scholarly journals 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)

2013 ◽  
pp. 117-136 ◽  
Author(s):  
Dinna N. Cruz ◽  
Kai M. Schmidt-Ott ◽  
Giorgio Vescovo ◽  
Andrew A. House ◽  
John A. Kellum ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Cardiorenal Syndrome ◽  
Consensus Conference ◽  
Syndrome Type ◽  
Acute Dialysis

scholarly journals Chronic Heart Failure and Comorbid Renal Dysfunction - A Focus on Type 2 Cardiorenal Syndrome

2016 ◽  
Vol 12 (3) ◽  
pp. 186-194 ◽  
Author(s):  
Jois Preeti ◽  
Mebazaa Alexandre ◽  
Pupalan Iyngkaran ◽  
Thomas C. Merlin ◽  
Ronco Claudio
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Renal Dysfunction ◽  
Cardiorenal Syndrome

scholarly journals Peritoneal Dialysis for Chronic Congestive Heart Failure

2015 ◽  
Vol 40 (1) ◽  
pp. 45-52 ◽  
Author(s):  
Karlien François ◽  
Claudio Ronco ◽  
Joanne M. Bargman
Keyword(s):  
Heart Failure ◽  
Peritoneal Dialysis ◽  
Clinical Symptoms ◽  
Positive Impact ◽  
Cardiorenal Syndrome ◽  
Current Evidence ◽  
Chronic Congestive Heart Failure ◽  
Syndrome Type ◽  
Fluid Removal

Maladaptive responses between a failing heart and the kidneys ultimately lead to permanent chronic kidney disease, referred to as cardiorenal syndrome type 2. In this narrative review, we discuss the pathophysiological pathways in the progression of cardiorenal failure and review the current evidence on peritoneal dialysis as a treatment strategy in cardiorenal syndrome type 2. A patient with heart failure can present with clinical symptoms related to venous congestion even in the absence of end-stage renal disease. Diuretics remain the cornerstone for the treatment of fluid overload related to heart failure. However, with chronic use, diuretic resistance can supervene. When medical therapy is no longer able to relieve congestive symptoms, ultrafiltration might be needed. Patients with heart failure tolerate well the gentle rate of fluid removal through peritoneal dialysis. Recent publications suggest a positive impact of starting peritoneal dialysis in patients with cardiorenal syndrome type 2 on the hospitalisation rate, functional status and quality of life.

scholarly journals CARDIORENAL SYNDROME IN PATIENTS WITH CHRONIC HEART FAILURE AS A STAGE OF THE CARDIORENAL CONTINUUM (PART I): DEFINITION, CLASSIFICATION, PATHOGENESIS, DIAGNOSIS, EPIDEMIOLOGY

2019 ◽  
Vol 9 (1) ◽  
pp. 5-22 ◽  
Author(s):  
E. V. Reznik ◽  
I. G. Nikitin
Keyword(s):  
Heart Failure ◽  
Acute Kidney Injury ◽  
Chronic Heart Failure ◽  
Impaired Renal Function ◽  
Prognostic Value ◽  
Kidney Injury ◽  
Cardiorenal Syndrome ◽  
Syndrome Type ◽  
Patients With Heart Failure

The combination of heart failure and renal failure is called cardiorenal syndrome. It is a stage of the cardiorenal continuum and, possibly, a small link of the cardiorenal-cerebral-metabolic axis. Despite the fact that the phrase “cardiorenal syndrome” and its five types have become a part of the medical lexicon, many aspects of this problem are still not clear. Cardiorenal syndrome can be diagnosed in 32-90.3% of patients with heart failure. Cardiorenal syndrome type 1 or 2 develops in most cases of heart failure: cardiorenal syndrome presents with the development ofchronic kidney disease in patients with chronic heart failure and acute kidney injury in patients with acute heart failure. Impaired renal function has an unfavorable prognostic value. It leads to an increase in the mortality of patients with heart failure. It is necessary to timely diagnose the presence of cardiorenal syndrome and take into account its presence when managing patients with heart failure. Further researches are needed on ways toprevent the development and prevent the progression of kidney damage in patients with heart failure, to which the efforts of the multidisciplinary team should be directed. The first part of this review examines the currently definition, classification, pathogenesis, epidemiology and prognosis of cardiorenal syndrome in patients with heart failure.

scholarly journals The Role of Congestion in Cardiorenal Syndrome Type 2: New Pathophysiological Insights into an Experimental Model of Heart Failure

2015 ◽  
Vol 6 (1) ◽  
pp. 61-72 ◽  
Author(s):  
Annalisa Angelini ◽  
Chiara Castellani ◽  
Grazia Maria Virzì ◽  
Marny Fedrigo ◽  
Gaetano Thiene ◽  
...  
Keyword(s):  
Heart Failure ◽  
Kidney Injury ◽  
Cardiorenal Syndrome ◽  
Heart Tissue ◽  
Heart Cell ◽  
Tubular Damage ◽  
Syndrome Type ◽  
Neutrophil Gelatinase Associated Lipocalin

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. Signs of hypertrophy and dilatation of the right ventricle demonstrated the occurrence of HF. Brain natriuretic peptide (BNP), serum creatinine (sCreatinine), both kidney and heart neutrophil gelatinase-associated lipocalin (NGAL), matrix metallopeptidase 9 (MMP9), serum cytokines as well as kidney and heart cell death, as assessed by TUNEL, were studied. Results: Rats with HF showed higher BNP levels [chronic HF (CHF) 4.8 ± 0.5 ng/ml; controls 1.5 ± 0.2 ng/ml; p < 0.0001], marked RV hypertrophy and dilatation (RV mass/RV volume: CHF 1.46 ± 0.31, controls 2.41 ± 0.81; p < 0.01) as well as pleural and peritoneal effusions. A significant increase in proinflammatory cytokines and sCreatinine was observed (CHF 3.06 ± 1.3 pg/ml vs. controls 0.54 ± 0.23 pg/ml; p = 0.04). Serum (CHF 562.7 ± 93.34 ng/ml vs. controls 245.3 ± 58.19 ng/ml; p = 0.02) as well as renal and heart tissue NGAL levels [CHF 70,680 ± 4,337 arbitrary units (AU) vs. controls 32,120 ± 4,961 AU; p = 0.001] rose significantly, and they were found to be complexed with MMP9 in CHF rats. A higher number of kidney TUNEL-positive tubular cells was also detected (CHF 114.01 ± 45.93 vs. controls 16.36 ± 11.60 cells/mm2; p = 0.0004). Conclusion: In this model of CHF with prevalent congestion, kidney injury is characterized by tubular damage and systemic inflammation. The upregulated NGAL complexed with MMP9 perpetuates the vicious circle of kidney/heart damage by enhancing the enzymatic activity of MMP9 with extracellular matrix degradation, worsening heart remodeling.

Cytokine status and matrix metalloproteinase-9 in patients with cardiorenal syndrome with chronic heart failure and type 2 diabetes

2014 ◽  
Vol 18 (4 (72)) ◽  
Author(s):  
A. V. Narizhna ◽  
P. G. Kravchun ◽  
N. G. Ryndina
Keyword(s):  
Heart Failure ◽  
Type 2 Diabetes ◽  
Chronic Heart Failure ◽  
Functional State ◽  
Cardiorenal Syndrome ◽  
Diabetes Type ◽  
The Relationship ◽  
Metalloproteinase 9

The aim is to assess the existence and nature of the relationship between cytokine status on the basis of the determination of pro-inflammatory IL-1β, anti-IL-10, the functional state of the kidneys and the indicator fibrolysis MMP-9 in patients with CRS against the background of chronic heart failure and 2 diabetes type. The imbalance in the system of cytokines was associated with hyperactivity of antifibrotic factor MMP-9 in patients with CRS with a chronic heart failure and type 2 diabetes as a background. High levels of MMP-9 are involved in disorders of the functional state of kidneys, more pronounced changes in the tubulointerstitial component less - tubular. Study is to determine the prospects predictor’s values of MMP-9 in progress of CRS with the background of CHF and type 2 diabetes.

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