What’s new in cardiorenal syndrome?
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Cardiorenal syndrome (CRS) is a bidirectional disorder in which heart and kidney may induce or perpetuate disease in the other organ [1, 2]. Five subtypes reflecting the primary dysfunction and its chronicity have been described. This “what’s new” paper will focus on CRS type 1 in which acute heart failure (AHF) (mostly in the setting of cardiogenic shock or acute decompensated heart failure) induces renal dysfunction and/or injury. CRS type 1 is common, may affect 25–33% of patients with AHF, and is associated with a grim prognosis [2, 3].
Definition and pathophysiology
The pathophysiological mechanisms underlying CRS type 1 include renal hypoperfusion due to hypotension and low cardiac output, renal congestion, maladaptive activation of the renin–angiotensin–aldosterone and the sympathetic nervous system, and inflammation [1, 2]. Recent literature has shifted from low cardiac output to venous congestion (causing increased renal backpressure and compartment syndrome) as...
Acute heart failure
Acute kidney injury
Glomerular filtration rate
Worsening renal function
Compliance with ethical standards
Conflicts of interest
None to declare.
- 2.Haase M, Müller C, Damman K et al (2013) 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). Contrib Nephrol 182:99–116. https://doi.org/10.1159/000349969 CrossRefPubMedGoogle Scholar
- 3.Dar O, Cowie MR (2008) Acute heart failure in the intensive care unit: epidemiology. Crit Care Med 36:S3–S8. https://doi.org/10.1097/01.CCM.0000296264.41365.80 CrossRefPubMedGoogle Scholar
- 15.Ponikowski P, Voors AA, Anker SD et al (2016) 2016 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure: the task force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur J Heart Fail 18:891–975. https://doi.org/10.1002/ejhf.592 CrossRefPubMedGoogle Scholar