Pathophysiology of cardio-renal syndrome

Meng Te Lin, Ming Song Tsai, Junne Ming Sung

Research output: Contribution to journalArticlepeer-review


Hospitalized patients with acute or chronic cardiac diseases may present with various degrees of kidney dysfunction; furthermore, the most common cause of death was cardiovascular disease in patients with chronic kidney diseases. Thus, there are underlying pathophysiological mechanisms causing the interactions between the heart and kidney disease. The term "cardio-renal syndrome (CRS)" is emerging as a new disease entity and is generally defined as a group of disorders of the concomitant cardiac and renal dysfunctions in which acute or chronic dysfunction of one organ may induce acute or chronic dysfunction of the other. To address the bidirectional nature of heart-kidney interactions, we presented here a new classification of the CRS with 5 subtypes. About acute or chronic cardio-renal syndrome, traditionally, we considered the hemodynamic change caused by cardiac dysfunction is the major mechanism leading to renal damage; however, recent studies demonstrated that high renal vein pressure, activation of renin-angiotension-aldosterone system and sympathetic nervous system, imbalance of nitric oxide level and oxidative stress, and inflammation may also play an important pathophysiological role. In chronic reno-cardiac syndrome, the pathophysiological mechanisms included the uremic cardiomyopathy, vascular calcification due to calcium and phosphorus imbalance, and anemia. This article reviewed the pathophysiology underlying the heart-kidney interaction of CRS and future perspectives.

Original languageEnglish
Pages (from-to)392-400
Number of pages9
JournalJournal of Internal Medicine of Taiwan
Issue number6
Publication statusPublished - 2011 Dec 1

All Science Journal Classification (ASJC) codes

  • Internal Medicine

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