title: Cardio-Pulmonary-Renal Interactions: A Multidisciplinary Approach.
abstract: Over the past decade, science has greatly advanced our understanding of interdependent feedback mechanisms involving the heart, lung, and kidney. Organ injury is the consequence of maladaptive neurohormonal activation, oxidative stress, abnormal immune cell signaling, and a host of other mechanisms that precipitate adverse functional and structural changes. The presentation of interorgan crosstalk may include an acute, chronic, or acute on chronic timeframe. We review the current, state-of-the-art understanding of cardio-pulmonary-renal interactions and their related pathophysiology, perpetuating nature, and cycles of increased susceptibility and reciprocal progression. To this end, we present a multidisciplinary approach to frame the diverse spectrum of published observations on the topic. Assessment of organ functional reserve and use of biomarkers are valuable clinical strategies to screen and detect disease, assist in diagnosis, assess prognosis, and predict recovery or progression to chronic disease.
authors.affiliation: International Renal Research Institute of Vicenza, San Bortolo Hospital, Vicenza, Italy; Department of Internal Medicine II, University Clinic Giessen and Marburg Lung Center, Member of the German Center for Lung Research-Campus Giessen, Giessen, Germany. Electronic address: faeqhusain@yahoo.de.
authors.forename: Faeq
authors.initials: F
authors.lastname: Husain-Syed
authors.affiliation: Baylor University Medical Center, Baylor Heart and Vascular Institute, Baylor Jack and Jane Hamilton Heart and Vascular Hospital, Dallas, Texas; The Heart Hospital, Plano, Texas.
authors.forename: Peter A
authors.initials: PA
authors.lastname: McCullough
authors.affiliation: Department of Internal Medicine II, University Clinic Giessen and Marburg Lung Center, Member of the German Center for Lung Research-Campus Giessen, Giessen, Germany.
authors.forename: Horst-Walter
authors.initials: HW
authors.lastname: Birk
authors.affiliation: Department of Internal Medicine I, Division of Cardiology and Angiology, University Clinic Giessen and Marburg-Campus Giessen, Giessen, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Renker
authors.affiliation: International Renal Research Institute of Vicenza, San Bortolo Hospital, Vicenza, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Brocca
authors.affiliation: Department of Internal Medicine II, University Clinic Giessen and Marburg Lung Center, Member of the German Center for Lung Research-Campus Giessen, Giessen, Germany.
authors.forename: Werner
authors.initials: W
authors.lastname: Seeger
authors.affiliation: International Renal Research Institute of Vicenza, San Bortolo Hospital, Vicenza, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Ronco
mesh_terms: D059347:Cardio-Renal Syndrome / Q000175:diagnosis* / Q000378:metabolism; D003952:Diagnostic Imaging / Q000379:methods*; D019468:Disease Management; D018450:Disease Progression; D006801:Humans; D018384:Oxidative Stress; D011379:Prognosis; D012131:Respiratory Insufficiency / Q000175:diagnosis* / Q000378:metabolism
keywords: acute kidney injury; acute respiratory distress syndrome; cardiorenal syndromes; chronic kidney disease; heart failure; pulmonary hypertension