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Cardiorenal Syndromes

  • Ali Valika
  • Aziz Valika
  • Suneel Udani
Chapter

Abstract

Combined disorders of heart and kidney are referred to as cardiorenal syndromes (CRS) (Ronco et al. Eur Heart J. 31(6):703–11, 2010). Disorders of one organ have a direct impact on the other organs, and can lead to worsened patient outcomes. We know that mortality is increased in patients with heart failure (HF) who have a reduced glomerular filtration rate (GFR). We also know that patients with chronic kidney disease (CKD) have an increased risk of both atherosclerotic cardiovascular disease and HF, with cardiac disorders responsible for up to 50% of deaths in patients with renal failure (Coresh et al. Levey Am J Kidney Dis. 41(1):1–12, 2003). Acute or chronic dysfunction of one organ often leads to functional impairment of the other, and diagnostic and treatment algorithms remain lacking in these scenarios. The Acute Dialysis Quality Initiative (ADQI) group has sought to further classify CRS, so that we may better understand and risk stratify patients into various subtypes, allowing for future therapeutic targets to emerge (Ronco et al. Eur Heart J. 31(6):703–11, 2010). This chapter reviews the five subtypes of CRS, and their associated pathology and current treatment options available.

Keywords

Cardiorenal syndromes Acute kidney injury Heart failure Renocardiac syndrome 

Abbreviations

ACEi

Angiotensin converting enzyme inhibitor

ACS

Acute coronary syndrome

ADHF

Acute decompensated heart failure

ADQI

Acute dialysis quality initiative

AKI

Acute kidney injury

ARB

Angiotensin receptor blockers

ARNI

Angiotensin neprilysin inhibitor

ATN

Acute tubular injury

CAD

Coronary artery disease

CKD

Chronic kidney disease

CO

Cardiac output

CRCL

Creatinine clearance

CRS

Cardiorenal syndrome

ESA

Erythropoietin stimulating agent

ESRD

End stage renal disease

FGF-23

Fibroblast growth factor 23

GFR

Glomerular filtration rate

HF

Heart failure

HTN

Hypertension

LVH

Left ventricular hypertrophy

MDRD

Modification of diet in renal disease

NGAL

Neutrophil gelatinase-associated lipocalin

RAAS

Renin–angiotensin–aldosterone system

RIFLE

Risk, injury, failure, loss, end stage renal disease

RV

Right ventricle

sCr

Serum creatinine

SNS

Sympathetic nervous system

UF

Ultrafiltration

VC

Vascular calcifications

WRF

Worsening renal function

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Advocate Medical Group-Advocate Heart Institute, Advocate Good Samaritan HospitalOak BrookUSA
  2. 2.Nephrology Associates of Northern Illinois and IndianaDowners GroveUSA

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