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Cardiorenal [corrected] syndrome: an emerging problem in pediatric critical care
John Lynn Jefferies1, Stuart L Goldstein
1The Heart Institute, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, 3333 Burnet Avenue, MLC 2003, Cincinnati, OH 45243, USA. john.jefferies@cchmc.org
Insights
Pediatric cardiorenal syndrome (CRS) involves coexisting heart and kidney problems. This review summarizes the limited pediatric data on CRS, highlighting its clinical impact and need for further research.
Area of Science:
- Pediatric Cardiology
- Nephrology
- Critical Care Medicine
Background:
- Cardiorenal syndrome (CRS) describes heart and kidney dysfunction.
- While adult CRS is well-documented, pediatric CRS literature is limited.
- CRS is recognized as clinically significant in children, impacting treatment and prognosis.
Purpose of the Study:
- To review the existing adult literature on cardiorenal syndrome.
- To summarize the current understanding of pediatric cardiorenal syndrome.
- To identify knowledge gaps in pediatric CRS, particularly in heart failure and kidney disease contexts.
Main Methods:
- Literature review of adult cardiorenal syndrome.
- Synthesis of available pediatric data on cardiorenal syndrome.
- Focus on perioperative, heart failure, acute kidney injury, and chronic kidney disease populations.
Main Results:
- Adult CRS literature provides a foundation for understanding the condition.
- Pediatric data on CRS is scarce, especially outside the perioperative setting.
- Significant knowledge gaps exist regarding pediatric acute heart failure, chronic heart failure, acute kidney injury, and chronic kidney disease.
Conclusions:
- Pediatric cardiorenal syndrome is an emerging clinical concern.
- Further research is crucial to define and manage CRS in pediatric populations.
- Understanding pediatric CRS is essential for improving patient outcomes.
Abstract:
The cardiorenal syndrome (CRS) refers to a complex pathophysiologic state in which heart and kidney dysfunction coexist. Although a robust amount of adult literature exists, limited reports have been made regarding CRS in pediatric patients. However, CRS is increasingly being recognized as an impactful clinical problem that can have important implications regarding the need for treatment and prognosis. Although wide acceptance of a unified definition of CRS is lacking, a general consensus exists that CRS can be either primarily caused by cardiac disease with secondary effects on the kidney, or vice versa, as well as systemic conditions in which cardiac and renal disease are both considered to be secondary. Convincing data in the pediatric perioperative population have been reported, but there is a paucity of information in acute and chronic heart failure (HF), as well as acute kidney injury (AKI) and chronic kidney disease (CKD). Herein, we briefly report on the adult literature and summarize the current pediatric experience.
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