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Cardiorenal Syndrome Type 1: Pathophysiological Crosstalk Leading to Combined Heart and Kidney Dysfunction in the Setting of Acutely Decompensated Heart Failure

Journal of the American College of Cardiology, 2012-09, Vol.60 (12), p.1031-1042 [Peer Reviewed Journal]

2015 INIST-CNRS ;Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. ;ISSN: 0735-1097 ;EISSN: 1558-3597 ;DOI: 10.1016/j.jacc.2012.01.077 ;PMID: 22840531 ;CODEN: JACCDI

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Title:
Cardiorenal Syndrome Type 1: Pathophysiological Crosstalk Leading to Combined Heart and Kidney Dysfunction in the Setting of Acutely Decompensated Heart Failure
Author: RONCO, Claudio ; CICOIRA, Mariantonietta ; MCCULLOUGH, Peter A
Subjects: Acute Disease ; Animals ; Biological and medical sciences ; Cardio-Renal Syndrome - epidemiology ; Cardio-Renal Syndrome - physiopathology ; Cardio-Renal Syndrome - therapy ; Cardiology. Vascular system ; Heart ; Heart Failure - epidemiology ; Heart Failure - physiopathology ; Heart Failure - therapy ; Heart failure, cardiogenic pulmonary edema, cardiac enlargement ; Humans ; Kidney Diseases - epidemiology ; Kidney Diseases - physiopathology ; Kidney Diseases - therapy ; Medical sciences ; Renal Insufficiency - epidemiology ; Renal Insufficiency - physiopathology ; Renal Insufficiency - therapy
Is Part Of: Journal of the American College of Cardiology, 2012-09, Vol.60 (12), p.1031-1042
Description: Cardiorenal syndrome (CRS) type 1 is characterized as the development of acute kidney injury (AKI) and dysfunction in the patient with acute cardiac illness, most commonly acute decompensated heart failure (ADHF). There is evidence in the literature supporting multiple pathophysiological mechanisms operating simultaneously and sequentially to result in the clinical syndrome characterized by a rise in serum creatinine, oliguria, diuretic resistance, and in many cases, worsening of ADHF symptoms. The milieu of chronic kidney disease has associated factors including obesity, cachexia, hypertension, diabetes, proteinuria, uremic solute retention, anemia, and repeated subclinical AKI events all work to escalate individual risk of CRS in the setting of ADHF. All of these conditions have been linked to cardiac and renal fibrosis. In the hospitalized patient, hemodynamic changes leading to venous renal congestion, neurohormonal activation, hypothalamic-pituitary stress reaction, inflammation and immune cell signaling, systemic endotoxemic exposure from the gut, superimposed infection, and iatrogenesis all contribute to CRS type 1. The final common pathway of bidirectional organ injury appears to be cellular, tissue, and systemic oxidative stress that exacerbate organ function. This review explores in detail the pathophysiological pathways that put a patient at risk and then effectuate the vicious cycle now recognized as CRS type 1.
Publisher: New York, NY: Elsevier
Language: English
Identifier: ISSN: 0735-1097
EISSN: 1558-3597
DOI: 10.1016/j.jacc.2012.01.077
PMID: 22840531
CODEN: JACCDI
Source: Geneva Foundation Free Medical Journals at publisher websites
MEDLINE
Alma/SFX Local Collection

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Cardiorenal Syndrome Type 1: Pathophysiological Crosstalk Leading to Combined Heart and Kidney Dysfunction in the Setting of Acutely Decompensated Heart Failure

2015 INIST-CNRS ;Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. ;ISSN: 0735-1097 ;EISSN: 1558-3597 ;DOI: 10.1016/j.jacc.2012.01.077 ;PMID: 22840531 ;CODEN: JACCDI

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