[Cardio-renal axis: pathophysiological evidences and clinical implications].

Area of Science:

• Nephrology
• Cardiology
• Internal Medicine

Background:

• Cardio-renal syndrome (CRS) describes conditions with concurrent heart and kidney dysfunction.
• A recent Consensus conference defined five distinct types of CRS.

Purpose of the Study:

• To elucidate the classification of cardio-renal syndrome (CRS).
• To differentiate the five types of CRS based on underlying pathophysiology and clinical presentation.

Main Methods:

• Review and synthesis of the definitions proposed by the Acute Dialysis Quality Initiative Group.
• Categorization of CRS into five distinct types based on the interplay between cardiac and renal function.

Main Results:

• Type 1 CRS: Acute cardiac dysfunction leading to acute kidney injury (AKI) in active cardiac disease (e.g., acute decompensated heart failure).
• Type 2 CRS: Chronic cardiac disease impacting kidney function.
• Type 3 CRS: Primarily driven by acute kidney injury affecting cardiac function.
• Type 4 CRS: Cardiovascular involvement in patients with chronic kidney disease.
• Type 5 CRS: Simultaneous cardiac and renal dysfunction due to systemic diseases like sepsis or hepatorenal syndrome.

Conclusions:

• The five-type classification provides a framework for understanding the diverse clinical scenarios of CRS.
• Differentiating CRS types is crucial for targeted diagnosis and management of patients with combined cardiac and renal compromise.