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The Cardiorenal Syndrome: Mechanistic Insights and Prognostication with Soluble Biomarkers

  • Cardiac Biomarkers (CR deFilippi, Section Editor)
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Abstract

Purpose of Review

To characterize and interpret recent studies of biomarkers of cardiorenal syndrome.

Recent Findings

Recent studies have questioned the mechanisms and significance of moderate worsening renal function (WRF) in patients with acute heart failure. In the setting of successful decongestion, WRF may not predict cardiorenal morbidity. Cardiac-specific biomarkers including cardiac troponins and natriuretic peptides are highly prognostic in acute and chronic HF patients with kidney impairment, and serial changes in these markers during hospitalization are also predictive of longer-term adverse outcomes. These markers also predict new HF in patients with established chronic kidney disease (CKD). The role of kidney tubular injury markers in acute HF remains controversial, with inconsistent associations with short- and long-term cardiorenal outcomes. Many cases of WRF in acute HF are not characterized by a clear pattern of renal tubular injury.

Summary

Cardiac-specific and renal-specific biomarkers may provide mechanistic and prognostic information in cardiorenal syndromes.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Authors and Affiliations

  1. University of Maryland School of Medicine, 22 S. Greene Street N3W143, Baltimore, MD, 21201, USA

    Stephen Seliger

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Correspondence to Stephen Seliger.

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Conflict of Interest

Stephen Seliger reports grants from Roche Diagnostics, Kadmon Corporation, Palladio Biosciences, Sanofi, and Reata and personal fees from Tricida Inc. In addition, Dr. Seliger has a patent “Methods for Assessing Differential Risk for Developing Heart Failure” (Patent No 10,509,044) issued.

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Seliger, S. The Cardiorenal Syndrome: Mechanistic Insights and Prognostication with Soluble Biomarkers. Curr Cardiol Rep 22, 114 (2020). https://doi.org/10.1007/s11886-020-01360-8

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