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Review
. 2014 Jan 6;18(1):201.
doi: 10.1186/cc13177.

Heart-kidney crosstalk and role of humoral signaling in critical illness

Grazia Virzì, Sonya Day, Massimo de Cal, Giorgio Vescovo, Claudio Ronco
Review

Heart-kidney crosstalk and role of humoral signaling in critical illness

Grazia Virzì et al. Crit Care. .

Abstract

Organ failure in the heart or kidney can initiate various complex metabolic, cell-mediated and humoral pathways affecting distant organs, contributing to the high therapeutic costs and significantly higher morbidity and mortality. The universal outreach of cells in an injured state has myriad consequences to distant organ cells and their milieu. Heart performance and kidney function are closely interconnected and communication between these organs occurs through a variety of bidirectional pathways. The term cardiorenal syndrome (CRS) is often used to describe this condition and represents an important model for exploring the pathophysiology of cardiac and renal dysfunction. Clinical evidence suggests that tissue injury in both acute kidney injury and heart failure has immune-mediated inflammatory consequences that can initiate remote organ dysfunction. Acute cardiorenal syndrome (CRS type 1) and acute renocardiac syndrome (CRS type 3) are particularly relevant in high-acuity medical units. This review briefly summarizes relevant research and focuses on the role of signaling in heart-kidney crosstalk in the critical care setting.

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Figures

Figure 1
Figure 1
Cardiorenal syndrome type 1 and cardiorenal syndrome type 3. (a) Cardiorenal syndrome (CRS) type 1 is characterized by acute worsening of heart function leading to acute kidney injury (AKI) and/or dysfunction. Acute cardiac events that may contribute to AKI include acute decompensated heart failure, acute coronary syndrome, cardiogenic shock and cardiac surgery-associated low cardiac output syndrome. (b) CRS type 3 is characterized by acute worsening of kidney function leading to acute cardiac injury and/or dysfunction, such as acute myocardial infarction, congestive heart failure, or arrhythmia. Conditions that may contribute to this syndrome include cardiac surgery-associated AKI, AKI after major noncardiac surgery, contrast-induced AKI, other drug-induced nephropathies, and rhabdomyolysis. ACE, angiotensin-converting enzyme; GFR, glomerular filtration rate; RAA, rennin-angiotensin-aldosterone.
Figure 2
Figure 2
Cellular types involved in heart–kidney crosstalk.
See this image and copyright information in PMC

Comment in

References

    1. Ronco C, Haapio M, House AA, Anavekar N, Bellomo R. Cardiorenal syndrome. J Am Coll Cardiol. 2008;52:1527–1539. doi: 10.1016/j.jacc.2008.07.051. - DOI - PubMed
    1. Goh CY, Vizzi G, De Cal M, Ronco C. Cardiorenal syndrome: a complex series of combined heart/kidney disorders. Contrib Nephrol. 2011;174:33–45. - PubMed
    1. McCullough PA, Kellum JA, Haase M, Müller C, Damman K, Murray PT, Cruz D, House AA, Schmidt-Ott KM, Vescovo G, Bagshaw SM, Hoste EA, Briguori C, Braam B, Chawla LS, Costanzo MR, Tumlin JA, Herzog CA, Mehta RL, Rabb H, Shaw AD, Singbartl K, Ronco C. Pathophysiology of the cardiorenal syndromes: executive summary from the eleventh consensus conference of the acute dialysis quality initiative (ADQI) Contrib Nephrol. 2013;182:82–98. - PubMed
    1. Bagshaw SM, Cruz DN, Aspromonte N, Daliento L, Ronco F, Sheinfeld G, Anker SD, Anand I, Bellomo R, Berl T, Bobek I, Davenport A, Haapio M, Hillege H, House A, Katz N, Maisel A, Mankad S, McCullough P, Mebazaa A, Palazzuoli A, Ponikowski P, Shaw A, Soni S, Vescovo G, Zamperetti N, Zanco P, Ronco C. Acute dialysis quality initiative consensus group: epidemiology of cardio-renal syndromes: workgroup statements from the 7th ADQI consensus conference. Nephrol Dial Transplant. 2010;25:1406–1416. doi: 10.1093/ndt/gfq066. - DOI - PubMed
    1. Grams ME, Rabb H. The distant organ effects of acute kidney injury. Kidney Int. 2012;81:942–948. doi: 10.1038/ki.2011.241. - DOI - PubMed

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