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Cardiorenal Syndrome: An Evolutionary Appraisal.

James B Young1, Garabed Eknoyan2

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Circulation. Heart Failure
|May 17, 2024
PubMed
Summary

The cardiovascular-kidney-metabolic syndrome integrates metabolic factors with cardiorenal syndrome, highlighting the interconnectedness of heart and kidney health. Understanding its evolutionary origins aids in managing this complex condition.

Keywords:
cardiorenal syndromeheart failurehomeostasismetabolic syndromeultrafiltration

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Area of Science:

  • Cardiovascular Medicine
  • Nephrology
  • Metabolic Disorders

Background:

  • The American Heart Association introduced the cardiovascular-kidney-metabolic syndrome, expanding the concept of cardiorenal syndrome.
  • This new syndrome emphasizes the pathophysiological links between cardiac, renal, and metabolic systems.
  • Cardiorenal syndrome, a key component, significantly impacts healthcare costs, disability, and mortality.

Purpose of the Study:

  • To explore the teleological origins of cardiorenal and cardiovascular-kidney-metabolic syndromes.
  • To provide an evolutionary perspective on the development of cardiovascular and renal systems.
  • To enhance understanding of the new cardiovascular-kidney-metabolic syndrome through historical and physiological insights.

Main Methods:

  • Review of evolutionary biology and physiological development of cardiovascular and renal systems.
  • Historical analysis of medical understanding of cardiorenal disease from ancient to modern times.
  • Integration of metabolic risk factors into the existing cardiorenal syndrome framework.

Main Results:

  • Early eukaryotes developed excretory and circulatory systems crucial for homeostasis.
  • Evolutionary pressures led to complex cardiovascular and renal functions, including calcium regulation.
  • Historical medical insights reveal a growing understanding of cardiorenal interdependencies, particularly post-WWII.

Conclusions:

  • The cardiovascular-kidney-metabolic syndrome represents a significant advancement in understanding interconnected organ systems.
  • An evolutionary perspective is vital for comprehending the complexities of cardiorenal disease.
  • Further research into the syndrome's origins can inform clinical management and prevention strategies.