Working Toward an Improved Understanding of Chronic Cardiorenal Syndrome Type 4

Adv Chronic Kidney Dis. 2018 Sep;25(5):454-467. doi: 10.1053/j.ackd.2018.08.010.

Abstract

Chronic diseases of the heart and of the kidneys commonly coexist in individuals. Certainly combined and persistent heart and kidney failure can arise from a common pathologic insult, for example, as a consequence of poorly controlled hypertension or of severe diffuse arterial disease. However, strong evidence is emerging to suggest that cross talk exists between the heart and the kidney. Independent processes are set in motion when kidney function is chronically diminished, and these processes can have distinct adverse effects on the heart. The complex chronic heart condition that results from chronic kidney disease (CKD) has been termed cardiorenal syndrome type 4. This review will include an updated description of the cardiac morphology in patients who have CKD, an overview of the most likely CKD-sourced culprits for these cardiac changes, and the potential therapeutic strategies to limit cardiac complications in patients who have CKD.

Keywords: Cardiorenal syndrome; Chronic kidney disease; Heart failure.

Publication types

  • Review

MeSH terms

  • Cardio-Renal Syndrome / classification*
  • Cardio-Renal Syndrome / physiopathology
  • Cardio-Renal Syndrome / therapy
  • Chronic Disease
  • Comorbidity
  • Comprehension
  • Disease Progression
  • Female
  • Heart Failure / diagnosis*
  • Heart Failure / epidemiology*
  • Heart Failure / therapy
  • Heart Function Tests
  • Humans
  • Kidney Function Tests
  • Male
  • Prognosis
  • Renal Insufficiency, Chronic / diagnosis*
  • Renal Insufficiency, Chronic / epidemiology*
  • Renal Insufficiency, Chronic / therapy
  • Risk Assessment
  • Survival Analysis