From Cardiorenal Syndrome to Chronic Cardiovascular and Kidney Disorder: A Conceptual Transition.

Autor:	Zoccali C; Renal Research Institute, New York and Institute of Molecular Biology and Genetics (Biogem), Ariano Irpino, Italy.; Associazione Ipertensione Nefrologia Trapianto Renal (IPNET), c/o Nefrologia, Grande Ospedale Metropolitano, Reggio Calabria, Italy., Mallamaci F; Nefrologia and CNR Unit, Grande Ospedale Metropolitano, Reggio Calabria, Italy., Halimi JM; Centre Hospitalier Régional Universitaire de Tours, Tours, France., Rossignol P; Inserm, Centre d'Investigations Cliniques-1433, Inserm U1116, CHRU Nancy, F-CRIN INI-CRCT, Université de Lorraine, Nancy, France.; Department of Medical Specialties-Nephrology Hemodialysis, Princess Grace Hospital, Monaco Private Hemodialysis Centre, Monaco, Monaco., Sarafidis P; Department of Nephrology, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece., De Caterina R; University of Pisa and Cardiology Division, Pisa University Hospital, Pisa, Italy., Giugliano R; Fondazione Villaserena per la Ricerca, Pescara, Italy., Zannad F; Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
Jazyk:	angličtina
Zdroj:	Clinical journal of the American Society of Nephrology : CJASN [Clin J Am Soc Nephrol] 2024 Jun 01; Vol. 19 (6), pp. 813-820. Date of Electronic Publication: 2023 Oct 30.
DOI:	10.2215/CJN.0000000000000361
Abstrakt:	The association between cardiac and kidney dysfunction has received attention over the past two decades. A putatively unique syndrome, the cardiorenal syndrome, distinguishing five subtypes on the basis of the chronology of cardiac and kidney events, has been widely adopted. This review discusses the methodologic and practical problems inherent to the current classification of cardiorenal 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 on the basis of the coexistence of cardiovascular disease and CKD, the chronic cardiovascular-kidney disorder (CCKD). This conceptual framework builds upon the fact that cardiovascular and CKD share common risk factors and pathophysiologic 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 dysfunction may improve the outcomes of both. The portfolio of interventions targeting the kidney-cardiovascular continuum is in an expanding phase. In the medium term, applying the new omics sciences may unravel new therapeutic targets and further improve the therapy of CCKD. Trials based on cardiovascular and kidney composite end points are an attractive and growing area. Targeting pathways common to cardiovascular and kidney diseases will help prevent the adverse health effects of CCKD. (Copyright © 2023 by the American Society of Nephrology.)
Databáze:	MEDLINE
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