Dickhout JG, Carlisle RE, Austin RC. Interrelationship between cardiac hypertrophy, heart failure and chronic kidney disease. Endoplasmic reticulum stress as a mediator of pathogenesis. Circ Res. 2011;106:629–42.

    Article  Google Scholar 

  16. Bush EW, McKinsey TA. Protein acetylation in the cardiorenal axis: the promise of histone deacetylase inhibitors. Circ Res. 2010;106:272–84.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Aristidis S. Charonis MD, PhD .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Charonis, A.S. (2015). Cardiorenal Syndrome: What Basic Research Can Contribute. In: Cokkinos, D. (eds) Introduction to Translational Cardiovascular Research. Springer, Cham. https://doi.org/10.1007/978-3-319-08798-6_26

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-08798-6_26

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-08797-9

  • Online ISBN: 978-3-319-08798-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics