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Colegio de Medicina Interna de México.

2021, Number 6

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Med Int Mex 2021; 37 (6)

Cardiorenal syndrome: Diagnostic, therapeutic and prognostic approach

Rozo-Ortiz EJ, Vargas LJ, Bautista-Moreno DG, Ortega-García SM, Valencia-Rincón LG, Hernández-Blanco LZ, Fonseca-Fonseca LC

Language: Spanish
References: 52
Page: 971-981
PDF size: 251.55 Kb.


ABSTRACT

Background: Cardiorenal syndrome represents a number of important interactions between the heart and kidney disease.
Objective: To review the scientific bibliography of patients with heart failure to evaluate the appearance of kidney failure or vice versa.
Methodology: A literature search was performed in the following databases: Pubmed/Medline, Science Direct, Scopus, DOAJ, Embase, Cochrane, Direme, Redalyc and Scielo. The words used to carry out the search were: Cardiorenal syndrome; Diagnosis; Treatment; Management; Prognosis.
Results: Cardiorenal syndrome is classified into five types listed from 1 to 5. Its clinical manifestations include those typical of heart and kidney disease according to the severity of involvement in the target organ. The diagnosis is based on the use of different biomarkers such as cystatin C, creatinine, albuminuria, IL-18, among others, which at the same time allows to establish a prognosis in each patient. Treatment is based on the indication of medicinal products that block the pathological mechanisms, including loop diuretics, thiazide-type diuretics, beta-blockers, vasodilators, inotropics, in addition to ultrafiltration and blocking of SARS.
Conclusions: Cardiorenal syndrome has a bidirectional relationship, in which the myocardial or renal involvement can affect the other, establishing a very common pathological association with a complex pathophysiology.


REFERENCES

  1. Naranjo M, Lerma E, Rangaswami J. Cardio-renal syndrome: A double edged sword. Disease-a-Month 2017; 20: 63-91.

  2. Pereira E, Boada L, Niño D, Caballero M, Rincón G, Jaimes T, et al. Síndrome cardiorrenal. Rev Colomb Cardiol 2017; 24 (6): 602-613. https://doi.org/10.1016/j.rccar.2017.05.019.

  3. Bell B, Ferrer I, Monteagudo A, Ferrer TI. Síndrome cardiorrenal. Revista Archivo Médico de Camagüey 2014: 18-3.

  4. Dean K, Triposkiadis F, Parissis J, Butler H, et al. The cardiorenal interrelationship. Prog Cardiovasc Dis 2017; 59: 638- 648. doi: 10.1016/j.pcad.2016.12.003.

  5. Agrawal A, Naranjo M, Kanjanahattakij N, Rangaswami J, et al. Cardiorenal syndrome in heart failure with preserved ejection fraction an under recognized clinical entity. Heart Fail Rev 2019; 24: 421-37. https://doi.org/10.1007/ s10741-018-09768-9.

  6. Scabbia E, Scabbia L. The cardiorenal syndrome (CRS). IJC Metabolic y Endocrine 2015: 1-4.

  7. Braam B, Joles J, Danishwar A, Gaillard C. Cardiorenal syndrome- current understanding and future perspectives. Nat Rev Nephrol 2014; 10: 48-55. doi: 10.1038/nrneph.2013.250.

  8. Virzì G, Day S, Cal M, Vescovo G, et al. Heart–kidney crosstalk and role of humoral signaling in critical illness. Critical Care 2014; 18: 201. doi: 10.1186/cc13177.

  9. Carubelli V, Lombardi C, Gorga E, Ravera A, et al. Cardiorenal interactions. Heart Failure Clin 2016; 12: 335-347. doi: 10.1016/j.hfc.2016.03.002.

  10. Chávez L, Alemán O, Nando C, Rosas E. Síndrome cardiorrenal: Nuevas perspectivas. Rev Mex Cardiol 2015; 26: 39-52.

  11. Bruno L, Bernarda F, Quevedo A, Renzo T, Ana Mr. Insuficiencia renal aguda y sepsis. Revista Nefrología Argentina 2018; 2591-278.

  12. Claudio R, Luca D, et al. Cardiorenal syndrome. Heart Failure Clin 2014; 10: 251-280.

  13. Núñez J, Miñana G, Santas E, Bertomeu V. Síndrome cardiorrenal en la insuficiencia cardiaca aguda: revisando paradigmas. Rev Esp Cardiol 2015; 68 (5): 426-35. DOI: 10.1016/j.recesp.2014.10.016.

  14. Wenxue H, Wenna H, Xiaowu F, Yanhua W, Feng Y, Wenke H. Risk factors and prognosis of cardiorenal syndrome type 1 in elderly Chinese patients: A retrospective observational cohort study. Kidney Blood Press Res 2016; 41: 672-679. doi: 10.1159/000447936.

  15. Grazia M, Anna C, Giovanni G, Claudio R, et al. Multi-omics approach: New potential key mechanisms implicated in cardiorenal syndromes. Cardiorenal Med 2019; 9: 201-211. doi: 10.1159/000497748.

  16. Bessy B, Ismael F, Alina M, Ismael F. Síndrome cardiorrenal. Revista Archivo Médico de Camagüey 2014; 18 (3): 342-355.

  17. Haase M, Devarajan P, Haase-Fielitz A, Bellomo R, et al. The outcome of neutrophil gelatinase-associated lipocalinpositive subclinical acute kidney injury: a multicenter pooled analysis of prospective studies. J Am Coll Card 2013; 57 (17): 1-6. doi: 10.1016/j.jacc.2010.11.051.

  18. Hiroyuki T, Masafumi K. Pathophysiology of cardiorenal syndrome in patients with heart failure: Potential therapeutic. Am J Physiol 2017; 313: 4. https://doi.org/10.1152/ ajpheart.00215.2017

  19. Gnanaraj J, Radhakrishnan J. Cardio-renal syndrome. F1000Res 2016; 5. doi: 10.12688/f1000research.8004.1.

  20. Lullo L, Bellasi A, Barbera D. Russo, et al. Pathophysiology of the cardio-renal syndromes types 1-5: An uptodate. Indian Heart J 2017; 69 (2): 255-265. doi: 10.1016/j. ihj.2017.01.005.

  21. Pinheiro S, Vaz S. Type 4 cardiorenal syndrome. Portuguese Society of Cardiology 2016: 35-11.

  22. Soni S, Barnela S, Saboo R, Chinchiole AB, et al. Cardiorenal syndrome. Clinical Queries: Nephrology 2014; 3 (1): 30-37.

  23. Carvalho L, Sposito AC. Vitamin D for the prevention of cardiovascular disease. Atherosclerosis 2015; 241: 729- 740. doi: 10.1016/j.atherosclerosis.2015.06.034.

  24. Nuñez J, Gema M, Enrique S, Bertomeu V. Cardiorenal syndrome in acute heart failure: Revisiting paradigms. Rev Esp Cardiol 2015; 68: 426-435. doi: 10.1016/j.rec.2014.10.016.

  25. Srivastava A, Dedhia P, Thakar C. Cardiorenal syndrome type 2. Critical Care Nephrology. 3rd ed. 2019; 690-695.

  26. Scabbia E, Scabbia L. The cardio-renal syndrome (CRS). Intern J Cardiol 2015; 9: 78-84. https://doi.org/10.1016/j. ijcme.2014.10.013.

  27. Levey A, James M. Acute Kidney injury. Ann Intern Med 2017; 167 (9): ITC66-ITC80. doi: 10.7326/AITC201711070.

  28. Cabrera V, Hansson J. Symptom management of the patient with CKD: there role of dialysis. Clin J Am Soc Nephrol 2017; 12: 687-693. doi: 10.2215/CJN.01650216.

  29. Quiroga B, Rodríguez R. Insuficiencia renal crónica. Medicine 2015; 11: 81-86.

  30. Diez J. Chronic heart failure as a state of reduced effectiveness of the natriuretic peptide system: implications for therapy. Eur J Heart Failure 2016; 19 (2):167-176. doi: 10.1002/ejhf.656.

  31. Metra M, Teerling JR. Heart failure. Lancet 2017; 390 (10106): 1981-1995. doi: 10.1016/S0140-6736(17)31071-1.

  32. Harjola V, Mullens W, Banaszewski M, Bauersachs J. Organ dysfunction, injury and failure in acute heart failure: from pathophysiology to diagnosis and management. A review on behalf of the Acute Heart Failure Committee of the Heart Failure Association (HFA) of the European Society of Cardiology (ESC). Eur J Heart Failure 2017; 19: 821-836. doi: 10.1002/ejhf.872.

  33. Cruz D, Gaiao S, Maisel A, Ronco C, et al. Neutrophil gelatinase- associated lipocalin as a biomarker of cardiovascular disease: a systematic review. Clin Chem Lab Med 2012; 50: 1533-1545. doi: 10.1515/cclm-2012-0307.

  34. Bouquegneau A, Krzesinki J, Delanaye P, Cavalier E, et al. Biomarkers and physiopathology in the cardiorenal syndrome. Clin Cimbia Acta 2015; 7 (1): 8-10. https://doi. org/10.1016/j.cca.2014.10.041.

  35. Zannad F, Rossignol P. Cardiorenal syndrome revisited. Circulation 2018; 138 (9): 929-944. DOI: 10.1161/CIRCULATIONAHA. 117.028814.

  36. Goicoechea M, de Vinuesa S, Quiroga B, Verde E, Bernis C, Morales E, et al. Aspirin for primary prevention of cardiovascular disease and renal disease progression in chronic kidney disease patients: A multicenter randomized clinical trial (AASER Study). Cardiovasc Drugs Ther 2018; 32 (3): 255-263. doi: 10.1007/s10557-018-6802-1.

  37. Floccari F, Rivera R. Ultrasonography: Ariadne’s thread in the diagnosis of cardiorenal syndrome. Cardiorenal 2012; 2: 11-17. doi: 10.1159/000334268.

  38. Gigante A, Liberatori M, Gasperini ML, Sardo L, et al. Prevalence and clinical features of patients with the cardiorenal syndrome admitted to an internal medicine ward. Cardiorenal Med 2014; 4: 88-94. doi: 10.1159/000362566.

  39. Ronco C, Lullo L. Cardiorenal syndrome in western countries: Epidemiology, diagnosis and management approaches. Kidney Dis (Basel) 2016; 2: 151-163. doi: 10.1159/000448749.

  40. Linhart C, Ulrich C, Greinert D, Dambeck S, Andreas W, Matthias G, Rainer U. Pliquett. Systemic inflammation in acute cardiorenal syndrome: an observational pilot study. ESC Heart Failure 2018; 5: 921-931. doi: 10.1002/ehf2.12327.

  41. Lullo L, Cozzolino M, Selvi A. Type-5 cardiorenal syndrome: an up to date. NEJM 2015; 3(1): e23-e32.

  42. Juniad-Nazar CM, Mauton-Bojerenu M, Safdar M, Ahmed A, Hammad-Akhtar M, Billmeier-Kindratt T. Efficacy of dietary interventions in end-stage renal disease patients; a systematic review. J Nephropharmacol. 2016; 5 (1): 28-40.

  43. Ravera A, Carubelli V. Nutrition and cardiovascular disease: Finding the perfect recipe for cardiovascular health. Nutrients 2016; 8 (6): 363. doi: 10.3390/nu8060363.

  44. Palmer S, Maggo JK, Campbell K, Craig J, et al. Dietary interventions for adults with chronic kidney disease. Cochrane Database Syst Rev 2017; 2017 (4): 152-161. doi: 10.1002/14651858.CD011998.pub2.

  45. Takahashi A, Hu SL, Bostom A. Physical activity in kidney transplant recipients: A review. Am J Kidney Dis 2018; 72: 433-443. doi: 10.1053/j.ajkd.2017.12.005.

  46. Huie R, Goeddeke-Merickel CM. Exercise guidelines for chronic kidney disease patients. Patient Education 2016; 115: 1021-1028. https://doi.org/10.1053/j.jrn.2016.03.001.

  47. Farmakis D, Parissis J, Lekakis J, Filippatos G. Insuficiencia cardiaca aguda: epidemiología, factores de riesgo y prevención. Rev Esp Cardiol 2015; 68 (3): 245-248. DOI: 10.1016/j. recesp.2014.11.009.

  48. Rico-Landazábal A, Perea D, Garizabalo O, Sanabria M, Vesga J, Ronderos I. Program for the prevention of chronic kidney disease based on integrated service networks in Colombia. Rev Salud Pública 2017; 19 (2): 171-176. https:// doi.org/10.15446/rsap.v19n2.45110.

  49. Verbrugge FH, Mullens W, Tang W. Management of cardio-renal syndrome and diuretic resistance. Curr Treat Options Cardiovasc Med 2016; 18 (2): 11. doi: 10.1007/ s11936-015-0436-4.

  50. Bart B, Goldsmith S, Lee K, Givertz M, O’Connor C, et al. Ultrafiltration in decompensated heart failure with cardiorenal syndrome. N Engl J Med. 2012; 367(24): 2296-2304. DOI: 10.1056/NEJMoa1210357.

  51. Costanzo M. Saltzberg M. Jessup M, Teerlink J. Ultrafiltration is associated with fewer rehospitalizations tan continuous diuretic infusion in patients with decompensated heart failure: Results from UNLOAD. J Card Fail 2010; 16 (4): 277-84. doi: 10.1016/j.cardfail.2009.12.009.

  52. House A, Haapio M, Lassus J, Bellomo R, Ronco C. Pharmacological Management of Cardiorenal Syndromes. Int J Nephrol 2011; 45: 672-679. doi: 10.4061/2011/630809.




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