title: Advances in the pathogenesis of cardiorenal syndrome type 3.
abstract: Cardiorenal syndrome (CRS) type 3 is a subclassification of the CRS whereby an episode of acute kidney injury (AKI) leads to the development of acute cardiac injury or dysfunction. In general, there is limited understanding of the pathophysiologic mechanisms involved in CRS type 3. An episode of AKI may have effects that depend on the severity and duration of AKI and that both directly and indirectly predispose to an acute cardiac event. Experimental data suggest that cardiac dysfunction may be related to immune system activation, inflammatory mediators release, oxidative stress, and cellular apoptosis which are well documented in the setting of AKI. Moreover, significant derangements, such as fluid and electrolyte imbalance, metabolic acidosis, and uremia, which are typical features of acute kidney injury, may impair cardiac function. In this review, we will focus on multiple factors possibly involved in the pathogenesis issues regarding CRS type 3.
authors.affiliation: Department of Nephrology and Dialysis, San Giovanni Di Dio, Agrigento 92100, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Clementi
authors.affiliation: Department of Nephrology, Dialysis and Transplant, San Bortolo Hospital, Vicenza 36100, Italy ; International Renal Research Institute Vicenza (IRRIV), Italy ; Clinical Genetics Unit, Department of Women's and Children's Health, University of Padua, Italy.
authors.forename: Grazia Maria
authors.initials: GM
authors.lastname: Virzì
authors.affiliation: Department of Nephrology, Dialysis and Transplant, San Bortolo Hospital, Vicenza 36100, Italy ; International Renal Research Institute Vicenza (IRRIV), Italy ; Department of Medicine (DIMED), University of Padova, Padova 35128, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Brocca
authors.affiliation: Department of Nephrology, Dialysis and Transplant, San Bortolo Hospital, Vicenza 36100, Italy ; International Renal Research Institute Vicenza (IRRIV), Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: de Cal
authors.affiliation: Department of Nephrology, Dialysis and Transplant, San Bortolo Hospital, Vicenza 36100, Italy ; International Renal Research Institute Vicenza (IRRIV), Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Pastori
authors.affiliation: Clinical Genetics Unit, Department of Women's and Children's Health, University of Padua, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Clementi
authors.affiliation: Department of Nephrology and Dialysis, San Giovanni Di Dio, Agrigento 92100, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Granata
authors.affiliation: Internal Medicine, San Bortolo Hospital, Vicenza 36100, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Vescovo
authors.affiliation: Department of Nephrology, Dialysis and Transplant, San Bortolo Hospital, Vicenza 36100, Italy ; International Renal Research Institute Vicenza (IRRIV), Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Ronco
mesh_terms: D058186:Acute Kidney Injury / Q000473:pathology; D056704:Adaptive Immunity; D017209:Apoptosis; D059347:Cardio-Renal Syndrome / Q000378:metabolism / Q000473:pathology*; D004573:Electrolytes / Q000378:metabolism; D044127:Epigenesis, Genetic; D006801:Humans; D007113:Immunity, Innate; D035683:MicroRNAs / Q000378:metabolism; D018384:Oxidative Stress
chemical_list: D004573:Electrolytes; D035683:MicroRNAs
references.citation: J Am Coll Cardiol. 1999 Feb;33(2):556-64
references.pmid: 9973039
references.citation: Kidney Int. 2007 Nov;72(9):1073-80
references.pmid: 17728706
references.citation: Semin Nephrol. 2012 Jan;32(1):31-9
references.pmid: 22365160
references.citation: J Immunol. 2006 Mar 1;176(5):3108-14
references.pmid: 16493070
references.citation: Amino Acids. 2003 Jun;24(4):375-81
references.pmid: 12768499
references.citation: J Immunol. 2006 Sep 1;177(5):3380-7
references.pmid: 16920979
references.citation: Atherosclerosis. 2008 Jan;196(1):405-412
references.pmid: 17173924
references.citation: Lancet. 1998 Aug;352 Suppl 1:SI34-8
references.pmid: 9736478
references.citation: ASAIO J. 1996 Sep-Oct;42(5):M911-5
references.pmid: 8945020
references.citation: Crit Care. 2012 Jul 27;16(4):R140
references.pmid: 22839577
references.citation: Kidney Int. 1999 Sep;56(3):922-31
references.pmid: 10469360
references.citation: J Am Coll Cardiol. 2008 Nov 4;52(19):1527-39
references.pmid: 19007588
references.citation: EMBO Mol Med. 2013 May;5(5):661-74
references.pmid: 23592557
references.citation: Crit Care Med. 2012 Jun;40(6):1753-60
references.pmid: 22610181
references.citation: J Innate Immun. 2010;2(3):216-27
references.pmid: 20375550
references.citation: Contrib Nephrol. 2013;182:137-57
references.pmid: 23689660
references.citation: Circulation. 2000 Mar 14;101(10):1130-7
references.pmid: 10715259
references.citation: Free Radic Biol Med. 2006 Jan 15;40(2):236-46
references.pmid: 16413406
references.citation: Clin Microbiol Rev. 2009 Apr;22(2):240-73, Table of Contents
references.pmid: 19366914
references.citation: Eur Heart J. 2005 Jan;26(1):11-7
references.pmid: 15615794
references.citation: Contrib Nephrol. 2010;164:39-45
references.pmid: 20427992
references.citation: N Engl J Med. 2008 Jul 3;359(1):7-20
references.pmid: 18492867
references.citation: Anesthesiology. 2012 May;116(5):1139-48
references.pmid: 22415388
references.citation: Heart. 2005 Aug;91(8):1094-5
references.pmid: 16020609
references.citation: J Inflamm (Lond). 2011 Apr 28;8:9
references.pmid: 21526997
references.citation: Circ Res. 2013 Aug 30;113(6):690-708
references.pmid: 23989713
references.citation: Proc Natl Acad Sci U S A. 1995 May 23;92(11):4862-6
references.pmid: 7539136
references.citation: Front Physiol. 2013 Sep 26;4:264
references.pmid: 24133451
references.citation: Nephrol Dial Transplant. 2010 May;25(5):1406-16
references.pmid: 20185818
references.citation: Transplantation. 2007 Aug 27;84(4):445-58
references.pmid: 17713425
references.citation: Nephron Exp Nephrol. 2008;109(4):e102-7
references.pmid: 18802372
references.citation: Nat Biotechnol. 2010 Oct;28(10):1057-68
references.pmid: 20944598
references.citation: Kidney Int. 2006 Aug;70(3):591-6
references.pmid: 16760907
references.citation: Kidney Int. 2008 Dec;74(12):1526-37
references.pmid: 18843253
references.citation: Cardiol Rev. 1999 Jul-Aug;7(4):196-206
references.pmid: 10423671
references.citation: Future Cardiol. 2011 Jul;7(4):485-97
references.pmid: 21797745
references.citation: Cardiorenal Med. 2011;1(4):243-254
references.pmid: 22096456
references.citation: Circ Res. 2004 Dec 10;95(12):1140-53
references.pmid: 15591236
references.citation: FASEB J. 2009 Mar;23(3):844-54
references.pmid: 18971259
references.citation: Circulation. 1993 Mar;87(3):893-9
references.pmid: 7680290
references.citation: Int Urol Nephrol. 2009;41(2):357-62
references.pmid: 19274487
references.citation: Cardiovasc Ultrasound. 2013 Nov 18;11:41
references.pmid: 24246005
references.citation: Contrib Nephrol. 2010;164:69-78
references.pmid: 20427995
references.citation: Crit Care. 2014 Jan 06;18(1):201
references.pmid: 24393300
references.citation: Exp Physiol. 2008 May;93(5):622-30
references.pmid: 18223026
references.citation: N Engl J Med. 2009 Oct 22;361(17):1627-38
references.pmid: 19846848
references.citation: Annu Rev Immunol. 1992;10:267-93
references.pmid: 1590988
references.citation: Contrib Nephrol. 2011;174:33-45
references.pmid: 21921607
references.citation: Ann N Y Acad Sci. 1995 Dec 29;771:219-33
references.pmid: 8597401
references.citation: Semin Nephrol. 2010 May;30(3):268-77
references.pmid: 20620671
references.citation: Nat Rev Immunol. 2006 Dec;6(12):907-18
references.pmid: 17124512
references.citation: Nat Clin Pract Nephrol. 2006 Aug;2(8):432-44
references.pmid: 16932478
references.citation: Clin Immunol. 2009 Jan;130(1):41-50
references.pmid: 18922742
references.citation: J Mol Cell Cardiol. 1997 Mar;29(3):859-70
references.pmid: 9152847
references.citation: J Clin Invest. 2007 Oct;117(10):2847-59
references.pmid: 17853945
references.citation: Exp Physiol. 1993 Jan;78(1):95-103
references.pmid: 8383505
references.citation: Circulation. 1998 Apr 14;97(14):1382-91
references.pmid: 9577950
references.citation: J Am Soc Nephrol. 2012 Jul;23(7):1258-70
references.pmid: 22626821
references.citation: J Clin Invest. 1996 Feb 15;97(4):1056-63
references.pmid: 8613529
references.citation: J Mol Cell Cardiol. 2003 Jul;35(7):851-9
references.pmid: 12818576
references.citation: Cardiovasc Res. 2004 Aug 15;63(3):443-9
references.pmid: 15276469
references.citation: Eur J Pharmacol. 2004 Mar 19;488(1-3):137-46
references.pmid: 15044045
references.citation: Am J Cardiol. 1995 Oct 15;76(11):803-8
references.pmid: 7572659
references.citation: Circulation. 1996 Nov 1;94(9):2193-200
references.pmid: 8901671
references.citation: J Am Soc Nephrol. 2003 Jun;14(6):1549-58
references.pmid: 12761255
references.citation: Clin Cardiol. 1998 Dec;21(12 Suppl 1):I20-4
references.pmid: 9853191
references.citation: Mediators Inflamm. 2009;2009:137072
references.pmid: 20182538
references.citation: Pharmacol Rev. 2000 Mar;52(1):11-34
references.pmid: 10699153
references.citation: Nature. 2012 Dec 20;492(7429):376-81
references.pmid: 23222520
references.citation: Semin Nephrol. 2013 Jul;33(4):327-40
references.pmid: 24011575
references.citation: Kidney Int. 2007 Apr;71(7):619-28
references.pmid: 17311071
references.citation: Am J Physiol Regul Integr Comp Physiol. 2003 Jul;285(1):R117-24
references.pmid: 12609817
references.citation: Intensive Care Med. 1995 Oct;21(10):826-31
references.pmid: 8557871
references.citation: Int J Nephrol. 2012;2012:505197
references.pmid: 21826270
references.citation: J Korean Med Sci. 2014 Apr;29(4):519-26
references.pmid: 24753699
references.citation: Int J Nephrol. 2010 Dec 28;2011:920195
references.pmid: 21253529
references.citation: JAMA. 1987 May 1;257(17):2318-24
references.pmid: 3553628
references.citation: J Am Soc Nephrol. 2011 Mar;22(3):416-25
references.pmid: 21335516
references.citation: Am J Physiol Renal Physiol. 2007 Sep;293(3):F741-7
references.pmid: 17567936
references.citation: J Immunol. 2007 May 1;178(9):5899-911
references.pmid: 17442974
references.citation: J Clin Invest. 2010 Jan;120(1):331-42
references.pmid: 20038794
references.citation: Minerva Urol Nefrol. 2009 Sep;61(3):171-88
references.pmid: 19773721
references.citation: Transplantation. 2002 Nov 15;74(9):1247-51
references.pmid: 12451261
references.citation: Crit Care Med. 2004 Nov;32(11):2358-9
references.pmid: 15640663
references.citation: Am J Physiol Renal Physiol. 2009 Oct;297(4):F961-70
references.pmid: 19656911
references.citation: JAMA. 1996 May 15;275(19):1489-94
references.pmid: 8622223
references.citation: Clin J Am Soc Nephrol. 2011 May;6(5):966-73
references.pmid: 21393482
references.citation: Nephrol Dial Transplant. 2011 Nov;26(11):3508-14
references.pmid: 21382993
references.citation: Trends Genet. 2002 Jun;18(6):275-7
references.pmid: 12044346
references.citation: Circ Res. 1994 Jun;74(6):1141-8
references.pmid: 8187280
references.citation: Int Rev Cell Mol Biol. 2012;298:229-317
references.pmid: 22878108