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Cardiorenal syndrome

John A Kellum
PURPOSE OF REVIEW: Acute kidney injury is common and is associated with increased morbidity and mortality. Rates of acute kidney injury in most settings remain high and in some settings are increasing. Moreover, outcomes associated with acute kidney injury remain relatively poor. This review focuses on recent advances in understanding of acute kidney injury and discusses possible interventions based on these advances. RECENT FINDINGS: Acute kidney injury is not a disease with a single etiology and clinical course but rather a loose collection of syndromes whose unifying phenotype is an acute loss of glomerular filtration...
October 18, 2016: Current Opinion in Critical Care
Jiří Charvát
Symptomatic cardiorenal syndrome presents the clinical condition with the serious prognosis when treatment is hardly succesful. A lot of inflammatory and hormonal factors used as biomarkers in clinical practice participate on the initiation, development and progression of cardiorenal syndrome. It means they play role of mediators between heart and kidney and therefore have the significant position in clinical presentation. However the mutual relations between heart and kidney are formed earlier already in the asymptomatic period...
2016: Vnitr̆ní Lékar̆ství
S Sakthi Selva Kumar
No abstract text is available yet for this article.
January 2016: Journal of the Association of Physicians of India
E Martinelli, C Locatelli, S Bassis, S Crosara, S Paltrinieri, P Scarpa, I Spalla, A M Zanaboni, C Quintavalla, P Brambilla
BACKGROUND: Veterinary literature lacks data about cardiovascular-renal disorders (CvRD) and cardiorenal-anemia syndrome (CRAS) in dogs. HYPOTHESIS: A direct correlation exists between ACVIM class and IRIS stage; chronic kidney disease (CKD) complicates chronic mitral valve disease (CMVD) more often than does anemia in dogs. ANIMALS: One hundred and fifty-eight client-owned dogs with CMVD. METHODS: Signalment, physical examination findings, electrocardiography, thoracic radiographs, echocardiography, and blood analysis were retrospectively evaluated to assess the prevalence of CKD and anemia in dogs with CMVD and to investigate the relationships among ACVIM class, IRIS stage, and survival...
September 2016: Journal of Veterinary Internal Medicine
Ana Luísa Pinheiro da Silva, Manuel Joaquim Vaz da Silva
The Acute Dialysis Quality Initiative consensus conference proposed a classification of cardiorenal syndrome (CRS), aiming for a better delineation of each subtype. Although the exact pathophysiology of type 4 CRS is not completely understood, the mechanisms involved are probably multifactorial. There is growing evidence that oxidative stress is a major connector in the development and progression of type 4 CRS. Giving its complexity, poor prognosis and increasing incidence, type 4 CRS is becoming a significant public health problem...
October 3, 2016: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
Naomi Nakazawa, Keisuke Nakabayashi, Toshiaki Oka
Renal congestion contributes to the cardiorenal syndrome. There are some heart failure cases that are refractory to diuretic therapy. If the dose of diuretics is titrated, it leads to irreversible renal dysfunction. Early administration of tolvaptan is effective in treating fluid retention and congestion. However, in case of tolvaptan resistance, starting extracorporeal ultrafiltration (ECUM) at an early stage should be considered. Tolvaptan has been proven efficient, and we believe it should be incorporated with the classical method, ECUM...
October 4, 2016: BMJ Case Reports
Wenxue Hu, Wenna He, Wei Liu, Xiaowu Fang, Yanhua Wu, Feng Yu, Wenke Hao
BACKGROUND/AIMS: Cardiorenal syndrome type 1 (CRS1) is a syndrome characterized by a rapid worsening of cardiac function leading to acute kidney injury (AKI). The aims of this study were to investigate the risk factors and the prognosis of CRS1 in elderly patients. METHODS: A total of 312 elderly patients (≥60 years old) with acute heart failure (AHF) were studied. They were assigned as CRS1 (suffered from in-hospital AKI) or NCRS1 (without AKI) group. Clinical and laboratory data were recorded...
September 28, 2016: Kidney & Blood Pressure Research
Silvia Lai, Mauro Ciccariello, Mira Dimko, Alessandro Galani, Silvio Lucci, Rosario Cianci, Amalia Mariotti
: Bakground/Aims: Cardiovascular diseases represent the leading causes of morbidity and mortality in patients with cronich kidney disease (CKD). The pathogenesis includes a complex, bidirectional interaction between heart and kidney termed cardiorenal syndrome type 4. The aim of study was to evaluate the association between renal and cardiovascular ultrasonographic parameters and identify early markers of cardiovascular risk. METHODS: A total of 35 patients with CKD and 25 healthy controls, were enrolled and we have evaluated inflammatory indexes, mineral metabolism, renal function, renal and cardiovascular ultrasonographic parameters...
September 26, 2016: Kidney & Blood Pressure Research
Chan Joon Kim, Ik-Jun Choi, Hun-Jun Park, Tae Hoon Kim, Pum-Joon Kim, Kiyuk Chang, Sang Hong Baek, Wook Sung Chung, Ki-Bae Seung
BACKGROUND: Dysfunctional interplay between the heart and kidneys may lead to the development of anemia. The aim of this study was to evaluate the impact of cardiorenal anemia syndrome (CRAS) on short- and long-term outcomes among patients hospitalized with heart failure (HF). METHODS: We enrolled 303 patients hospitalized with HF. We divided the patients into two groups: a CRAS group (n = 64) and a non-CRAS group (n = 239). We defined CRAS as HF accompanied by (1) an estimated glomerular filtration rate <60 ml/min/1...
August 2016: Cardiorenal Medicine
Chunbo Chen, Xiaobing Yang, Ying Lei, Yan Zha, Huafeng Liu, Changsheng Ma, Jianwei Tian, Pingyan Chen, Tiecheng Yang, Fan Fan Hou
BACKGROUND AND OBJECTIVES: A major challenge in early treatment of acute cardiorenal syndrome (CRS) is the lack of predictors for progression of AKI. We aim to investigate the utility of urinary angiotensinogen and other renal injury biomarkers in predicting AKI progression in CRS. DESIGN, SETTINGS, PARTICIPANTS, & MEASUREMENTS: In this prospective, multicenter study, we screened 732 adults who admitted for acute decompensated heart failure from September 2011 to December 2014, and evaluated whether renal injury biomarkers measured at time of AKI diagnosis can predict worsening of AKI...
September 7, 2016: Clinical Journal of the American Society of Nephrology: CJASN
Florence Sens, Éric Pouliquen, Sandrine Lemoine, Éric Bonnefoy-Cudraz, Laurent Juillard
Kidney dysfunction during congestive heart failure, although frequent, is often neglected. Yet, it represents a life-threatening condition, oven when the kidney dysfunction is moderate. The initial approach involvus strict application of recommendations, cardiologic and nephrologic joined management and close follow-up involving patient's general practitioner. Cases of true diuretics resistance are infrequent and late. Yet, it represents a significant turning point. Mortality is high, with a major individual unpredictability...
June 2016: La Revue du Praticien
Éric Thervet
The pathophysiology of cardiorenal syndromes (SCR) is becoming better understood. The traditional view was that the left ventricular systolic dysfunction leads to a decrease in renal blood flow. Although this mechanism still makes sense as a contributing factor to SCR, its role as the principal pathophysiological SCR component or even as essential hemodynamic underlying factor has been challenged by recent discoveries. Regarding hemodynamic, the role of increased venous pressure is more and more accepted as demonstrated by the increase in abdominal pressure...
June 2016: La Revue du Praticien
Bruno Moulin
Cardiorenal syndromes refer to clinical and metabolic consequences of acute and chronic heart failure or kidney disease on other organ. Recent studies have further clarified the pathophysiological mechanisms behind the different types of cardiorenal syndromes and propose a new classification. The cardiorenal syndrome type 1 corresponds to an acute heart failure (cardiogenic shock, acute decompensated congestive heart failure) which induces acute renal dysfunction. In the cardiorenal syndrome type 2 heart failure is chronic (congestive heart failure) and induces chronic kidney damages in the long-term...
June 2016: La Revue du Praticien
David S Cooper, David M Kwiatkowski, Stuart L Goldstein, Catherine D Krawczeski
OBJECTIVES: The objectives of this review are to discuss the definition, diagnosis, and pathophysiology of acute kidney injury and its impact on immediate, short-, and long-term outcomes. In addition, the spectrum of cardiorenal syndromes will be reviewed including the pathophysiology on this interaction and its impact on outcomes. DATA SOURCE: MEDLINE and PubMed. CONCLUSION: The field of cardiac intensive care continues to advance in tandem with congenital heart surgery...
August 2016: Pediatric Critical Care Medicine
Einat Hertzberg-Bigelman, Rami Barashi, Ran Levy, Lena Cohen, Jeremy Ben-Shoshan, Gad Keren, Michal Entin-Meer
BACKGROUND: Chronic kidney disease (CKD) is often accompanied by impairment of cardiac function that may lead to major cardiac events. Erythropoietin (EPO), a kidney-produced protein, was shown to be beneficial to heart function. It was suggested that reduced EPO secretion in CKD may play a role in the initiation of heart damage. OBJECTIVES: To investigate molecular changes in the EPO/ erythropoietin receptor (EPO-R) axis in rat cardiomyocytes using a rat model for CKD...
June 2016: Israel Medical Association Journal: IMAJ
Sarah Chua, Fan-Yen Lee, Hsin-Ju Chiang, Kuan-Hung Chen, Hung-I Lu, Yen-Ta Chen, Chih-Chao Yang, Kun-Chen Lin, Yi-Ling Chen, Gour-Shenq Kao, Chih-Hung Chen, Hsueh-Wen Chang, Hon-Kan Yip
We investigated the cardioprotective effect of melatonin (Mel) and exendin-4 (Ex4) treatment in a rat model of cardiorenal syndrome (CRS). Male-adult SD rats (n=48) were randomly and equally divided into sham-control (SC), dilated cardiomyopathy (DCM) (doxorubicin 7 mg/kg i.p. every five days/ 4 doses), CRS (defined as DCM + CKD) only, CRS-Mel (20 mg/kg/day), CRS-Ex4 (10 μg/kg/day) and CRS-Mel-Ex4. In-vitro results showed protein expressions of oxidative-stress (NOX-1/NOX-2/oxidized protein), DNA/mitochondrial-damaged (γ-H2AX/cytosolic cytochrome-C) and apoptotic (cleaved caspase-3/PARP) biomarkers, and senescence (β-galactosidase cells) were upregulated, whereas mitochondrial ATP level was decreased in doxorubicin/ p-Cresol-treated H9C2 cells that were revised by Mel and Ex4 treatments (all p<0...
July 28, 2016: Journal of Pineal Research
Daniel F Arruda-Junior, Flavia L Martins, Rafael Dariolli, Leonardo Jensen, Ednei L Antonio, Leonardo Dos Santos, Paulo J F Tucci, Adriana C C Girardi
Circulating dipeptidyl peptidase IV (DPPIV) activity is associated with worse cardiovascular outcomes in humans and experimental heart failure (HF) models, suggesting that DPPIV may play a role in the pathophysiology of this syndrome. Renal dysfunction is one of the key features of HF, but it remains to be determined whether DPPIV inhibitors are capable of improving cardiorenal function after the onset of HF. Therefore, the present study aimed to test the hypothesis that DPPIV inhibition by vildagliptin improves renal water and salt handling and exerts anti-proteinuric effects in rats with established HF...
2016: Frontiers in Physiology
Jinshun Li, Yuqin Xu, Jia Xu, Jinhua Wang, Liying Wu
Venous congestion and volume overload are important in cardiorenal syndromes, in which multiple regulated factors are involved, including long non‑coding RNAs (lncRNAs). To investigate the underlying role of lncRNAs in regulating the development of venous congestion, an Affymetrix microarray associated with peripheral venous congestion was annotated, then a bipartite dynamic lncRNA-mRNA co-expression network was constructed in which nodes indicated lncRNAs or mRNAs. The nodes were connected when the lncRNAs or mRNAs were dynamically co‑expressed...
September 2016: Molecular Medicine Reports
Luca Di Lullo, Antonio Bellasi, Vincenzo Barbera, Mario Cozzolino, Domenico Russo, Antonio De Pascalis, Francesca Santoboni, Annalisa Villani, Silvia De Rosa, Marco Colafelice, Luigi Russo, Claudio Ronco
Cardiovascular disease and major cardiovascular events represent main cause of death in both acute and chronic kidney disease patients. Kidney and heart failure are common and frequently co-exist This organ-organ interaction, also called organ cross-talk, leads to well-known definition of cardiorenal syndrome (CRS). Here we will describe cardiovascular involvement in patients with acute kidney injury (AKI). Also known as Type-3 CRS or acute reno-cardiac CRS, it occurs when AKI contributes and/or precipitates development of acute cardiac injury...
May 2016: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
Valentina Carubelli, Carlo Lombardi, Elio Gorga, Alice Ravera, Marco Metra, Robert J Mentz
Recently, there has been increased appreciation of the identification and management of comorbidities in heart failure patients, and for therapies targeting conventional heart failure signs and symptoms. Renal dysfunction is common in patients with heart failure and is associated with high morbidity and mortality. Early identification of renal damage through novel biomarkers and the use of new pharmacological strategies aimed at preserving renal function may represent an important objective in the treatment...
July 2016: Heart Failure Clinics
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