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Insuficiencia cardíaca
versión On-line ISSN 1852-3862
Resumen
DAVILA MORA¹, Sylvia et al. Cardio renal syndrome type 1: Pathophysiological mechanisms and role of new biomarkers. Insuf. card. [online]. 2016, vol.11, n.1, pp.47-54. ISSN 1852-3862.
Renal dysfunction is common in patients with heart failure and is associated with high morbidity and mortality. This interaction between heart and kidney is called cardiorenal syndrome (CRS), where the primary organ dysfunction results in secondary injury of the other. This review aims to provide an overview of CRS type 1, its pathogenesis and diagnostic. The CRS type 1 is present in approximately 23-33% of patients hospitalized with HF. It is characterized by the rapid development of kidney injury in patients with acute cardiac dysfunction. Multiple mechanisms are involved in its pathogenesis, which feed a vicious cycle of cardiac and renal dysfunction. Hemodynamic alterations lead to venous congestion, activation of the renin-angiotensin-aldosterone system and sympathetic system, responsible for higher volume overload and renal dysfunction. New biomarkers such as NGAL, KIM-1 are being evaluated for early detection of kidney injury in patients with HF. NGAL combined with the BNP are probably the biggest markers that have shown evidence of success in diagnosing CRS type 1, BNP indicated presence of volume overload and NGAL indicates early kidney injury. A better understanding of the pathophysiology of this disease will allow finding strategies to help in the prevention of renal changes in HF patients.
Palabras clave : Heart failure; Acute kidney injury; Cardiorenal syndrome.