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Cardiorenal Med. 2013 Apr;3(1):63-70. doi: 10.1159/000350397.

Cardiorenal syndrome type 4: a review.

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  • 1Department of Nephrology and Dialysis, San Giovanni Di Dio Hospital, Agrigento, Vicenza, Italy ; International Renal Research Institute (IRRI), San Bortolo Hospital, Vicenza, Italy.


There is a bidirectional and complex relationship between the heart and kidneys. This interaction is physical, chemical as well as biological and is also reflected in a strong connection between renal and cardiovascular diseases. Cardiorenal syndrome type 4 (CRS type 4) is characterized by primary chronic kidney disease (CKD) leading to an impairment of cardiac function, with ventricular hypertrophy, diastolic dysfunction, and/or increased risk of adverse cardiovascular events. The incidence of CKD is increasing, and CRS type 4 is becoming a major public health problem associated with a high morbidity and mortality. In this study, we briefly review the epidemiology and pathophysiology of CRS type 4, the role of biomarkers in its early identification, and its management.


Biomarkers; Cardiorenal syndrome type 4; Cardiovascular events; Chronic kidney disease

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