I Balint, J Vučak, N Bašić-Marković, D Klarić, V Amerl Šakić
Cardiorenal syndrome, a complex pathophysiological disorder of both the heart and kidneys, is a condition in which acute or chronic damage to one organ can lead to acute or chronic dysfunction of the other organ. Depending on primary organ dysfunction and disease duration, there are five different types of cardiorenal syndrome. Type 1 cardiorenal syndrome (acute cardiorenal syndrome) is defined as acute kidney injury caused by sudden decrease in heart function. Type 2 cardiorenal syndrome (chronic cardiorenal syndrome) refers to chronic kidney disease linked to chronic heart failure. Type 3 cardiorenal syndrome (acute renocardial syndrome) is caused by acute kidney injury that leads to heart failure. Type 4 cardiorenal syndrome (chronic renocardial syndrome) includes chronic heart failure due to chronic kidney disease. Type 5 cardiorenal syndrome (secondary cardiorenal syndrome) is reversible or irreversible condition marked by simultaneous heart and kidney insufficiency, as a result of multiorgan disease such as sepsis, diabetes mellitus, sarcoidosis, amyloidosis, etc. The pathophysiological patterns of cardiorenal syndrome are extremely complicated. Despite numerous publications, perplexed physiological, biochemical and hormonal disturbances as parts of the main pathogenic mechanisms of cardiorenal syndrome remain obscure. Even though there are guidelines for the treatment of patients with heart failure and chronic kidney disease, similar guidelines for the treatment of cardiorenal syndrome are lacking. In everyday practice, it is crucial to diagnose cardiorenal syndrome and use all diagnostic and therapeutic procedures available to prevent or alleviate kidney and heart failure.
{"title":"[PATHOPHYSIOLOGY OF THE CARDIORENAL SYNDROME].","authors":"I Balint, J Vučak, N Bašić-Marković, D Klarić, V Amerl Šakić","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Cardiorenal syndrome, a complex pathophysiological disorder of both the heart and kidneys, is a condition in which acute\u0000or chronic damage to one organ can lead to acute or chronic dysfunction of the other organ. Depending on primary organ\u0000dysfunction and disease duration, there are five different types of cardiorenal syndrome. Type 1 cardiorenal syndrome\u0000(acute cardiorenal syndrome) is defined as acute kidney injury caused by sudden decrease in heart function. Type 2\u0000cardiorenal syndrome (chronic cardiorenal syndrome) refers to chronic kidney disease linked to chronic heart failure. Type\u00003 cardiorenal syndrome (acute renocardial syndrome) is caused by acute kidney injury that leads to heart failure. Type 4\u0000cardiorenal syndrome (chronic renocardial syndrome) includes chronic heart failure due to chronic kidney disease. Type\u00005 cardiorenal syndrome (secondary cardiorenal syndrome) is reversible or irreversible condition marked by simultaneous\u0000heart and kidney insufficiency, as a result of multiorgan disease such as sepsis, diabetes mellitus, sarcoidosis, amyloidosis,\u0000etc. The pathophysiological patterns of cardiorenal syndrome are extremely complicated. Despite numerous publications,\u0000perplexed physiological, biochemical and hormonal disturbances as parts of the main pathogenic mechanisms of\u0000cardiorenal syndrome remain obscure. Even though there are guidelines for the treatment of patients with heart failure\u0000and chronic kidney disease, similar guidelines for the treatment of cardiorenal syndrome are lacking. In everyday practice,\u0000it is crucial to diagnose cardiorenal syndrome and use all diagnostic and therapeutic procedures available to prevent or\u0000alleviate kidney and heart failure.</p>","PeriodicalId":35756,"journal":{"name":"Acta Medica Croatica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35559234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chronic kidney disease (CKD) is one of the leading public health issues due to frequent and serious complications. Once the function of kidneys is disrupted, regardless of etiology, there are numerous factors that can speed up decrease of glomerular filtration rate, including hypertension, proteinuria and dyslipidemia. Statins are widely used in primary and secondary prevention of cardiovascular diseases in general population. Clinical advantages of statins in CKD patients are not as clear. The aim of this paper is to present lipid status in CKD patients and indications for statin therapy with the aim to reduce cardiovascular risk in this group of patients. CKD is a well-known independent risk factor in cardiovascular events, but professional associations issuing guidelines differ in the approach to treatment of dyslipidemia. The results of some studies indicate that treatment with statins may slow down the rate of kidney function reduction in patients with mild to moderate kidney damage, whereas other studies deny this effect. Furthermore, CKD patients have a higher risk of side effects, in part due to the reduced kidney excretion, polypharmacy, and numerous other comorbidities. Family physician has the role of providing preventive measures, with focus on appropriate treatment of patients with hypertension or diabetes, as the most common cause of CKD, and timely detection of CKD in initial stage.
{"title":"[USE OF STATINS IN PATIENTS WITH CHRONIC KIDNEY DISEASE TO PREVENT\u0000CARDIOVASCULAR DISEASE].","authors":"T Zavidić, B Lodeta, Đ Lovrinić","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Chronic kidney disease (CKD) is one of the leading public health issues due to frequent and serious complications. Once\u0000the function of kidneys is disrupted, regardless of etiology, there are numerous factors that can speed up decrease of\u0000glomerular filtration rate, including hypertension, proteinuria and dyslipidemia. Statins are widely used in primary and\u0000secondary prevention of cardiovascular diseases in general population. Clinical advantages of statins in CKD patients\u0000are not as clear. The aim of this paper is to present lipid status in CKD patients and indications for statin therapy with the\u0000aim to reduce cardiovascular risk in this group of patients. CKD is a well-known independent risk factor in cardiovascular\u0000events, but professional associations issuing guidelines differ in the approach to treatment of dyslipidemia. The results\u0000of some studies indicate that treatment with statins may slow down the rate of kidney function reduction in patients with\u0000mild to moderate kidney damage, whereas other studies deny this effect. Furthermore, CKD patients have a higher risk\u0000of side effects, in part due to the reduced kidney excretion, polypharmacy, and numerous other comorbidities. Family\u0000physician has the role of providing preventive measures, with focus on appropriate treatment of patients with hypertension\u0000or diabetes, as the most common cause of CKD, and timely detection of CKD in initial stage.</p>","PeriodicalId":35756,"journal":{"name":"Acta Medica Croatica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35558690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}