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Heart failure, chronic kidney disease, and biomarkers--an integrated viewpoint--
Yoshitaka Iwanaga1, Shunichi Miyazaki
1Division of Cardiology, Faculty of Medicine, Kinki University, Osakasayama, Japan. yiwanaga@med.kindai.ac.jp
Insights
Chronic kidney disease (CKD) and heart failure (HF) share a dangerous relationship. This review examines biomarkers for early detection and management of cardiorenal syndrome in CKD patients.
Area of Science:
- Cardiology
- Nephrology
- Biomarker Research
Background:
- Chronic kidney disease (CKD) often progresses to end-stage renal disease (ESRD).
- Heart failure (HF) is a major cause of death in CKD and ESRD patients.
- The cardiorenal syndrome highlights the critical heart-kidney interaction, worsening prognosis in combined conditions.
Purpose of the Study:
- To review current evidence on laboratory biomarkers in heart failure (HF) and chronic kidney disease (CKD).
- To emphasize emerging cardiac biomarkers (BNPs, troponins) and renal injury markers (cystatin C, neutrophil gelatinase-associated lipocalin).
- To discuss the role of these biomarkers in diagnosing and managing cardiorenal syndrome.
Main Methods:
- Literature review of current evidence on laboratory biomarkers.
- Focus on cardiac biomarkers (BNPs, troponins) and renal injury biomarkers (cystatin C, NGAL).
- Discussion of biomarker utility in heart-kidney interactions and cardiorenal syndrome management.
Main Results:
- Biomarkers like BNPs, cardiac troponins, cystatin C, and neutrophil gelatinase-associated lipocalin are crucial in HF and CKD.
- The utility of these biomarkers in renal dysfunction contexts requires further study.
- These markers show potential for improved diagnostic and therapeutic strategies in cardiorenal syndrome.
Conclusions:
- Early diagnosis and aggressive management of HF are essential in CKD/ESRD patients.
- Biomarkers play a vital role in understanding and managing the cardiorenal syndrome.
- Further research is needed to fully elucidate biomarker utility in cardiorenal interactions.
Abstract:
Chronic kidney disease (CKD) is frequently associated with a progressive decrease in the glomerular filtration rate, which leads to endstage renal disease (ESRD). Heart failure (HF) is a complex syndrome rather than a primary diagnosis, and considered as the endpoint of all cardiovascular disorders. It is the leading cause of death among the cardiovascular diseases in patients with CKD and ESRD. There is some interaction between the heart and kidney (the so-called "cardiorenal syndrome"), and HF patients with the complication of CKD or ESRD show a worse prognosis. Thus, early diagnosis and aggressive management of HF are needed in patients with CKD and ESRD. A number of biomarkers appear to have growing clinical importance and are reported for detection and stratification of HF. Although HF and CKD have a close interrelationship, the utility of the biomarkers has not been adequately studied with regard to the relationship with renal dysfunction. This paper reviews of the current evidence about laboratory biomarkers in patients with HF or CKD, emphasizing the emerging cardiac biomarkers (ie, BNPs and cardiac troponins), and the biomarkers of renal injury (ie, cystatin C and neutrophil gelatinase-associated lipocalin). Furthermore, it discusses the potential role of these markers in terms of heart - kidney interactions and their utility in the diagnostic and therapeutic strategies for cardiorenal syndrome.
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