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Cardiorenal Complex

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
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
S P Keller, A Kovacevic, J Howard, A Schweighauser, T Francey
OBJECTIVES: Cardiac involvement in the course of acute kidney injury is described in humans as cardiorenal syndrome type 3 but has received only limited attention in dogs. This study was designed to evaluate cardiac injury and dysfunction in acute kidney injury in dogs and its association with outcome. METHODS: This prospective cohort study enrolled 24 client-owned dogs with acute kidney injury. Cardiac disorders were evaluated with thoracic radiographs, echocardiography, 24-hour Holter monitoring and cardiac troponin I concentrations within 2 days of admission and 7 to 10 days later...
August 2016: Journal of Small Animal Practice
Annalisa Angelini, Chiara Castellani, Grazia Maria Virzì, Marny Fedrigo, Gaetano Thiene, Marialuisa Valente, Claudio Ronco, Giorgio Vescovo
BACKGROUND: In cardiorenal syndrome type 2 (CRS2), the role of systemic congestion in heart failure (HF) is still obscure. We studied a model of CRS2 [monocrotaline (MCT)-treated rats] secondary to pulmonary hypertension and right ventricular (RV) failure in order to evaluate the contribution of prevalent congestion to the development of kidney injury. METHODS: Ten animals were treated with MCT for 4 weeks until they developed HF. Eleven animals were taken as controls...
December 2015: Cardiorenal Medicine
Kenichi Matsushita
BACKGROUND: Cardiorenal syndrome (CRS) is the term used to describe a complex disorder of the heart and kidneys, in which acute or chronic dysfunction of one organ initiates and perpetuates disease in the other. CRS is recognized as an important clinical condition that is increasingly becoming a major public health problem due to the high associated morbidity and mortality rates. METHODS: This review discusses current understanding of the pathogenetic pathways involved in CRS and future therapeutic implications of such pathways for patients...
May 10, 2016: Current Pharmaceutical Design
Kurt W Prins, Thenappan Thenappan, Jeremy S Markowitz, Marc R Pritzker
OBJECTIVE: To present a review of cardiorenal syndrome type 1 (CRS1). METHODS: Review of the literature. RESULTS: Acute kidney injury occurs in approximately one-third of patients with acute decompensated heart failure (ADHF) and the resultant condition was named CRS1. A growing body of literature shows CRS1 patients are at high risk for poor outcomes, and thus there is an urgent need to understand the pathophysiology and subsequently develop effective treatments...
September 2015: Journal of Clinical Outcomes Management: JCOM
Beverly Giam, David M Kaye, Niwanthi W Rajapakse
Renal dysfunction and heart failure commonly co-exist; it is termed the cardiorenal syndrome (CRS). This combination of renal and cardiac impairment presents a substantial clinical challenge and is associated with adverse prognosis. The pathogenesis of the CRS is complex, including chronic activation of the renin-angiotensin-aldosterone system (RAAS) and the sympathetic nervous system, together with reduced renal perfusion. Chronic activation of the RAAS can impair mitochondrial function, and increase mitochondrial derived oxidative stress which in turn can lead to renal injury and sodium and water retention...
August 2016: Heart, Lung & Circulation
Tansu Sav, Faruk Cecen, Enver S Albayrka
BACKGROUND: Cardiorenal syndrome (CRS) is defined as complex pathophysiological disorder of the heart and kidneys. Both heart and renal failure are characterized by increased systemic oxidative stress in CRS. The aim of the present study is to assess the impacts of ultrafiltration (UF) and furosemide treatment on oxidative stress markers and renal functions in patients with CRS. METHOD: 77 patients with CRS (37 patients in the UF group and 40 patients in the furosemide group) were included in the study...
April 20, 2016: Minerva Urologica e Nefrologica, the Italian Journal of Urology and Nephrology
Daniel Eckstein, Ravi Korabathina
Heart failure (HF) is a complex clinical condition. The newer guidelines have phased out the designations of systolic and diastolic HF and replaced them with the more physiologically applicable classifications of HF with reduced or preserved ejection fraction (EF). Although the numbers of new patients within these two groups are similar, patient characteristics and risk factors often differ. There also are differences in the incidence of HF among racial and ethnic groups, with blacks having the highest incidence...
March 2016: FP Essentials
J Núñez, E Santas
No abstract text is available yet for this article.
March 2016: Revista Clínica Española
Silvia Pastori, Grazia Maria Virzì, Alessandra Brocca, Massimo de Cal, Vincenzo Cantaluppi, Chiara Castellani, Marny Fedrigo, Gaetano Thiene, Maria Luisa Valente, Annalisa Angelini, Giorgio Vescovo, Claudio Ronco
Cardiorenal syndrome type 1 (CRS1) pathophysiology is complex, and immune-mediated damage, including alterations in the immune response with monocyte apoptosis and cytokine release, has been reported as a potential mechanism. In this study, we examined the putative role of renal tubular epithelial cell (RTC) apoptosis as a pathogenic mechanism in CRS1. In particular, we investigated the caspase pathways involved in induced apoptosis. We enrolled 29 patients with acute heart failure (AHF), 11 patients with CRS1, and 15 controls (CTR) without AHF or acute kidney injury (AKI)...
October 2015: Cardiorenal Medicine
Savvas Hadjiphilippou, Sui Phin Kon
Renal and cardiac diseases are both prevalent and carry significant morbidity and mortality. They share common vascular risk factors and are physiologically interlinked. Dysfunction in one organ affects the other. Concurrent renal and cardiac disease is associated with a poor prognosis. This close relationship is reflected through cardiorenal syndrome. A classification system has been proposed; however, the underlying process is complex and multifactorial. Management of this syndrome focuses on improving heart function, reducing volume overload, and managing heart failure and chronic kidney disease...
January 2016: Journal of the Royal Society of Medicine
J L Pouchelon, C E Atkins, C Bussadori, M A Oyama, S L Vaden, J D Bonagura, V Chetboul, L D Cowgill, J Elliot, T Francey, G F Grauer, V Luis Fuentes, N Sydney Moise, D J Polzin, A M Van Dongen, N Van Israël
OBJECTIVES: There is a growing understanding of the complexity of interplay between renal and cardiovascular systems in both health and disease. The medical profession has adopted the term "cardiorenal syndrome" (CRS) to describe the pathophysiological relationship between the kidney and heart in disease. CRS has yet to be formally defined and described by the veterinary profession and its existence and importance in dogs and cats warrant investigation. The CRS Consensus Group, comprising nine veterinary cardiologists and seven nephrologists from Europe and North America, sought to achieve consensus around the definition, pathophysiology, diagnosis and management of dogs and cats with "cardiovascular-renal disorders" (CvRD)...
September 2015: Journal of Small Animal Practice
Pramesh Dhakal, Kan Liu, Hani Kozman, Robert L Carhart, Daniel Villarreal
Heart failure constitutes a significant source of morbidity and mortality in the United States, and its incidence and prevalence continue to grow, increasing its burden on the health care system. Renal dysfunction in patients with heart failure is common and has been associated with adverse clinical outcomes. This complex interaction is characterized by a pathophysiological disequilibrium between the heart and the kidney, in which cardiac malfunction promotes renal impairment, which in turn feeds back, resulting in further deterioration of cardiovascular function...
2015: Clinical Medicine Insights. Cardiology
Niwanthi W Rajapakse, Shane Nanayakkara, David M Kaye
A highly complex interplay exists between the heart and kidney in the setting of both normal and abnormal physiology. In the context of heart failure, a pathophysiological condition termed the cardiorenal syndrome (CRS) exists whereby dysfunction in the heart or kidney can accelerate pathology in the other organ. The mechanisms that underpin CRS are complex, and include neuro-hormonal activation, oxidative stress and endothelial dysfunction. The endothelium plays a central role in the regulation of both cardiac and renal function, and as such impairments in endothelial function can lead to dysfunction of both these organs...
October 2015: Pharmacology & Therapeutics
Grazia Maria Virzì, Anna Clementi, Massimo de Cal, Alessandra Brocca, Sonya Day, Silvia Pastori, Chiara Bolin, Giorgio Vescovo, Claudio Ronco
Cardiorenal Syndrome Type 1 (Type 1) is a specific condition which is characterized by a rapid worsening of cardiac function leading to acute kidney injury (AKI). Even though its pathophysiology is complex and not still completely understood, oxidative stress seems to play a pivotal role. In this study, we examined the putative role of oxidative stress in the pathogenesis of CRS Type 1. Twenty-three patients with acute heart failure (AHF) were included in the study. Subsequently, 11 patients who developed AKI due to AHF were classified as CRS Type 1...
2015: Oxidative Medicine and Cellular Longevity
Julio Núñez, Gema Miñana, Enrique Santas, Vicente Bertomeu-González
Cardiorenal syndrome has been defined as the simultaneous dysfunction of both the heart and the kidney. Worsening renal function that occurs in patients with acute heart failure has been classified as cardiorenal syndrome type 1. In this setting, worsening renal function is a common finding and is due to complex, multifactorial, and not fully understood processes involving hemodynamic (renal arterial hypoperfusion and renal venous congestion) and nonhemodynamic factors. Traditionally, worsening renal function has been associated with worse outcomes, but recent findings have revealed mixed and heterogeneous results, perhaps suggesting that the same phenotype represents a diversity of pathophysiological and clinical situations...
May 2015: Revista Española de Cardiología
Rosita Zakeri, John C Burnett, S Jeson Sangaralingham
The public health and economic burden of heart failure (HF) is staggering and the need for relevant pathophysiologic and clinical biomarkers to advance the field and improve HF therapy remains high. Renal dysfunction is common among HF patients and is associated with increased HF hospitalization and mortality. It is widely recognized that mechanisms contributing to HF pathogenesis include a complex bidirectional interaction between the kidney and heart, encompassed by the term cardiorenal syndrome (CRS). Among a new wave of urinary biomarkers germane to CRS, C-type natriuretic peptide (CNP) has emerged as an innovative biomarker of renal structural and functional impairment in HF and chronic renal disease states...
March 30, 2015: Clinica Chimica Acta; International Journal of Clinical Chemistry
Youakim Saliba, Ralph Karam, Viviane Smayra, Georges Aftimos, Joel Abramowitz, Lutz Birnbaumer, Nassim Farès
Transient receptor potential canonical (TRPC) Ca(2+)-permeant channels, especially TRPC3, are increasingly implicated in cardiorenal diseases. We studied the possible role of fibroblast TRPC3 in the development of renal fibrosis. In vitro, a macromolecular complex formed by TRPC1/TRPC3/TRPC6 existed in isolated cultured rat renal fibroblasts. However, specific blockade of TRPC3 with the pharmacologic inhibitor pyr3 was sufficient to inhibit both angiotensin II- and 1-oleoyl-2-acetyl-sn-glycerol-induced Ca(2+) entry in these cells, which was detected by fura-2 Ca(2+) imaging...
August 2015: Journal of the American Society of Nephrology: JASN
Alessia Buglioni, John C Burnett
Heart failure (HF) is a syndrome characterized by a complex pathophysiology which involves multiple organ systems, with the kidney playing a major role. HF can present with reduced ejection fraction (EF), HFrEF, or with preserved EF (HFpEF). The interplay between diverse organ systems contributing to HF is mediated by the activation of counteracting neurohormonal pathways focused to re-establishing hemodynamic homeostasis. During early stages of HF, these biochemical signals, consisting mostly of hormones and neurotransmitters secreted by a variety of cell types, are compensatory and the patient is asymptomatic...
March 30, 2015: Clinica Chimica Acta; International Journal of Clinical Chemistry
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