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Acute kidney injury in cardiogenic shock: A comprehensive review

Omar Sheikh1, Tung Nguyen1, Shweta Bansal2

  • 1Division of Cardiology, Department of Medicine, The University of Texas Health Science Center at San Antonio, San Antonio, Texas.

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|July 30, 2020
PubMed

Insights

Acute kidney injury (AKI) is common in cardiogenic shock (CS) and increases mortality. Early detection with urinary biomarkers and interventions like vasopressors and circulatory support are crucial for managing AKI in CS patients.

Area of Science:

  • Nephrology
  • Cardiology
  • Critical Care Medicine

Background:

  • Acute kidney injury (AKI) is a significant predictor of mortality in patients experiencing cardiogenic shock (CS).
  • Understanding the pathophysiology and risk factors for AKI in CS is critical for improving patient outcomes.
  • Current diagnostic criteria and the role of emerging biomarkers require further elucidation.

Purpose of the Study:

  • To review the pathophysiology of AKI in cardiogenic shock.
  • To summarize diagnostic criteria, biomarkers, risk factors, and therapeutic interventions for AKI in CS.
  • To highlight the potential of novel biomarkers and treatments in managing AKI within the CS context.

Main Methods:

  • Comprehensive literature review of studies on AKI in cardiogenic shock.
  • Analysis of diagnostic criteria, including traditional and novel urinary biomarkers.
  • Identification and synthesis of risk factors and therapeutic strategies.

Main Results:

  • AKI is frequently observed in CS patients, correlating with elevated morbidity and mortality.
  • Urinary biomarkers show promise for earlier AKI detection but are not yet standard clinical practice.
  • Vasopressor selection, mechanical circulatory support, and renal replacement therapy are emerging as key therapeutic considerations.

Conclusions:

  • AKI presents a substantial challenge in cardiogenic shock management.
  • Enhanced diagnostic capabilities through biomarkers could lead to earlier interventions.
  • Multimodal therapeutic approaches, including advanced circulatory and renal support, are essential for improving survival in CS patients with AKI.

Keywords:
cardiorenal syndromemechanical supportmyocardial infarctionrenal replacement therapy

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