Intensive Care Medicine

, Volume 44, Issue 6, pp 908–910 | Cite as

What’s new in cardiorenal syndrome?

  • Michael DarmonEmail author
  • Miet Schetz
What's New in Intensive Care


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


Cardiorenal syndrome


Glomerular filtration rate


Worsening renal function


Compliance with ethical standards

Conflicts of interest

None to declare.

Supplementary material

134_2018_5190_MOESM1_ESM.docx (15 kb)
Supplementary material 1 (DOCX 14 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature and ESICM 2018

Authors and Affiliations

  1. 1.Medical ICU, Saint-Louis University Hospital, AP-HPParisFrance
  2. 2.Faculté de MédecineUniversité Paris-Diderot, Sorbonne-Paris-CitéParisFrance
  3. 3.ECSTRA Team, Biostatistics and Clinical EpidemiologyUMR 1153 (Center of Epidemiology and Biostatistic Sorbonne Paris Cité, CRESS), INSERMParisFrance
  4. 4.Clinical Department and Laboratory of Intensive Care Medicine, Division of Cellular and Molecular MedicineKU Leuven UniversityLouvainBelgium

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