Cardiorenal Syndrome: Pathophysiology

Overview

Journal Cardiol Clin

Publisher Elsevier

Specialty Cardiology & Vascular Diseases

Date 2019 Jul 8

PMID 31279419

Citations 71

Authors

Ujjala Kumar

Nicholas Wettersten

Pranav S Garimella

Affiliations

Soon will be listed here.

Abstract

Cardiorenal syndrome commonly refers to the collective dysfunction of heart and kidney resulting in a cascade of feedback mechanism causing damage to both the organs and is associated with adverse clinical outcomes. The pathophysiology of cardiorenal syndrome is complex, multifactorial, and dynamic. Improving the understanding of disease mechanisms will aid in developing targeted pharmacologic and nonpharmacologic therapies for the management of this syndrome. This article discusses the various mechanisms involved in the pathophysiology of the cardiorenal syndrome.

Citing Articles

Uric Acid to Albumin Ratio: A Predictive Marker for Acute Kidney Injury in Isolated Tricuspid Valve Surgery.

Liao Y, Li L, Li J, Zhao F, Zhang C Rev Cardiovasc Med. 2025; 26(2):26391.

PMID: 40026514 PMC: 11868903. DOI: 10.31083/RCM26391.

Sodium-Glucose-Cotransporter-2 Inhibitor Therapy and Intermitted Fasting in Cardiorenal Syndrome: The Role of Glucose-Mediated Oxidative Stress.

Schroder K J Clin Med. 2025; 14(3).

PMID: 39941418 PMC: 11818847. DOI: 10.3390/jcm14030746.

Gut Dysbiosis and Probiotic Therapy in Chronic Kidney Disease: A Comprehensive Review.

Ribeiro F, de Luna Freire M, de Oliveira Coutinho D, de Santana Cirilo M, Alves J Probiotics Antimicrob Proteins. 2024; .

PMID: 39668321 DOI: 10.1007/s12602-024-10427-9.

Correlation analysis of AVPR1a and AVPR2 with abnormal water and sodium and potassium metabolism in rats.

Sun K, Qiu Y, Sun Y Open Life Sci. 2024; 19(1):20220949.

PMID: 39588122 PMC: 11588004. DOI: 10.1515/biol-2022-0949.

Butyrate-Mediated Modulation of Paraoxonase-1 Alleviates Cardiorenometabolic Abnormalities in a Rat Model of Polycystic Ovarian Syndrome.

Olaniyi K, Areloegbe S, Badejogbin O, Ajadi I, Ajadi M Cardiovasc Drugs Ther. 2024; .

PMID: 39549177 DOI: 10.1007/s10557-024-07649-y.

References

Testani J, McCauley B, Chen J, Coca S, Cappola T, Kimmel S . Clinical characteristics and outcomes of patients with improvement in renal function during the treatment of decompensated heart failure. J Card Fail. 2011; 17(12):993-1000. PMC: 3248245. DOI: 10.1016/j.cardfail.2011.08.009. View

Astor B, Hallan S, Miller 3rd E, Yeung E, Coresh J . Glomerular filtration rate, albuminuria, and risk of cardiovascular and all-cause mortality in the US population. Am J Epidemiol. 2008; 167(10):1226-34. DOI: 10.1093/aje/kwn033. View

Di Lullo L, Bellasi A, Barbera V, Russo D, Russo L, Di Iorio B . Pathophysiology of the cardio-renal syndromes types 1-5: An uptodate. Indian Heart J. 2017; 69(2):255-265. PMC: 5415026. DOI: 10.1016/j.ihj.2017.01.005. View

Haase M, Muller C, Damman K, Murray P, Kellum J, Ronco C . Pathogenesis of cardiorenal syndrome type 1 in acute decompensated heart failure: workgroup statements from the eleventh consensus conference of the Acute Dialysis Quality Initiative (ADQI). Contrib Nephrol. 2013; 182:99-116. DOI: 10.1159/000349969. View

Neuhofer W, Pittrow D . Role of endothelin and endothelin receptor antagonists in renal disease. Eur J Clin Invest. 2006; 36 Suppl 3:78-88. DOI: 10.1111/j.1365-2362.2006.01689.x. View

Denton K, Shweta A, Anderson W . Preglomerular and postglomerular resistance responses to different levels of sympathetic activation by hypoxia. J Am Soc Nephrol. 2001; 13(1):27-34. DOI: 10.1681/ASN.V13127. View

Virzi G, Clementi A, De Cal M, Brocca A, Day S, Pastori S . Oxidative stress: dual pathway induction in cardiorenal syndrome type 1 pathogenesis. Oxid Med Cell Longev. 2015; 2015:391790. PMC: 4364374. DOI: 10.1155/2015/391790. View

Bardoux P, Martin H, Ahloulay M, Schmitt F, Bouby N, Trinh-Trang-Tan M . Vasopressin contributes to hyperfiltration, albuminuria, and renal hypertrophy in diabetes mellitus: study in vasopressin-deficient Brattleboro rats. Proc Natl Acad Sci U S A. 1999; 96(18):10397-402. PMC: 17899. DOI: 10.1073/pnas.96.18.10397. View

Johnson M, Malvin R . Stimulation of renal sodium reabsorption by angiotensin II. Am J Physiol. 1977; 232(4):F298-306. DOI: 10.1152/ajprenal.1977.232.4.F298. View

10.

Grune T, Sommerburg O, Siems W . Oxidative stress in anemia. Clin Nephrol. 2000; 53(1 Suppl):S18-22. View

11.

Bellomo R, Chapman M, Finfer S, Hickling K, Myburgh J . Low-dose dopamine in patients with early renal dysfunction: a placebo-controlled randomised trial. Australian and New Zealand Intensive Care Society (ANZICS) Clinical Trials Group. Lancet. 2001; 356(9248):2139-43. DOI: 10.1016/s0140-6736(00)03495-4. View

12.

Damman K, van Deursen V, Navis G, Voors A, Van Veldhuisen D, Hillege H . Increased central venous pressure is associated with impaired renal function and mortality in a broad spectrum of patients with cardiovascular disease. J Am Coll Cardiol. 2009; 53(7):582-588. DOI: 10.1016/j.jacc.2008.08.080. View

13.

Lekawanvijit S . Cardiotoxicity of Uremic Toxins: A Driver of Cardiorenal Syndrome. Toxins (Basel). 2018; 10(9). PMC: 6162485. DOI: 10.3390/toxins10090352. View

14.

Rubattu S, Mennuni S, Testa M, Mennuni M, Pierelli G, Pagliaro B . Pathogenesis of chronic cardiorenal syndrome: is there a role for oxidative stress?. Int J Mol Sci. 2013; 14(11):23011-32. PMC: 3856103. DOI: 10.3390/ijms141123011. View

15.

Granata S, Zaza G, Simone S, Villani G, Latorre D, Pontrelli P . Mitochondrial dysregulation and oxidative stress in patients with chronic kidney disease. BMC Genomics. 2009; 10:388. PMC: 2737002. DOI: 10.1186/1471-2164-10-388. View

16.

Torzewski J, Torzewski M, BOWYER D, Frohlich M, Koenig W, Waltenberger J . C-reactive protein frequently colocalizes with the terminal complement complex in the intima of early atherosclerotic lesions of human coronary arteries. Arterioscler Thromb Vasc Biol. 1998; 18(9):1386-92. DOI: 10.1161/01.atv.18.9.1386. View

17.

Hostetter T, Pfeffer J, Pfeffer M, Dworkin L, Braunwald E, Brenner B . Cardiorenal hemodynamics and sodium excretion in rats with myocardial infarction. Am J Physiol. 1983; 245(1):H98-103. DOI: 10.1152/ajpheart.1983.245.1.H98. View

18.

Ronco C, McCullough P, Anker S, Anand I, Aspromonte N, Bagshaw S . Cardio-renal syndromes: report from the consensus conference of the acute dialysis quality initiative. Eur Heart J. 2009; 31(6):703-11. PMC: 2838681. DOI: 10.1093/eurheartj/ehp507. View

19.

Berl T, Henrich W . Kidney-heart interactions: epidemiology, pathogenesis, and treatment. Clin J Am Soc Nephrol. 2007; 1(1):8-18. DOI: 10.2215/CJN.00730805. View

20.

Cruz D, Schmidt-Ott K, Vescovo G, House A, Kellum J, Ronco C . Pathophysiology of cardiorenal syndrome type 2 in stable chronic heart failure: workgroup statements from the eleventh consensus conference of the Acute Dialysis Quality Initiative (ADQI). Contrib Nephrol. 2013; 182:117-36. DOI: 10.1159/000349968. View