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- Cardiorenal syndrome (CRS) type 1 is the development of acute kidney injury (AKI) in the patient with acute cardiac illness, most commonly acute decompensated heart failure (ADHF)
- Multiple pathophysiological mechanisms result in CRS characterized by a rise in serum creatinine, oliguria, diuretic resistance, and worsening ADHF
- There are a host of predisposing factors that create baseline risk for CRS (DM, HTN, HLD, OSA)
- The final common pathway often results in bidirectional organ injury, drug resistance, and death
- The combination of worsening renal function, volume overload, and diuretic refractoriness makes the management of CRS challenging
- Current therapies although often ineffective include aggressive diuresis and positive inotropes
References
Ronco C, et al. Cardiorenal Syndrome Type I: Pathophysiological Crosstalk Leading to Combined Heart and Kidney Dysfunction in the Setting of Acutely Decompensated Heart Failure. JACC Vol. 60, No. 12, 2012