Preclinical models of cardio-renal syndrome: a systematic review

Area of Science:

• Cardiology
• Nephrology
• Pathophysiology

Background:

• Rising prevalence of heart failure (HF) and chronic kidney disease (CKD) creates significant clinical challenges.
• HF and CKD frequently coexist, leading to cardiorenal syndrome (CRS), which worsens patient outcomes.
• The bidirectional interaction between HF and CKD in CRS is established, but underlying pathophysiological mechanisms remain incompletely understood.

Purpose of the Study:

• To review and analyze recent studies utilizing various animal models to investigate the pathophysiology of cardiorenal syndrome (CRS).
• To explore insights gained from primary HF models, primary CKD models, and proposed "double-hit" models in understanding CRS development.
• To emphasize the complexity of CRS and identify areas requiring further research.

Main Methods:

• Analysis of recent studies employing animal models of primary heart failure (HF).
• Review of studies using animal models of primary chronic kidney disease (CKD).
• Examination of research utilizing "double-hit" animal models designed to simulate cardiorenal syndrome (CRS).

Main Results:

• HF models demonstrated renal pathology including fibrosis, inflammation, and decreased glomerular filtration rate (GFR), with KIM-1 and NGAL as early damage markers.
• CKD models showed cardiac pathology such as hemodynamic changes, increased systolic blood pressure, and fibrosis.
• "Double-hit" models provided insights into the cross-talk between heart and kidney, offering a more comprehensive view of CRS pathophysiology.

Conclusions:

• Animal models, particularly "double-hit" models, offer valuable insights into the complex pathophysiological mechanisms of cardiorenal syndrome (CRS).
• Further research is crucial to fully elucidate the intricate interactions and underlying mechanisms driving the cardiorenal syndrome.
• Understanding CRS pathophysiology is essential for improving management strategies for patients with coexisting heart failure and chronic kidney disease.