Unraveling Chronic Cardiovascular and Kidney Disorder through the Butterfly Effect

Diagnostics (Basel). 2024 Feb 20;14(5):463. doi: 10.3390/diagnostics14050463.

Abstract

Chronic Cardiovascular and Kidney Disorder (CCKD) represents a growing challenge in healthcare, characterized by the complex interplay between heart and kidney diseases. This manuscript delves into the "butterfly effect" in CCKD, a phenomenon in which acute injuries in one organ lead to progressive dysfunction in the other. Through extensive review, we explore the pathophysiology underlying this effect, emphasizing the roles of acute kidney injury (AKI) and heart failure (HF) in exacerbating each other. We highlight emerging therapies, such as renin-angiotensin-aldosterone system (RAAS) inhibitors, SGLT2 inhibitors, and GLP1 agonists, that show promise in mitigating the progression of CCKD. Additionally, we discuss novel therapeutic targets, including Galectin-3 inhibition and IL33/ST2 pathway modulation, and their potential in altering the course of CCKD. Our comprehensive analysis underscores the importance of recognizing and treating the intertwined nature of cardiac and renal dysfunctions, paving the way for more effective management strategies for this multifaceted syndrome.

Keywords: acute injury and long-term aftereffects; butterfly effect; cardiorenal syndrome; cardiovascular chronic kidney disorder; vicious circle.

Publication types

  • Review

Grants and funding

This research was funded by the Société Française de Néphrologie, Dialyse et Transplantation, Bourse recherche 2023. Dimitri Bedo was funded by the Année Recherche, ARS Bas Rhin grant 2023–2024.