CARDIORENAL AND RENOCARDIAL SYNDROMES
https://doi.org/10.24884/1561-6274-2009-13-4-59-63
Abstract
THE AIM. Cardiorenal syndrome (CRS) – pathophysiological state in which acute or chronic dysfunction of one organ leads to acute or chronic dysfunction of another. The purpose of this study - to present characteristics of patients who have chronic heart failure associated with chronic kidney disease. PATIENTS AND METHODS. The study involved 368 patients (187 – male, 181 – female) with chronic heart failure (CHF) II-IV FC at the age of 18 to 84 years (average age – 60 ± 10 years). The majority of patients – 247 (67%) had heart failure with preserved ejection fraction. Glomerular filtration rate was calculated by the MDRD formula, chronic kidney disease diagnosed according to NKF-K/DOQI, Guidelines, 2002. RESULTS. GFR was 68,8 ± 20,9 ml/min/1.73 m2 (from 18.4 to 142.6 ml/min/1, 73 m2), while in 136 (37%) patients had GFR <60 ml/min/1.73 m2 . Patients with CKD were older, predominantly women, among them there were more patients with diabetes. 42 patients had diabetes mellitus and to determine the causal relationship between cardiac and renal dysfunction was not possible. CONCLUSION. Renal impairment occurs in one third of patients with chronic heart failure (chronic cardiorenal syndrome). In patients with diabetes mellitus revealed causal relationship between the pathology of heart and kidney in many cases impossible, these clinical situations are not reasonably regarded as cardiorenal or renocardial syndromes. Need to develop uniform criteria for cardiorenal relationships (renocardial and cardiorenal syndrome), an option the authors proposed a variant of classification.
About the Authors
A. I. Shutov
Ульяновский государственный университет, г.Ульяновск
Russian Federation
Russian Federation
V. A. Serov
Ульяновский государственный университет, г.Ульяновск
Russian Federation
Russian Federation
References
1. Ronco C, Haapio C, House AA et al. Саrdiorenal syndrome. J Am Coll Cardiol 2008;52(19):1527-1539
2. Национальные Рекомендации ВНОК и ОССН по диагностике и лечению ХСН (второй пересмотр). Сердечная недостаточность. 2007;1:4-41
3. National Kidney Foundation. K/DOQI Clinical Practice Guidelines for Chronic Kidney Disease: Evaluation, Classification and Stratification. Am J Kidney Dis 2002; 39 (suppl 1):S1-S266
4. Butler J. Addressing the challenges of cardiorenal syndrome. Clevelend Clinic Journal of Medicine 2006; 73(5): 485-491
5. Shlipak MG, Massie BM. The Clinical Challenge of Cardiorenal Syndrome. Circulation 2004;110:1514-1517
6. Portoles PJ, Cuevas BX. Cardiorenal syndrome. Nefrologia 2008; 28 [Suppl 3]: 29-32
7. Bongartz LG, Cramer MJ, Doevendans PA et al. The severe cardiorenal syndrome: ‘Guyton revisited’. Eur Heart J 2005; 26:11-17
8. Kociol R, Rogers J, Shaw A. Organ cross talk in the critically ill: the heart and kidney. Blood Purif 2009; 27(4):311-320.
9. Мухин НА, Фомин ВВ, Моисеев СВ и др. Кардиоренальный синдром при ишемической болезни почек (атеросклеротической реноваскулярной гипертонии) Тер архив 2008; 8: 30-38
10. Schrier RW. Cardiorenal versus renocardiac syndrome: Is there a difference? Nat Clin Pract Nephrol 2007; 3: 637
11. van Kimmenade RRJ, Pinto Y, Januzzi JL. When renal and cardiac insufficiencies intersect: is there a role for natriuretic peptide testing in the ‘cardio-renal syndrome’?
12. Knight EL, Glynn RJ, McIntyre KM et al. Predictors of decreased renal function with heart failure during angiotensin-converting enzyme inhibitor therapy: results from studies of left ventricular dysfunction. Am Heart J 1999; 138: 849-855
13. Dries DL, Exner DV, Domaski MJ et al. The prognostic implications of renal insufficiency in asymptomatic and symptomatic patients with left ventricular systolic dysfunction. J Am Coll Cardiol 2000; 35: 681-689
14. Серов ВА, Шутов АМ, Сучков ВН и др. Прогностическое значение снижения функции почек у больных с хронической сердечной недостаточностью. Нефрология и диализ 2008; 3–4: 214-218
15. Hillege HL, Nisch D, Pfeffer MA et al. Renal function as a predictor of outcome in a broad spectrum of patients with heart failure. Circulation 2006;113: 671-678
16. Amsalem Y, Garty M, Schwartz R. Prevalence and significance of unrecognized renal insufficiency in patients with heart failure. Eur Heart J 2008; 29: 1029-1036
17. Francis G. Acute decompensated heart failure: The cardiorenal syndrome. Clev Clin J Med 2006; 73[Suppl 2]: S8-13
18. Bhatia RS, Ty JV, Lee DS et al. Outcome of heart failure with preserved ejection fraction in a population-based study. N Engl J Med 2006; 355: 260-269
19. Brosius FC, Hostetter TH, Kelepouris E et al. Detection of chronic kidney disease in patients with or at increased risk of cardiovascular disease. Circulation 2006;114(10):1083-1087
20. Butler J, Forman DE, Abraham WT et al. Relationship between heart failure treatment and development of worsening renal function among hospitalized patients. Am Heart J 2004; 147:331-338
21. Neuberg GW, Miller AB, O’Connor CM et al. Diuretic resistance predicts mortality in patients with advanced heart failure (Prospective Randomized Amlodipine Survival Evaluation). Am Heart J 2002; 144: 31-38
22. Liang KV, Williams AW, Greene EL, Redfield MM. Acute decompensated heart failure and the cardiorenal syndrome. Crit Care Med 2008; 36: S75-88
23. Heymes C, Bendall JK, Ratajczak P et al. Increased myocardial NADPH oxidase activity in human heart failure. J Am Coll Cardiol 2003; 41: 2164-2171
24. Moe GW, Rouleau JL, Nguyen QT et al. Role of endothelins in congestive heart failure. Can J Physiol Pharmacol 2003; 81: 588-597
25. Guyton AC. The surprising kidney-fluid mechanism for pressure control–its infinite gain! Hypertension 1990;16:725-730
26. Pokhrel N, Maharjan N, Dhakal B, Arora RR. Cardiorenal syndrome: A literature review. Exp Clin Cardiol 2008;13(4):165-170
27. Шутов АМ, Серов ВА, Гердт АМ и др. Хроническая болезнь почек предрасполагает к фибрилляции предсердий у больных с хронической сердечной недостаточностью. Нефрология 2008; 4: 49-53
28. Диагностика и лечение метаболического синдрома. Российские рекомендации, Москва, 2007. Кардиоваскулярная терапия и профилактика 2007; 6(приложение 2)
Review
For citations:
Shutov A.I., Serov V.A. CARDIORENAL AND RENOCARDIAL SYNDROMES. Nephrology (Saint-Petersburg). 2009;13(4):59-63. (In Russ.) https://doi.org/10.24884/1561-6274-2009-13-4-59-63
Views:
4375
Email this article 