Cardiorenal syndrome: clinical diagnosis, molecular mechanisms and therapeutic strategies

Acta Pharmacologica Sinica, Год журнала: 2025, Номер unknown

Опубликована: Фев. 5, 2025

Язык: Английский

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

The Journal of Physiology, Год журнала: 2025, Номер unknown

Опубликована: Апрель 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.

Язык: Английский

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

International Journal of Molecular Sciences, Год журнала: 2025, Номер 26(6), С. 2456 - 2456

Опубликована: Март 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.

Язык: 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, Год журнала: 2025, Номер 12

Опубликована: Март 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 < 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.

Язык: 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, Год журнала: 2025, Номер 4(1), С. 4 - 10

Опубликована: Янв. 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.

Язык: Английский

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The Need to Identify Novel Markers for Early Renal Injury in Cardiorenal Syndrome

Cells, Год журнала: 2024, Номер 13(15), С. 1283 - 1283

Опубликована: Июль 30, 2024

The term “Cardiorenal Syndrome” (CRS) refers to the complex interplay between heart and kidney dysfunction. First described by Robert Bright in 1836, CRS was brought its modern view Ronco et al. 2008, who defined it as one organ’s primary dysfunction leading secondary other, a that led distinction of five different types depending on organ temporal pattern (acute vs. chronic). Their pathophysiology is intricate, involving various hemodynamic, neurohormonal, inflammatory processes result damage both organs. While traditional biomarkers have been utilized for diagnosing prognosticating CRS, they are inadequate early detection acute renal damage. Hence, there pressing need discover new enhance clinical outcomes treatment approaches.

Язык: Английский

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

Frontiers in Cell and Developmental Biology, Год журнала: 2024, Номер 12

Опубликована: Окт. 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.

Язык: Английский

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Chronic Kidney Disease Associated with Ischemic Heart Disease: To What Extent Do Biomarkers Help?

Life, Год журнала: 2023, Номер 14(1), С. 34 - 34

Опубликована: Дек. 25, 2023

Chronic kidney disease represents a complex and multifaceted pathology characterized by the presence of structural or functional renal anomalies associated with persistent reduction in function. As progresses, complications arise due to chronic inflammatory syndrome, hydro-electrolytic disorders, toxicity secondary uremic environment. Cardiovascular are leading cause death for these patients. Ischemic cardiac can be both consequence complication disease, highlighting need identify specific cardiorenal dysfunction biomarkers targeting pathophysiological mechanisms common conditions. This identification is crucial establishing accurate diagnoses, prognoses, risk stratifications work intended elucidate intricate relationship between ischemic heart investigate roles biomarkers, including troponin, natriuretic peptides, galectin-3, copeptin, fibroblast growth factor 23 its co-receptor Klotho, soluble suppression tumorigenicity 2, plasma differentiation 15.

Язык: Английский

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The protective effect of Bergamot Polyphenolic Fraction on reno-cardiac damage induced by DOCA-salt and unilateral renal artery ligation in rats

Biomedicine & Pharmacotherapy, Год журнала: 2024, Номер 171, С. 116082 - 116082

Опубликована: Янв. 21, 2024

To date, the complex pathological interactions between renal and cardiovascular systems represent a real global epidemic in both developed developing countries. In this context, renovascular hypertension (RVH) remains among most prevalent, but also potentially reversible, risk factor for numerous reno-cardiac diseases humans pets. Here, we investigated anti-inflammatory protective effects of polyphenol-rich fraction bergamot (BPF) an experimental model induced by unilateral artery ligation. Adult male Wistar rats underwent ligation treatment with deoxycorticosterone acetate (DOCA) (20 mg/kg, s.c.), twice week period 4 weeks, 1% sodium chloride (NaCl) water (n = 10). A subgroup hypertensive received BPF (100 mg/kg/day 28 consecutive days, n 10) gavage. Another group animals was treated sub-cutaneous injection vehicle (that served as control, 8). Unilateral followed DOCA NaCl resulted significant increase mean arterial blood pressure (MAP; p< 0.05. vs CTRL) which strongly increased resistive index (RI; p<0.05 contralateral flow kidney volume after weeks (p<0.001 CTRL). Renal dysfunction led to cardiac tissue strain associated overt dyssynchrony wall motion when compared CTRL group, shown time-to-peak (T2P; p<0.05) decreased whole peak capacity (Pk; p<0.01) displacement rate (p<0.05, respectively) longitudinal motion. Consequently, hearts RAL DOCA-Salt showed larger time delay fastest lowest region (Maximum Opposite Wall Delay-MOWD) (p<0.05 p <0.01 rate). Furthermore, levels circulating pro-inflammatory cytokines chemokines (p< 0.05 IL-12(40), 0.01 GM-CSF, KC, IL-13, TNF- α) NGAL expression ligated 0.001) observed group. Interestingly, condition is prevented treatment. particular, prevents 0.05) exerts effect on (p <0.01). Moreover, ameliorates increasing Pk <0.01) reducing T2P (p<0.05). These latter significantly improve MOWD <0.05) preventing Finally, reduction serum level some KC p<0.01 restoring physiological neutrophil gelatinase-associated lipocalin (NGAL, protein tethered kidney. conclusion, present results show, first time, that promotes efficient protection progression inflammation damage. Overall, these data point potential clinical veterinary role dietary supplementation citrus counteracting hypertension-induced syndrome.

Язык: 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, Год журнала: 2024, Номер 24(1)

Опубликована: Март 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

Язык: Английский

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