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Cardiorenal syndrome

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https://www.readbyqxmd.com/read/29118766/the-role-of-endotoxin-in-the-setting-of-cardiorenal-syndrome-type-5
#1
REVIEW
Anna Clementi, Grazia Maria Virzì, Alessandra Brocca, Claudio Ronco
Lipopolysaccharide or endotoxin, the major cell wall component of gram-negative bacteria, plays a pivotal role in the pathogenesis of sepsis. It is able to activate the host defense system through the interaction with Toll-like receptor 4, thus triggering pro-inflammatory mechanisms. When the production of inflammatory mediators becomes uncontrolled and excessive, septic shock develops with multiple organ dysfunction, such as myocardial and renal impairment, which are hallmarks of cardiorenal syndrome type 5...
October 2017: Cardiorenal Medicine
https://www.readbyqxmd.com/read/29111542/a-call-to-action-to-develop-integrated-curricula-in-cardiorenal-medicine
#2
Claudio Ronco, Federico Ronco, Peter A McCullough
With the adoption of the new definition and classification of cardiorenal syndrome (CRS) and its relevant subtypes, much attention has been placed on elucidating the mechanisms of heart and kidney interactions. The pathophysiologic pathways are of great interest by which acute heart failure may result in acute kidney injury (AKI; type 1), chronic heart failure accelerates the progression of chronic kidney disease (CKD; type 2), AKI provokes cardiac events (type 3), and CKD increases the risk and severity of cardiovascular disease (type 4)...
2017: Reviews in Cardiovascular Medicine
https://www.readbyqxmd.com/read/29111106/2017-comprehensive-update-of-the-canadian-cardiovascular-society-guidelines-for-the-management-of-heart-failure
#3
Justin A Ezekowitz, Eileen O'Meara, Michael A McDonald, Howard Abrams, Michael Chan, Anique Ducharme, Nadia Giannetti, Adam Grzeslo, Peter G Hamilton, George A Heckman, Jonathan G Howlett, Sheri L Koshman, Serge Lepage, Robert S McKelvie, Gordon W Moe, Miroslaw Rajda, Elizabeth Swiggum, Sean A Virani, Shelley Zieroth, Abdul Al-Hesayen, Alain Cohen-Solal, Michel D'Astous, Sabe De, Estrellita Estrella-Holder, Stephen Fremes, Lee Green, Haissam Haddad, Karen Harkness, Adrian F Hernandez, Simon Kouz, Marie-Hélène LeBlanc, Frederick A Masoudi, Heather J Ross, Andre Roussin, Bruce Sussex
Since the inception of the Canadian Cardiovascular Society heart failure (HF) guidelines in 2006, much has changed in the care for patients with HF. Over the past decade, the HF Guidelines Committee has published regular updates. However, because of the major changes that have occurred, the Guidelines Committee believes that a comprehensive reassessment of the HF management recommendations is presently needed, with a view to producing a full and complete set of updated guidelines. The primary and secondary Canadian Cardiovascular Society HF panel members as well as external experts have reviewed clinically relevant literature to provide guidance for the practicing clinician...
November 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/29107962/apoptosis-signal-regulating-kinase-1-inhibition-attenuates-cardiac-hypertrophy-and-cardiorenal-fibrosis-induced-by-uremic-toxins-implications-for-cardiorenal-syndrome
#4
Feby Savira, Longxing Cao, Ian Wang, Wendi Yang, Kevin Huang, Yue Hua, Beat M Jucker, Robert N Willette, Li Huang, Henry Krum, Zhiliang Li, Qiang Fu, Bing Hui Wang
Intracellular accumulation of protein-bound uremic toxins in the setting of cardiorenal syndrome leads to adverse effects on cardiorenal cellular functions, where cardiac hypertrophy and cardiorenal fibrosis are the hallmarks. In this study, we sought to determine if Apoptosis Signal-Regulated Kinase 1 (ASK1), an upstream regulator of cellular stress response, mediates cardiac hypertrophy and cardiorenal fibrosis induced by indoxyl sulfate (IS) and p-cresol sulfate (PCS) in vitro, and whether ASK1 inhibition is beneficial to ameliorate these cellular effects...
2017: PloS One
https://www.readbyqxmd.com/read/29075956/visceral-congestion-in-heart-failure-right-ventricular-dysfunction-splanchnic-hemodynamics-and-the-intestinal-microenvironment
#5
REVIEW
Vincenzo B Polsinelli, Arjun Sinha, Sanjiv J Shah
PURPOSE OF REVIEW: Visceral venous congestion of the gut may play a key role in the pathogenesis of right-sided heart failure (HF) and cardiorenal syndromes. Here, we review the role of right ventricular (RV) dysfunction, visceral congestion, splanchnic hemodynamics, and the intestinal microenvironment in the setting of right-sided HF. We review recent literature on this topic, outline possible mechanisms of disease pathogenesis, and discuss potential therapeutics. RECENT FINDINGS: There are several mechanisms linking RV-gut interactions via visceral venous congestion which could result in (1) hypoxia and acidosis in enterocytes, which may lead to enhanced sodium-hydrogen exchanger 3 (NHE3) expression with increased sodium and fluid retention; (2) decreased luminal pH in the intestines, which could lead to alteration of the gut microbiome which could increase gut permeability and inflammation; (3) alteration of renal hemodynamics with triggering of the cardiorenal syndrome; and (4) altered phosphate metabolism resulting in increased pulmonary artery stiffening, thereby increasing RV afterload...
December 2017: Current Heart Failure Reports
https://www.readbyqxmd.com/read/29070522/left-ventricular-assist-devices-and-the-kidney
#6
REVIEW
Daniel W Ross, Gerin R Stevens, Rimda Wanchoo, David T Majure, Sandeep Jauhar, Harold A Fernandez, Massini Merzkani, Kenar D Jhaveri
Left ventricular assist devices (LVADs) are common and implantation carries risk of AKI. LVADs are used as a bridge to heart transplantation or as destination therapy. Patients with refractory heart failure that develop chronic cardiorenal syndrome and CKD often improve after LVAD placement. Nevertheless, reversibility of CKD is hard to predict. After LVAD placement, significant GFR increases may be followed by a late return to near baseline GFR levels, and in some patients, a decline in GFR. In this review, we discuss changes in GFR after LVAD placement, the incidence of AKI and associated mortality after LVAD placement, the management of AKI requiring RRT, and lastly, we review salient features about cardiorenal syndrome learned from the LVAD experience...
October 25, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29065398/a-call-to-action-to-develop-integrated-curricula-in-cardiorenal-medicine
#7
Claudio Ronco, Federico Ronco, Peter A McCullough
With the adoption of the new definition and classification of cardiorenal syndrome (CRS) and its relevant subtypes, much attention has been placed on elucidating the mechanisms of heart and kidney interactions. Of great interest are the pathophysiological pathways by which acute heart failure may result in acute kidney injury (AKI; type 1), chronic heart failure accelerating the progression of chronic kidney disease (CKD; type 2), AKI provoking cardiac events (type 3), and CKD increasing the risk and severity of cardiovascular disease (type 4)...
October 25, 2017: Blood Purification
https://www.readbyqxmd.com/read/29043996/clinical-therapeutic-strategy-of-recombinant-human-brain-natriuretic-peptide-and-dopamine-in-cardiorenal-syndrome-type-4-patients-combined-with-hypotension
#8
Bing Han, Hua Li, Qiaoli Ma
Aim of the present study is to investigate the clinical efficacy of recombinant human brain natriuretic peptide (rhBNP) and dopamine combination treatment in patients with cardiorenal syndrome type 4 (CRS4) combined with hypotension. A total of 160 CRS4 patients admitted to our hospital from July 2010 to December 2014 were recruited, and were randomly divided into two groups, the observational group (n=80) and the control group (n=80). CRS4 patients treated with dopamine were recruited into the control group...
July 2017: Pakistan Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28994186/chronic-kidney-disease-with-comorbid-cardiac-dysfunction-exacerbates-cardiac-and-renal-damage
#9
Shan Liu, Bing H Wang, Darren J Kelly, Henry Krum, Andrew R Kompa
To address the pathophysiological mechanisms underlying chronic kidney disease with comorbid cardiac dysfunction, we investigated renal and cardiac, functional and structural damage when myocardial infarction (MI) was applied in the setting of kidney injury (induced by 5/6 nephrectomy-STNx). STNx or Sham surgery was induced in male Sprague-Dawley rats with MI or Sham surgery performed 4 weeks later. Rats were maintained for a further 8 weeks. Rats (n = 36) were randomized into four groups: Sham+Sham, Sham+MI, STNx+Sham and STNx+MI...
October 10, 2017: Journal of Cellular and Molecular Medicine
https://www.readbyqxmd.com/read/28939714/kidney-disease-measures-and-left-ventricular-structure-and-function-the-atherosclerosis-risk-in-communities-study
#10
Kunihiro Matsushita, Lucia Kwak, Yingying Sang, Shoshana H Ballew, Hicham Skali, Amil M Shah, Josef Coresh, Scott Solomon
BACKGROUND: Heart failure is one of the most important complications of chronic kidney disease (CKD). However, few studies comprehensively investigated left ventricular (LV) structure and function in relation to 2 key CKD measures, estimated glomerular filtration rate (eGFR) and urine albumin/creatinine ratio (ACR). METHODS AND RESULTS: Among 4175 ARIC (Atherosclerosis Risk in Communities) participants (aged 66-90 years during 2011-2013), we quantified the association of eGFR and ACR with echocardiogram parameters of LV mass, size, systolic function, and diastolic function...
September 22, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28937442/orally-active-epoxyeicosatrienoic-acid-analogs
#11
William B Campbell, John D Imig, James M Schmitz, John R Falck
Biologically active epoxyeicosatrienoic acid (EET) regioisomers are synthesized from arachidonic acid by cytochrome P450 epoxygenases of endothelial, myocardial, and renal tubular cells. EETs relax vascular smooth muscle and decrease inflammatory cell adhesion and cytokine release. Renal EETs promote sodium excretion and vasodilation to decrease hypertension. Cardiac EETs reduce infarct size after ischemia-reperfusion injury and decrease fibrosis and inflammation in heart failure. In diabetes, EETs improve insulin sensitivity, increase glucose tolerance, and reduce the renal injury...
October 2017: Journal of Cardiovascular Pharmacology
https://www.readbyqxmd.com/read/28931700/peritoneal-dialysis-for-the-treatment-of-cardiorenal-syndrome-type-1-a-prospective-brazilian-study
#12
Daniela Ponce, Cassiana Góes, Mariele Oliveira, Andre Balbi
This study aimed to explore the role of high-volume peritoneal dialysis (HVPD) in cardiorenal syndrome (CRS) type 1 patients in relation to metabolic and fluid control and outcome. Sixty-four patients were treated by HVPD (prescribed Kt/V = 0.50/session), flexible catheter and cycler. Mean age was 68.8 ± 15.4 years, 54.7% needed intravenous inotropic agents and/or intravenous vasodilators, 31.2% were on mechanical ventilation, acute coronary syndrome (ACS) was the main cause of acute disease heart failure (ADHF) 48...
September 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/28921803/the-pathophysiology-of-arterial-vasodilatation-and-hyperdynamic-circulation-in-cirrhosis
#13
Søren Møller, Flemming Bendtsen
Patients with cirrhosis and portal hypertension often develop complications from a variety of organ systems leading to a multiple organ failure. The combination of liver failure and portal hypertension result in a hyperdynamic circulatory state partly owing to simultaneous splanchnic and peripheral arterial vasodilatation. Increases in circulatory vasodilators are believed to be due to portosystemic shunting and bacterial translocation leading to redistribution of the blood volume with central hypovolemia. Portal hypertension per se and increased splanchnic blood flow are mainly responsible for the development and perpetuation of the hyperdynamic circulation and the associated changes in cardiovascular function with development of cirrhotic cardiomyopathy, autonomic dysfunction, and renal dysfunction as part of a cardiorenal syndrome...
September 16, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/28905081/-cardiorenal-syndrome
#14
REVIEW
D Salleck, S John
Patients in the intensive care unit often suffer from cardiorenal syndrome, which can have an important influence on the patient's outcome. The heart and kidney influence each other via organ crosstalk. We screened and evaluated current publications on cardiorenal syndromes and their therapy. A key role in the management of cardiorenal syndromes is renal decongestion via loop diuretics.
September 13, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28903379/extracorporeal-shock-wave-treatment-attenuated-left-ventricular-dysfunction-and-remodeling-in-mini-pig-with-cardiorenal-syndrome
#15
Jiunn-Jye Sheu, Hani E E Ali, Ben-Chung Cheng, Hsin-Ju Chiang, Pei-Hsun Sung, Kuan-Hung Chen, Chih-Chao Yang, Yen-Ta Chen, John Y Chiang, Pao-Yuan Lin, Sarah Chua, Han-Tan Chai, Sheng-Ying Chung, Cheuk-Kwan Sun, Hon-Kan Yip
This study tested the hypothesis that extracorporeal shock wave (ECSW) treatment can improve ischemia-induced left ventricular (LV) dysfunction in mini-pig with co-existing chronic kidney disease (CKD). LV ischemia in mini-pigs was induced by applying an ameroid constrictor over mid-left anterior descending artery (LAD), while model of CKD was established by right nephrectomy with partial ligation of left renal arterioles 2 weeks before LAD constriction. Thirty mini-pigs were randomly divided into group 1 (sham-control), group 2 (LV-ischemia), group 3 (LV-ischemia + CKD), Group 4 [LV-ischemia + ECSW (applied 1200 shots at 0...
August 15, 2017: Oncotarget
https://www.readbyqxmd.com/read/28902380/-organ-interactions-heart-and-kidney
#16
Daniel Salleck, Stefan John
The interactions between heart and kidney are various and of clinical relevance. Worsening of one organ often influences the function of the other. With NYHA and KDIGO we have classification systems for heart and kidney failure and those should be used for cardiorenal systems as well. Furthermore there is a useful classification system for cardiorenal syndromes itself. Cardiorenal syndrome is a complex illness which should be treated by interdisciplinary medical teams. A key roll in pathophysiology is the renin-angiotensin-aldosteron-system (RAAS)...
September 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28881261/cardiorenal-syndrome-in-sepsis-a-narrative-review
#17
REVIEW
Aditya Kotecha, Saraschandra Vallabhajosyula, Hongchuan H Coville, Kianoush Kashani
Multi-organ dysfunction is seen in nearly 40-60% of all patients presenting with sepsis, including renal and cardiac dysfunction. Cardiorenal syndrome type-5 reflects concomitant cardiac and renal dysfunction secondary to a systemic condition that primarily affects both organs, such as sepsis. There are limited data on the etiology, pathogenesis and clinical implications of cardiorenal syndrome in sepsis. Cardiac dysfunction and injury can be measured with cardiac biomarkers, echocardiographic dysfunction, and hemodynamic parameters...
September 1, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28831296/histopathological-changes-in-the-kidney-following-congestive-heart-failure-by-volume-overload-in-rats
#18
Noureddin B Aboryag, Doaa M Mohamed, Lukas Dehe, Mohammed Shaqura, Sacha Treskatsch, Mehdi Shakibaei, Michael Schäfer, Shaaban A Mousa
BACKGROUND: This study investigated histopathological changes and apoptotic factors that may be involved in the renal damage caused by congestive heart failure in a rat model of infrarenal aortocaval fistula (ACF). METHODS: Heart failure was induced using a modified approach of ACF in male Wistar rats. Sham-operated controls and ACF rats were characterized by their morphometric and hemodynamic parameters and investigated for their histopathological, ultrastructural, and apoptotic factor changes in the kidney...
2017: Oxidative Medicine and Cellular Longevity
https://www.readbyqxmd.com/read/28826934/inotropes-and-cardiorenal-syndrome-in-acute-heart-failure-a-retrospective-comparative-analysis
#19
Marta Madeira, Francisca Caetano, Inês Almeida, Andreia Fernandes, Liliana Reis, Marco Costa, Lino Gonçalves
INTRODUCTION: Cardiorenal syndrome (CRS) is common in acute heart failure (AHF), and is associated with dire prognosis. Levosimendan, a positive inotrope that also has diuretic effects, may improve patients' renal profile. Published results are conflicting. OBJECTIVES: We aimed to assess the incidence of CRS in AHF patients according to the inotrope used and to determine its predictors in order to identify patients who could benefit from the most renoprotective inotrope...
August 18, 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/28801528/epidemiology-and-natural-history-of-the-cardiorenal-syndromes-in-a-cohort-with-echocardiography
#20
Thomas A Mavrakanas, Aisha Khattak, Karandeep Singh, David M Charytan
BACKGROUND AND OBJECTIVES: It is unknown whether echocardiographic parameters are independently associated with the cardiorenal syndrome. No direct comparison of the natural history of various cardiorenal syndrome types has been conducted. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Our retrospective cohort study enrolled adult patients with at least one transthoracic echocardiography between 2004 and 2014 at a single health care system. Information on comorbidities was extracted using condition-specific diagnostic codes...
October 6, 2017: Clinical Journal of the American Society of Nephrology: CJASN
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