Heart Failure Reviews

, Volume 17, Issue 3, pp 355–366

The cardiorenal syndrome in heart failure: cardiac? renal? syndrome?

  • Filippos Triposkiadis
  • Randall C. Starling
  • Harisios Boudoulas
  • Gregory Giamouzis
  • Javed Butler
Article

Abstract

There has been increasing interest on the so-called cardiorenal syndrome (CRS), defined as a complex pathophysiological disorder of the heart and kidneys whereby acute or chronic dysfunction in one organ may induce acute or chronic dysfunction in the other. In this review, we contend that there is lack of evidence warranting the adoption of a specific clinical construct such as the CRS within the heart failure (HF) syndrome by demonstrating that: (a) the approaches and tools regarding the definition of kidney involvement in HF are suboptimal; (b) development of renal failure in HF is often confounded by age, hypertension, and diabetes; (c) worsening of renal function (WRF) in HF may be largely independent of alterations in cardiac function; (d) the bidirectional association between HF and renal failure is not unique and represents one of the several such associations encountered in HF; and (e) inflammation is a common denominator for HF and associated noncardiac morbidities. Based on these arguments, we believe that dissecting one of the multiple bidirectional associations in HF and constructing the so-called cardiorenal syndrome is not justified pathophysiologically. Fully understanding of all morbid associations and not only the cardiorenal is of great significance for the clinician who is caring for the patient with HF.

Keywords

Heart failure Cardiorenal syndrome Worsening renal function Noncardiac morbidities 

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Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Filippos Triposkiadis
    • 1
  • Randall C. Starling
    • 2
  • Harisios Boudoulas
    • 3
  • Gregory Giamouzis
    • 1
  • Javed Butler
    • 4
  1. 1.Department of CardiologyLarissa University HospitalLarissaGreece
  2. 2.Cardiology DivisionCleveland ClinicClevelandUSA
  3. 3.Foundation of Biomedical ResearchAcademy of AthensAthensGreece
  4. 4.Cardiology DivisionEmory UniversityAtlantaUSA

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