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Cardiorenal Complex

Jingbin Guo, Lu Lu, Yue Hua, Kevin Huang, Ian Wang, Li Huang, Qiang Fu, Aihua Chen, Paul Chan, Huimin Fan, Zhong-Min Liu, Bing Hui Wang
Chronic kidney disease (CKD) often leads to and accelerates the progression of cardiovascular disease (CVD), whilst CVD also causes kidney dysfunction. This bidirectional interaction leads to the development of a complex syndrome known as cardiorenal syndrome (CRS). CRS not only involves both the heart and the kidney, but also the vascular system through a vast array of contributing factors. In addition to hemodynamic, neuro-hormonal, mechanical and biochemical factors, the non-dialyzable protein-bound uremic toxins (PBUTs) are also key contributing factors that have been demonstrated through in vitro, in vivo and clinical observations...
April 14, 2017: American Journal of Physiology. Heart and Circulatory Physiology
H R Shah, N P Singh, N P Aggarwal, D Singhania, A Kumar
BACKGROUND: Over recent years, the field of medicine has been challenged by the twin epidemic of heart failure and renal insufficiency. The coexistence of the two problems in the same patient, referred to as cardiorenal syndrome (CRS), is defined as 'disorders of the heart and kidneys whereby acute or chronic dysfunction in one organ may induce acute or chronic dysfunction of the other. The mechanisms underlying this interaction are complex and multifactorial in nature. OBJECTIVE OF STUDY: Identify and classify patients admitted with cardiorenal syndrome into various subtypes and assess clinical outcome at discharge and at three months...
December 2016: Journal of the Association of Physicians of India
Bradley T Endres, Ruben M Sandoval, George J Rhodes, Silvia B Campos-Bilderback, Malgorzata M Kamocka, Christopher McDermott-Roe, Alexander Staruschenko, Bruce A Molitoris, Aron M Geurts, Oleg Palygin
Hypertension is one of the most prevalent diseases worldwide, and a major risk factor for renal failure and cardiovascular disease. The role of albuminuria, a common feature of hypertension and robust predictor of cardiorenal disorders, remains incompletely understood. The goal of this study was to investigate the mechanisms leading to albuminuria in the kidney of a rat model of hypertension, the Dahl salt-sensitive (SS) rat. To determine the relative contributions of the glomerulus and proximal tubule (PT) to albuminuria, we applied intravital two-photon-based imaging to investigate the complex renal physiological changes that occur during salt-induced hypertension...
April 12, 2017: American Journal of Physiology. Renal Physiology
Allyson Zabell, W H Wilson Tang
Heart failure is the leading cause of mortality and morbidity in the world today. While there have been major advances in our understanding of the pathophysiology of heart failure over the past decades, disease progression remains inevitable in the majority of patients and effective therapies to prevent heart failure are still lacking. Research has turned to better understand the gut microbiome because alterations in their ecosystems have been associated with various downstream chronic conditions including cardiovascular diseases...
April 2017: Current Treatment Options in Cardiovascular Medicine
Steve Antoine, Gaurang Vaidya, Haider Imam, Daniel Villarreal
The syndrome of heart failure involves complex pathophysiologic mechanisms and is associated with extremely high-morbidity, mortality and economic costs. This growing global epidemic has diverse etiologies and is fundamentally characterized by dyshomeostasis between heart and kidneys, leading to development and progression of the cardiorenal syndrome. Excessive and sustained sympathoexcitation has emerged as a single prominent factor involved in the structural and functional dysfunction of multiple organ systems during this disease...
January 2017: American Journal of the Medical Sciences
Srikanta Banerjee, Raymond Panas
INTRODUCTION: Diabetes is known to be associated with chronic kidney disease (CKD) and cardiovascular disease (CVD) independently. Type 2 cardiorenal syndrome (CRS), a recently defined syndrome, is characterized by a primary renal failure that progressively leads to cardiac dysfunction. The effect of diabetes on cardiorenal syndrome has not been explored in a multi-ethnic population. In this retrospective secondary analysis the hypothesis was tested if diabetes modifies the effect of CVD on CKD...
January 9, 2017: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
Feras M Bader, Nizar Attallah
PURPOSE OF REVIEW: Acute decompensated heart failure (ADHF) is one of the biggest challenges in the management of chronic heart failure. Despite the advances in medical and device therapy, high readmission and mortality rates continue to be a burden on healthcare systems worldwide. One of the strongest predictors of adverse outcomes in ADHF is renal dysfunction, referred to as cardiorenal syndrome (CRS) type 1. This review discusses some of the recently introduced findings related to the pathophysiology, diagnosis, and management of this disorder...
March 2017: Current Opinion in Cardiology
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...
November 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...
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...
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
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