Cardiorenal syndrome: clinical diagnosis, molecular mechanisms and therapeutic strategies

Acta Pharmacologica Sinica, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 5, 2025

Language: Английский

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Preoperative routine measurement of NT-proBNP predicts postoperative morbidity after non-cardiac surgery with intermediate or high surgical risk: an observational study

BMC Anesthesiology, Journal Year: 2024, Volume and Issue: 24(1)

Published: March 23, 2024

Abstract Background Chronic heart failure (HF) is a common clinical condition associated with adverse outcomes in elderly patients undergoing non-cardiac surgery. This study aimed to estimate clinically applicable NT-proBNP cut-off that predicts postoperative 30-day morbidity surgical cohort. Methods One hundred ninety-nine consecutive older than 65 years elective surgery intermediate or high risk were analysed. Preoperative was measured, and events assessed up day 30. The primary endpoint the composite (CME) consisting of rehospitalisation, acute decompensated (ADHF), kidney injury (AKI), infection at Secondary endpoints included perioperative fluid balance incidence, duration, severity hypotension. Results 443 pg/ml had highest accuracy predicting endpoint; 450 implemented compare endpoints. Although 35.2% above threshold, only 10.6% known history HF. infection. Event rates significantly increased > (70.7% vs. 32.4%, p < 0.001), which due incidence cardiac rehospitalisation (4.4% 0%, = 0.018), ADHF (20.1% 4.0%, AKI (39.8% 8.3%, (46.3% 24.4%, 0.01). Perioperative hypotension comparable between groups. an independent predictor CME multivariable Cox regression model (hazard ratio 2.92 [1.72–4.94]). Conclusions Patients exhibited profoundly morbidity. Further studies should focus on interdisciplinary approaches improve through integrated interventions period. Trial registration German Clinical Trials Register: DRKS00027871, 17/01/2022

Language: Английский

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Multiple roles of mitochondrial autophagy receptor FUNDC1 in mitochondrial events and kidney disease

Frontiers in Cell and Developmental Biology, Journal Year: 2024, Volume and Issue: 12

Published: Oct. 9, 2024

This article reviews the latest research progress on role of mitochondrial autophagy receptor FUN14 domain containing 1 (FUNDC1) in events and kidney disease. FUNDC1 is a protein located outer membrane mitochondria, which maintains function quality mitochondria by regulating autophagy, that is, selective degradation process mitochondria. The structural characteristics enable it to respond intracellular signal changes regulate activity through phosphorylation dephosphorylation. During phosphorylation, unc-51-like kinase (ULK1) promotes activation mitophagy phosphorylating Ser17 FUNDC1. In contrast, Src CK2 kinases inhibit interaction between LC3 Tyr18 Ser13, thereby inhibiting mitophagy. dephosphorylation, PGAM5 phosphatase enhances dephosphorylating activating BCL2L1 inhibits interacting with PGAM5, preventing dephosphorylation plays an important events, participating fission, maintaining homeostasis iron proteins matrix, mediating crosstalk endoplasmic reticulum lysosomes, have effects cell energy metabolism programmed death. aspect disease, abnormal closely related occurrence development many diseases. acute injury (AKI), cardiorenal syndrome (CRS), diabetic nephropathy (DN), chronic disease (CKD) ,renal fibrosis (RF) renal anemia, FUNDC1-mediated imbalance may be one key factors progression. Therefore, in-depth study regulatory mechanism great significance for understanding pathogenesis developing new treatment strategies.

Language: Английский

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Heart Failure—Focus on Kidney Replacement Therapy: Why, When, and How?

International Journal of Molecular Sciences, Journal Year: 2025, Volume and Issue: 26(6), P. 2456 - 2456

Published: March 10, 2025

Heart failure (HF) is a major health problem because of its high prevalence, morbidity, mortality, and cost care. An important contributor to morbidity mortality in patients with advanced HF kidney dysfunction. Almost half develop cardiorenal syndrome (CRS). The management complicated by CRS challenging. Two main strategies have been widely accepted for the CRS, namely improving cardiac output relieving congestion. Diuretics remain cornerstone first-line therapy decongestion; however, substantial number diuretic resistance. In face persistent congestion progressive deterioration function, implementation replacement may become only solution. review current evidence on extracorporeal peritoneal-based techniques are presented.

Language: Английский

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Inverse associations of the lifestyle critical 9 with cardiorenal syndrome: the mediating role of the dietary inflammatory index

Frontiers in Nutrition, Journal Year: 2025, Volume and Issue: 12

Published: March 13, 2025

Background Cardiorenal syndrome (CRS) represents a burgeoning global health concern characterized by its increasing prevalence. Life’s Crucial 9 (LC9), an innovative tool for cardiovascular assessment, and the Dietary Inflammatory Index (DII), which quantifies diet’s impact on body inflammation, have not been previously studied in conjunction regarding their association with CRS. Objective This study aims to explore relationship between LC9 CRS, using data from National Health Nutrition Examination Survey (NHANES), examine whether DII serves as mediator this association. Methods research included 25,792 NHANES participants spanning 2005 2018. The leverages dataset’s comprehensive representativeness robust statistical power ensure generalizable reliable findings. We employed weighted logistic regression evaluate scores CRS presence, conducted subgroup analyses, performed mediation analysis investigate role of DII. Results Our demonstrated significant inverse Upon controlling confounders, each 10-point rise correlates 26% reduction prevalence ( p &lt; 0.001). Additionally, stratifying into tertiles T1 reference group revealed that T2 (OR = 0.59, 95% CI 0.48–0.72, 0.001) T3 0.57, 0.38–0.88, exhibited strong negative correlation trend. dose–response curve illustrates linear CRS; increases, occurrence decreases. shows positive connection 0.001), but indicates decreasing trend when rises β −0.65, Mediation reveals mediates proportion 12.5% Conclusion findings indicate incidence, is associated relationship. suggests potential preventive strategies against through lifestyle modifications guided LC9.

Language: Английский

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Unraveling the cardiorenal metabolic syndrome: A deep dive into the Indian population’s health crisis

Annals of Medical Science and Research, Journal Year: 2025, Volume and Issue: 4(1), P. 4 - 10

Published: Jan. 1, 2025

Abstract Cardiorenal metabolic syndrome (CRMS) is emerging as a health crisis in the Indian population, marked by interplay of cardiovascular disease, renal dysfunction, and disorders. This study delves into multifaceted nature CRMS, highlighting its rising prevalence driven lifestyle changes, urbanization, dietary habits. With growing burden obesity, hypertension, diabetes, demographic faces unique challenges that exacerbate risk CRMS. The explores pathophysiological mechanisms underlying this syndrome, emphasizing interdependence heart, kidney, health. Effective screening strategies tailored to context, including use anthropometric measurements comprehensive panels, are vital for early detection intervention. discussion extends pharmacological nonpharmacological management approaches, underscoring importance modifications alongside medication adherence. Community engagement education pivotal fostering awareness promoting preventive measures. By analyzing implications CRMS on public health, aims illuminate urgent need integrated healthcare solutions policy initiatives address faced population. Ultimately, it advocates framework combines appropriate research, prevention methods, combat threat ensuring healthier future individuals communities across India.

Language: Английский

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Heart dysfunction in a rat model with autosomal recessive polycystic kidney disease

The Journal of Physiology, Journal Year: 2025, Volume and Issue: unknown

Published: April 11, 2025

Abstract Autosomal recessive polycystic kidney disease (ARPKD) is a congenital hepatorenal fibrocystic pathology and one of the most significant childhood nephropathies leading to chronic (CKD). While damage has been well studied in this pathology, only few studies have investigated specific cardiac during ARPKD. This study aimed conduct large analysis heart dysfunction progression CKD. ARPKD rats with Pkhd1 gene mutation (IVS35‐2A>T) were monitored for CKD via echocardiography. Heart fibrosis was assessed using Sirius red staining, cardiokines mRNA expressions tissue analysed. exhibited increased blood pressure, hypertrophy thickening left ventricular posterior wall, correlated elevated plasma creatinine levels. Diastolic evident, shown by altered E / A e ′ ratios, which worsened severity. renal dysfunction, signalling pathways activated, marked galectin‐3, collagen‐1, fibroblast growth factor 23, suppressor tumorigenicity 2 (ST2) soluble ST2 expression. Growth differentiation 15 levels rose progression, while Irisin decreased, negatively correlating ratio. highlights diastolic fibrosis, severe These changes are linked dysregulation cardiokine signalling, providing new insights into uraemia‐induced failure image Key points rare genetic disorder reduced life expectancy broad clinical spectrum including systemic hypertension, failure, portal hepatic fibrosis. PCK spontaneous gene, same affected human develop cysts other manifestations Changes (fibrosis, hypertrophy) (decreasing increasing ratios) worsen rats. dysfunctions associated such as Irisin, could be marker function patients.

Language: Английский

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Temporal trends in heart failure and acute kidney injury-related mortality in the U.S.: a 21-year retrospective analysis of the CDC WONDER database

International Urology and Nephrology, Journal Year: 2025, Volume and Issue: unknown

Published: April 25, 2025

Language: Английский

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A Pragmatic Approach to Acute Cardiorenal Syndrome: Diagnostic Strategies and Targeted Therapies to Overcome Diuretic Resistance

Journal of Clinical Medicine, Journal Year: 2025, Volume and Issue: 14(9), P. 2996 - 2996

Published: April 26, 2025

Cardiorenal syndrome (CRS) is a challenging condition characterised by interdependent dysfunction of the heart and kidneys. Despite advancements in understanding its pathophysiology, clinical management remains complex due to overlapping mechanisms high rates diuretic resistance. Relevant literature was identified through comprehensive narrative review PubMed, Embase, Cochrane Library databases, focusing on pivotal trials relating CRS from 2005 2024. This aims provide pragmatic, evidence-based approach acute addressing common misconceptions, outlining diagnostic strategies, proposing structured algorithm manage We discuss role thoracic venous excess ultrasound (VeXUS) providing reliable measures systemic congestion, natriuresis-guided sequential nephron blockade, more targeted therapies, including ultrafiltration refractory cases. In addition, we explore emerging that target renal hypoperfusion congestion CRS. Designed for broad audience, general physicians, cardiologists, nephrologists, this integrates evidence with practical guidance support effective timely decision-making care patients

Language: Английский

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Investigation Into the Pathogenesis of Type 2 Cardiorenal Syndrome via the ROS–TRPM2 Signaling Axis

Frontiers in Bioscience-Landmark, Journal Year: 2025, Volume and Issue: 30(5)

Published: April 30, 2025

Background: Type 2 cardiorenal syndrome (CRS) is a complex disease characterized by the interplay between heart and kidneys. The pathophysiology of type CRS involves multiple molecular signaling pathways. Transient receptor potential melastatin (TRPM2) reactive oxygen species (ROS)-sensitive non-selective calcium-permeable cation channel, which plays regulatory role in intracellular Ca2+ homeostasis. Thus, this study aimed to explore biological functions mechanisms ROS–TRPM2 axis CRS. Methods: model rats (a rat induced through left anterior descending coronary artery ligation combined with 5/6 total nephrectomy) lipopolysaccharide (LPS)-induced cell lines, human kidney-2 (HK-2), were transfected small interfering RNA (siRNA) knock down TRPM2 or calcium ion channel activator Yoda1 evaluate involvement on Changes kidney tissue morphology observed using H&E staining; viability apoptosis monitored CCK-8, Annexin V-FITC/PI, TUNEL kits, alongside quantitative real-time polymerase chain reaction (qRT-PCR), Western blot, ELISA, immunofluorescence assays confirm interaction ROS, TRPM2, Ca2+. Results: highly expressed HK-2 cells after LPS stimulation renal tissues rats. Intervention via improves injured viability, mitigates apoptosis, inhibits inflammatory cytokines interleukin 10 (IL-10) tumor necrosis factor-α (TNF-α), as well indices oxidative stress—malondialdehyde (MDA) ROS—promotes antioxidant capacity (T-AOC) expression, alleviates pathological changes CRS; promoted contrasting effect deletion. Conclusions: abnormally damaged kidneys during pathogenesis Silencing can inhibit stress responses, reduce promote survival, alleviate loss; may be related inhibition influx. This suggests that pathway significant for development, an effective therapeutic target

Language: Английский

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