Cardio-renal syndrome – new clinical entity or just coexisting insufficiency of two organs? Review article
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Abstract
The interactions between the heart and the kidney recently have been the focus of intense interest because of epidemiological evidence indicating that even mild deterioration of renal function is an important risk factor for poor outcome in patients with congestive heart failure. Sharing many of the same risk factors, it is not surprising that heart failure and renal insufficiency should often coexist in the same patients. Since kidneys play an important role in heart disease and the heart plays a role in all patients with renal disease, cardiorenal interactions are becoming more and more important. The role of the kidney not only as a marker but also as a pathogenic factor in cardiorenal syndromes, whether primary heart or primary kidney disease or both are the initiators of the subsequent pathophysiological events. Renal dysfunction is a constant feature of congestive heart failure and is a stronger predictor of mortality than left ventricular ejection fraction or New York Heart Association classification. The recognition of the cardiorenal syndrome is an important determinant of prognosis. In many cases of heart failure, coexisting renal dysfunction, known as the cardiorenal syndrome, complicates treatment. With an understanding of the underlying etiology and physiology of the renal dysfunction, the appropriate therapy can improve the prognosis of patients with both heart failure and renal dysfunction.
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