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Semin Nephrol. 2019 Jan;39(1):31-40. doi: 10.1016/j.semnephrol.2018.10.003.

Cardiorenal Syndrome in Acute Kidney Injury.

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Department of Nephrology and Dialysis, L. Parodi-Delfino Hospital, Colleferro (Rome), Italy. Electronic address:
Division of Renal Medicine, Brigham and Women's Hospital, Boston, Massachusetts.
Research, Innovation and Brand Reputation, ASST (Azienda Socio Sanitaria Territoriale) Papa Giovanni XXIII, Bergamo, Italy.
International Renal Research Institute, S. Bortolo Hospital, Vicenza, Italy.


Varying degrees of cardiac and kidney dysfunction commonly are observed in hospitalized patients. As a demonstration of the significant interplay between the heart and kidneys, dysfunction or injury of one organ often contributes to dysfunction or injury of the other. The term cardiorenal syndrome (CRS) was proposed to describe this complex organ cross-talk. Type 3 CRS, also known as acute renocardiac syndrome, is a subtype of CRS that occurs when acute kidney injury contributes to or precipitates the development of acute cardiac dysfunction. Acute kidney injury may directly or indirectly produce acute cardiac dysfunction by way of volume overload, metabolic acidosis, electrolyte disorders such as hyperkalemia and hypocalcemia, and other mechanisms. In this review, we examine the definition, epidemiology, pathophysiology, and treatment options for CRS with an emphasis on type 3 CRS.


Acute kidney injury (AKI); cardiorenal syndrome (CRS); diagnosis; pathophysiology; treatment

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