From Cardio Renal Syndrome to Chronic Cardiovascular and Kidney Disorder: A Conceptual Transition

Clin J Am Soc Nephrol. 2023 Oct 30. doi: 10.2215/CJN.0000000000000361. Online ahead of print.ABSTRACTThe association between cardiac and kidney dysfunction has received exponentially increasing attention over the last two decades. A putatively unique syndrome, the "cardio-renal syndrome", distinguishing five subtypes based on the chronology of cardiac and kidney events, has been widely adopted. This review discusses the methodological and practical problems inherent to the current classification of cardio renal syndrome. The term disorder is more appropriate than the term "syndrome" to describe concomitant cardiovascular and kidney dysfunction and/or damage. Indeed, the term disorder designates a disruption induced by disease states to the normal function of organs or organ systems. We apply Occam's razor to the chronology-based construct to arrive at a simple definition based on the coexistence of cardiovascular disease and chronic kidney disease (CKD), the "chronic cardiovascular -kidney disorder" (CCKD). This conceptual framework builds upon the fact that cardiovascular and CKD share common risk factors and pathophysiological mechanisms. Biological changes set in motion by kidney dysfunction accelerate cardiovascular disease progression and vice-versa. Depending on various combinations of risk factors and precipitating conditions, patients with CCKD may present initially with cardiovascular disease or with hallmarks of CKD. Treatment targeting cardiovascular or kidney dysf...
Source: Clinical Journal of the American Society of Nephrology : CJASN - Category: Urology & Nephrology Authors: Source Type: research