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Recent Developments in the Evaluation and Management of Cardiorenal Syndrome: A Comprehensive Review.
Kim, Jitae A; Wu, Lingling; Rodriguez, Mario; Lentine, Krista; Virk, Hafeez Ul Hassan; Hachem, Karim El; Lerma, Edgar V; Kiernan, Michael S; Rangaswami, Janani; Krittanawong, Chayakrit.
  • Kim JA; Department of Medicine, Baylor College of Medicine, Houston, TX.
  • Wu L; Cardiovascular Division, the University of Alabama at Birmingham, Birmingham, AL.
  • Rodriguez M; John T Milliken Department of Medicine, Division of Cardiovascular disease, Barnes-Jewish Hospital/Washington University in St. Louis School of Medicine, St. Louis, MO.
  • Lentine K; Center for Abdominal Transplantation, Saint Louis University, St. Louis, Missouri.
  • Virk HUH; Harrington Heart & Vascular Institute, Case Western Reserve University, University Hospitals Cleveland Medical Center, Cleveland, OH.
  • Hachem KE; Division of Nephrology, Icahn School of Medicine at Mount Sinai, Mount Sinai Hospital, New York, NY.
  • Lerma EV; Division of Nephrology, University of Illinois at Chicago, Chicago, USA.
  • Kiernan MS; CardioVascular Center, Tufts Medical Center, Boston MA.
  • Rangaswami J; George Washington University School of Medicine, Washington, DC.
  • Krittanawong C; 1Cardiology Division, NYU Langone Health and NYU School of Medicine, New York, NY, USA.
Curr Probl Cardiol ; : 101509, 2022 Nov 16.
Article in English | MEDLINE | ID: covidwho-2231904
ABSTRACT
Cardiorenal syndrome (CRS) is increasingly recognized diagnostic entity associated with high morbidity and mortality among acutely ill heart failure (HF) patients with acute and/ or chronic kidney diseases (CKD). While traditionally viewed as a state of decline in glomerular filtration rate (GFR) due to decreased renal perfusion, mainly due to therapeutic interventions to relieve congestive in HF, Recent insights into the underlying pathophysiologic mechanisms of CRS led to a broader definition and further classification of CRS into five distinct types. In this comprehensive review, we discuss the classification of CRS, highlighting the underlying common pathogenetic pathways of heart failure and kidney injury, including increased congestion, neurohormonal dysregulation, oxidative stress as well as inflammation, and cytokine storm that are particularly evident in COVID-19 patients with multiorgan failure and also in those with other disorders including sepsis, systemic lupus erythematosus and amyloidosis. In this review we also present the recent advances in the diagnostic strategies of CRS including cardiac and renal biomarkers as well as advanced cardiac and renal imaging techniques that are available to aid in the diagnosis as well as in the prognostication of this disorder. Finally, we discuss the various therapeutic options available to-date, including fluid optimization, hemofiltration, renal replacement therapy as well as the role of SGLT2 inhibitors in light of recent data from RCTs. It is important to note that, CRS population are either excluded or underrepresented, at best, in major RCTs and therefore, therapeutic recommendations are largely extrapolated from FH and CKD clinical trials.
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Full text: Available Collection: International databases Database: MEDLINE Type of study: Experimental Studies / Prognostic study Language: English Journal: Curr Probl Cardiol Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Experimental Studies / Prognostic study Language: English Journal: Curr Probl Cardiol Year: 2022 Document Type: Article