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Cardiorenal Syndrome: An Overview
Claudio Ronco1, Antonio Bellasi1, Luca Di Lullo1
1International Renal Research Institute, S. Bortolo Hospital, Vicenza, Italy; Department of Nephrology and Dialysis, ASST Lariana, S. Anna Hospital, Como, Italy; and Department of Nephrology and Dialysis, L. Parodi - Delfino Hospital, Colleferro, Italy.
Insights
Cardiorenal syndrome involves heart and kidney dysfunction. A new 5-subtype classification highlights the bidirectional relationship between these organs in disease.
Area of Science:
- Cardiology
- Nephrology
- Cardiorenal Medicine
Background:
- Patients with acute decompensated heart failure often exhibit concurrent heart and kidney dysfunction.
- Primary heart or kidney disease can lead to dysfunction or injury in the other organ.
- The term cardiorenal syndrome lacked a consistent definition, encompassing diverse interrelated derangements.
Purpose of the Study:
- To propose a new classification for cardiorenal syndrome.
- To address the bidirectional nature of heart-kidney interactions.
- To define cardiorenal syndrome based on pathophysiology, time frame, and nature of dysfunction.
Main Methods:
- Review of existing literature on cardiorenal interactions.
- Development of a novel classification system for cardiorenal syndrome.
- Analysis of the pathophysiology linking cardiac and renal dysfunction.
Main Results:
- A new 5-subtype classification for cardiorenal syndrome was proposed.
- The classification emphasizes the bidirectional relationship between heart and kidney dysfunction.
- Cardiorenal syndrome is defined as a disorder where dysfunction of one organ induces dysfunction in the other.
Conclusions:
- The proposed classification provides a framework for understanding cardiorenal syndrome.
- It highlights the crucial interplay between cardiac and renal health.
- Recognizing the bidirectional impact is essential for patient management.
Abstract:
It is well established that a large number of patients with acute decompensated heart failure present with various degrees of heart and kidney dysfunction usually primary disease of heart or kidney often involve dysfunction or injury to the other. The term cardiorenal syndrome increasingly had been used without a consistent or well-accepted definition. To include the vast array of interrelated derangements and to stress the bidirectional nature of heart-kidney interactions, a new classification of the cardiorenal syndrome with 5 subtypes that reflect the pathophysiology, the time frame, and the nature of concomitant cardiac and renal dysfunction was proposed. Cardiorenal syndrome can generally be defined as a pathophysiological disorder of the heart and kidneys, in which acute or chronic dysfunction of one organ may induce acute or chronic dysfunction to the other. Although cardiorenal syndrome was usually referred to as acute kidney dysfunction following acute cardiac disease, it is now clearly established that impaired kidney function can have an adverse impact on cardiac function.
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