title: A Clinical Approach to the Acute Cardiorenal Syndrome.
abstract: Acute kidney injury is a frequent complication of acute heart failure syndromes, portending an adverse prognosis. Acute cardiorenal syndrome represents a unique form of acute kidney injury specific to acute heart failure syndromes. The pathophysiology of acute cardiorenal syndrome involves renal venous congestion, ineffective forward flow, and impaired renal autoregulation caused by neurohormonal activation. Biomarkers reflecting different aspects of acute cardiorenal syndrome pathophysiology may allow patient phenotyping to inform prognosis and treatment. Adjunctive vasoactive, neurohormonal, and diuretic therapies may relieve congestive symptoms and/or improve renal function, but no single therapy has been proved to reduce mortality in acute cardiorenal syndrome.
authors.affiliation: Department of Critical Care Medicine, UPMC Presbyterian Hospital, University of Pittsburgh Medical Center, 200 Lothrop Street, Pittsburgh, PA 15213, USA.
authors.forename: Jacob C
authors.initials: JC
authors.lastname: Jentzer
authors.affiliation: Division of Intensive Care Medicine, Department of Medicine, Washington DC Veterans Affairs Medical Center, 50 Irving Street, Washington, DC 20422, USA; Division of Nephrology, Department of Medicine, Washington DC Veterans Affairs Medical Center, 50 Irving Street, Washington, DC 20422, USA. Electronic address: minkchawla@gmail.com.
authors.forename: Lakhmir S
authors.initials: LS
authors.lastname: Chawla
mesh_terms: D000208:Acute Disease; D015415:Biomarkers / Q000097:blood / Q000652:urine; D059347:Cardio-Renal Syndrome / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy*; D002316:Cardiotonic Agents / Q000627:therapeutic use; D004232:Diuretics / Q000627:therapeutic use*; D005440:Fluid Therapy; D005919:Glomerular Filtration Rate; D006440:Hemofiltration; D006801:Humans; D045283:Natriuretic Agents / Q000627:therapeutic use; D020097:Natriuretic Peptide, Brain / Q000627:therapeutic use; D011379:Prognosis; D014665:Vasodilator Agents / Q000627:therapeutic use
chemical_list: D015415:Biomarkers; D002316:Cardiotonic Agents; D004232:Diuretics; D045283:Natriuretic Agents; D014665:Vasodilator Agents; D020097:Natriuretic Peptide, Brain
keywords: Acute heart failure syndromes; Acute kidney injury; Cardiorenal syndrome; Chronic kidney disease; Diuretics; Heart failure; Ultrafiltration