Emerging Treatments of Cardiorenal Syndrome: An Update on Pathophysiology and Management.

cardiac resynchronization therapy cardiorenal syndrome management pathophysiology sglt2 inhibitors tolvaptan

Journal

Cureus
ISSN: 2168-8184
Titre abrégé: Cureus
Pays: United States
ID NLM: 101596737

Informations de publication

Date de publication:
Aug 2021
Historique:
received: 23 07 2021
accepted: 16 08 2021
entrez: 20 9 2021
pubmed: 21 9 2021
medline: 21 9 2021
Statut: epublish

Résumé

Cardiorenal syndrome refers to combined cardiac and renal dysfunction that adversely impacts both organs and is also associated with severe clinical outcomes. The pathophysiology is believed to be multifactorial and complex. Increased central venous pressure and intra-abdominal pressure, overactivation of the Renin-Angiotensin-Aldosterone System (RAAS), systemic illnesses like sepsis, amyloidosis, diabetes are important factors in developing the cardiorenal syndrome. Our review article attempts to review the pathophysiology and treatment aspect of cardiorenal syndrome and explores potential therapeutic strategies that can be adopted for the management. We searched PubMed, EMBASE, Google Scholar for relevant articles using different keywords and Medical Subject Headings, and finalized 38 articles to be included in our study. Cardiorenal syndrome management aims to eliminate venous congestion and fluid retention, which leads to improved cardiorenal status. This is usually achieved using pharmacologic agents like diuretics, vasodilators, inotropes, angiotensin-converting enzyme inhibitors (ACEIs)/angiotensin II receptor blockers (ARBs), neprilysin inhibitors, and extracorporeal methods like ultrafiltration. The use of therapeutic agents such as sodium-glucose co-transporter 2 inhibitors and tolvaptan (a vasopressin V2 receptor antagonist), and cardiac resynchronization therapy has also been shown to have potential benefits in managing the disease. These agents can be instrumental in the management and require large-scale clinical trials specifically aimed at improving cardiorenal outcomes based on severity and type of cardiorenal syndrome.

Identifiants

pubmed: 34540466
doi: 10.7759/cureus.17240
pmc: PMC8448169
doi:

Types de publication

Journal Article Review

Langues

eng

Pagination

e17240

Informations de copyright

Copyright © 2021, Verma et al.

Déclaration de conflit d'intérêts

The authors have declared that no competing interests exist.

Références

J Am Coll Cardiol. 2018 Oct 9;72(15):1845-1855
pubmed: 30075873
Circulation. 2010 Jul 20;122(3):265-72
pubmed: 20606118
Cardiol Res. 2017 Jun;8(3):87-95
pubmed: 28725324
Cardiol Res. 2020 Apr;11(2):76-88
pubmed: 32256914
N Engl J Med. 1999 Sep 2;341(10):709-17
pubmed: 10471456
N Engl J Med. 2017 Aug 17;377(7):644-657
pubmed: 28605608
N Engl J Med. 2011 Mar 3;364(9):797-805
pubmed: 21366472
Adv Chronic Kidney Dis. 2018 Sep;25(5):425-433
pubmed: 30309460
Eur Heart J. 2011 Jan;32(2):184-90
pubmed: 21068051
JAMA. 2007 Mar 28;297(12):1319-31
pubmed: 17384437
Cardiovasc Diabetol. 2019 Aug 5;18(1):99
pubmed: 31382965
Am J Physiol Cell Physiol. 2020 Feb 1;318(2):C328-C336
pubmed: 31721613
Clin J Am Soc Nephrol. 2013 Oct;8(10):1816-28
pubmed: 23723339
Cardiol Clin. 2019 Aug;37(3):251-265
pubmed: 31279419
J Heart Lung Transplant. 2013 Dec;32(12):1205-13
pubmed: 24119728
Hypertension. 2004 Nov;44(5):727-31
pubmed: 15381677
Cardiorenal Med. 2016 Feb;6(2):83-98
pubmed: 26989394
Circulation. 2013 Oct 15;128(16):1810-52
pubmed: 23741057
Core Evid. 2008 Jun;3(1):31-43
pubmed: 20694082
N Engl J Med. 2019 Jan 24;380(4):347-357
pubmed: 30415602
Expert Opin Investig Drugs. 2007 Oct;16(10):1639-47
pubmed: 17922627
Cardiol Clin. 2019 Aug;37(3):267-273
pubmed: 31279420
Ther Adv Cardiovasc Dis. 2020 Jan-Dec;14:1753944720939383
pubmed: 32715944
N Engl J Med. 2019 Jun 13;380(24):2295-2306
pubmed: 30990260
Curr Drug Saf. 2018;13(2):84-91
pubmed: 29485006
N Engl J Med. 2015 Nov 26;373(22):2117-28
pubmed: 26378978
Diabetes Obes Metab. 2019 Jun;21(6):1291-1298
pubmed: 30762288
Eur Endocrinol. 2020 Oct;16(2):113-121
pubmed: 33117442
Clin J Am Soc Nephrol. 2013 Aug;8(8):1293-303
pubmed: 23660183
Pacing Clin Electrophysiol. 2015 Oct;38(10):1192-200
pubmed: 26179289
Curr Heart Fail Rep. 2013 Mar;10(1):81-8
pubmed: 23354831
Int J Nephrol. 2011;2011:168461
pubmed: 21716684
Circulation. 2004 Mar 2;109(8):1004-9
pubmed: 14769700
Heart Rhythm. 2019 Jun;16(6):928-935
pubmed: 30590191
Circulation. 2019 Apr 16;139(16):e840-e878
pubmed: 30852913
Clin Med (Lond). 2020 Mar;20(2):146-150
pubmed: 32188648
Curr Heart Fail Rep. 2018 Aug;15(4):224-238
pubmed: 29987499
J Am Coll Cardiol. 2005 Jul 5;46(1):57-64
pubmed: 15992636

Auteurs

Deepak Verma (D)

Internal Medicine/Family Medicine, Janaki Medical College, Janakpurdham, NPL.
Research, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.

Amena Firoz (A)

Pediatrics, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.

Sameer Krishna Prasad Garlapati (SKP)

Internal Medicine, Andhra Medical College, Visakhapatnam, IND.

Thanmay Sai Charaan Reddy Sathi (T)

Internal Medicine, King George Hospital, Visakhapatnam, IND.

Muhammad Haris (M)

Internal Medicine, Royal Lancaster Infirmary/Health Education England/ North West, Lancaster, GBR.
Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.

Bibek Dhungana (B)

Internal Medicine, KIST Medical College, Lalitpur, NPL.

Barun Ray (B)

Internal Medicine, B.P. Koirala Institute of Health Sciences, Dharan, NPL.

Gunjan Shah (G)

Internal Medicine, Janaki Medical College, Janakpurdham, NPL.

Bibek Kc (B)

Internal Medicine, KIST Medical College, Lalitpur, NPL.

Palak Paudel (P)

Gynaecology, Bhaktapur Cancer Hospital, Kathmandu, NPL.

Classifications MeSH