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Kidney Int Suppl (2011). 2011 Jun;1(1):2-5.

The complexity of the cardio-renal link: taxonomy, syndromes, and diseases.

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Nephrology, Dialysis and Transplantation Unit and CNR-IBIM Clinical Epidemiology and Pathophysiology of Renal Diseases and Hypertension , Reggio Calabria, Italy.
Renal Unit, Guy's and St Thomas' NHS Foundation Hospital, King's Health Partners , London, UK.
Indiana University and VAMC , Indianapolis, Indiana, USA.
Department of Nephrology, University Medical Center , Utrecht, The Netherlands.
Department of Internal Medicine IV, Saarland University Medical Centre , Homburg/Saar, Germany.
Division of Internal Medicine and Nephrology, Department of Nephrology, Endocrinology and Metabolic Diseases, Medical University of Silesia , Katowice, Poland.
Nephrology Division, Department of Medicine, Akdeniz University Medical School , Antalya, Turkey.
Fundación Jiménez Díaz, Universidad Autónoma de Madrid, Fundación Renal Iñigo Alvarez de Toledo , Madrid, Spain.
INSERM ERI-12 (EA 4292) , Amiens, France ; Amiens University Hospital and the Jules Verne University of Picardie , Amiens, France.
Clinic of Nephrology, C.I. Parhon University Hospital, Gr. T. Popa University of Medicine and Pharmacy , Iasi, Romania.
Hospital Universitario de Bellvitge, IDIBELL, L'Hospitalet de Llobregat , Barcelona, Spain.
ERA-EDTA Registry, Department of Medical Informatics, Academic Medical Center, University of Amsterdam , Amsterdam, The Netherlands.
Department of Clinical Epidemiology, Leiden University Medical Center , Leiden, The Netherlands.
Department of Clinical Science, Intervention and Technology, Karolinska Institutet , Stockholm, Sweden.
INSERM U970, Hôpital Européen Georges Pompidou , Paris, France.


Bidirectional mechanisms exist that link diseases affecting the heart and kidney. This link is complex and remains poorly understood; therefore, charting the shared territory of cardiovascular (CV) and renal medicine poses major problems. Until now, no convincing rationale for delineating new syndromes existed. The multiple connections of the arterial system and the heart and kidney with other systems, from energy and protein balance to the musculoskeletal, clearly require special focus and rigorous framing. Nephrologists have yet to fully understand why the application of dialysis has had only limited success in halting the parallel burdens of CV and non-CV death in patients with end-stage renal disease. Cardiologists, intensivists, and nephrologists alike should settle whether and when extracorporeal ultrafiltration benefits patients with decompensated heart failure. These sparse but interconnected themes spanning from the basic science-clinical transition phase to clinical science, epidemiology, and medical technology already form the basis for the young discipline of 'CV and renal medicine'.


CKD; ESRD; cardio-renal; cardiovascular risk; death; progression of CKD

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