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Cardiorenal Nexus: A Review With Focus on Combined Chronic Heart and Kidney Failure, and Insights From Recent

Peter A McCullough1, Alpesh Amin2, Kevin M Pantalone3

  • 1Truth for Health Foundation Tucson AZ.

Journal of the American Heart Association
|May 26, 2022
PubMed

Insights

The cardiorenal nexus describes the heart-kidney connection, where disease in one organ worsens the other. Understanding this link is crucial for managing heart and kidney conditions, especially with rising chronic disease rates.

Area of Science:

  • Cardiorenal medicine
  • Nephrology
  • Cardiology

Background:

  • The cardiorenal nexus highlights the bidirectional relationship between heart and kidney health.
  • Chronic heart dysfunction can cause kidney disease, and kidney disease can impair cardiac function and increase cardiovascular disease risk.
  • Prevalence of chronic kidney disease, cardiovascular disease, and type 2 diabetes is increasing, particularly in aging populations.

Purpose of the Study:

  • To summarize the evidence supporting the cardiorenal nexus.
  • To emphasize the need for a multidisciplinary approach to managing cardiorenal syndromes.
  • To underscore the importance of understanding cardiorenal pathophysiology for treatment optimization.

Main Methods:

  • Review of observational studies and clinical trial data.
  • Analysis of follow-up data from placebo arms in chronic kidney disease and cardiovascular disease trials.
  • Synthesis of current understanding of cardiorenal pathophysiology.

Main Results:

  • Evidence from observational studies confirms the cardiorenal nexus.
  • Patients with type 2 diabetes show higher rates of renal and cardiovascular events in clinical trial subgroups.
  • Cardiorenal syndromes share an interlinked pathophysiological trajectory.

Conclusions:

  • A holistic, collaborative, multidisciplinary approach is essential for managing cardiorenal syndromes.
  • Existing treatment options are available, but further understanding of pathophysiology is needed.
  • Optimizing management of these interconnected diseases requires a deeper insight into the cardiorenal nexus.

Keywords:
cardiorenal nexuscardiorenal syndromescardiovascular diseasechronic kidney diseaseheart failuretype 2 diabetes

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