A comprehensive review of acute cardio-renal syndrome: need for novel biomarkers

Cardiorenal syndrome represents a wide-spectrum disorder involving the heart and kidneys as the primary affected organs. India has an increasingly high burden of acute CRS, coinciding with the rise in global statistics. Up to 2022, approximately 46.1% of all cardiorenal patients have been diagnosed...

Full description

Bibliographic Details
Main Authors: Abhi Dutta, Shubham Saha, Ajay Bahl, Anupam Mittal, Trayambak Basak
Format: Article
Language:English
Published: Frontiers Media S.A. 2023-05-01
Series:Frontiers in Pharmacology
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fphar.2023.1152055/full
_version_ 1797822043501101056
author Abhi Dutta
Abhi Dutta
Shubham Saha
Shubham Saha
Ajay Bahl
Anupam Mittal
Trayambak Basak
Trayambak Basak
author_facet Abhi Dutta
Abhi Dutta
Shubham Saha
Shubham Saha
Ajay Bahl
Anupam Mittal
Trayambak Basak
Trayambak Basak
author_sort Abhi Dutta
collection DOAJ
description Cardiorenal syndrome represents a wide-spectrum disorder involving the heart and kidneys as the primary affected organs. India has an increasingly high burden of acute CRS, coinciding with the rise in global statistics. Up to 2022, approximately 46.1% of all cardiorenal patients have been diagnosed with acute CRS in India. Acute CRS involves a sudden deterioration of kidney functionalities, referred to as acute kidney injury (AKI) in acute heart failure patients. The pathophysiology of CRS involves hyperactivation of the sympathetic nervous system (SNS) and the renin-angiotensin-aldosterone system (RAAS) following acute myocardial stress. The pathological phenotype of acute CRS is associated with perturbed inflammatory, cellular, and neurohormonal markers in circulation. These complications increase the risk of mortality in clinically diagnosed acute CRS patients, making it a worldwide healthcare burden. Hence, effective diagnosis and early prevention are crucial to prevent the progression of CRS in AHF patients. Present biomarkers, such as serum creatinine (sCr), cystatin C (CysC), glomerular filtration rate (GFR), blood urea nitrogen (BUN), serum and/or urine neutrophil gelatinase-associated lipocalin (NGAL), B-type natriuretic peptide (BNP), and NT-proBNP, are clinically used to diagnose AKI stages in CRS patients but are limitedly sensitive to the early detection of the pathology. Therefore, the need for protein biomarkers is emerging for early intervention in CRS progression. Here, we summarized the cardio-renal nexus in acute CRS, with an emphasis on the present clinicopathological biomarkers and their limitations. The objective of this review is to highlight the need for novel proteomic biomarkers that will curb the burgeoning concern and direct future research trials.
first_indexed 2024-03-13T10:02:01Z
format Article
id doaj.art-3e2653d32b5d4fa9ae6e16a6952fbbcc
institution Directory Open Access Journal
issn 1663-9812
language English
last_indexed 2024-03-13T10:02:01Z
publishDate 2023-05-01
publisher Frontiers Media S.A.
record_format Article
series Frontiers in Pharmacology
spelling doaj.art-3e2653d32b5d4fa9ae6e16a6952fbbcc2023-05-23T04:43:52ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122023-05-011410.3389/fphar.2023.11520551152055A comprehensive review of acute cardio-renal syndrome: need for novel biomarkersAbhi Dutta0Abhi Dutta1Shubham Saha2Shubham Saha3Ajay Bahl4Anupam Mittal5Trayambak Basak6Trayambak Basak7School of Biosciences and Bioengineering, Indian Institute of Technology (IIT)-Mandi, Mandi, Himachal Pradesh, IndiaBioX Center, Indian Institute of Technology (IIT)-Mandi, Mandi, Himachal Pradesh, IndiaSchool of Biosciences and Bioengineering, Indian Institute of Technology (IIT)-Mandi, Mandi, Himachal Pradesh, IndiaBioX Center, Indian Institute of Technology (IIT)-Mandi, Mandi, Himachal Pradesh, IndiaDepartment of Cardiology, Postgraduate Institute of Medical Education and Research, Chandigarh, IndiaDepartment of Translational and Regenerative Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, IndiaSchool of Biosciences and Bioengineering, Indian Institute of Technology (IIT)-Mandi, Mandi, Himachal Pradesh, IndiaBioX Center, Indian Institute of Technology (IIT)-Mandi, Mandi, Himachal Pradesh, IndiaCardiorenal syndrome represents a wide-spectrum disorder involving the heart and kidneys as the primary affected organs. India has an increasingly high burden of acute CRS, coinciding with the rise in global statistics. Up to 2022, approximately 46.1% of all cardiorenal patients have been diagnosed with acute CRS in India. Acute CRS involves a sudden deterioration of kidney functionalities, referred to as acute kidney injury (AKI) in acute heart failure patients. The pathophysiology of CRS involves hyperactivation of the sympathetic nervous system (SNS) and the renin-angiotensin-aldosterone system (RAAS) following acute myocardial stress. The pathological phenotype of acute CRS is associated with perturbed inflammatory, cellular, and neurohormonal markers in circulation. These complications increase the risk of mortality in clinically diagnosed acute CRS patients, making it a worldwide healthcare burden. Hence, effective diagnosis and early prevention are crucial to prevent the progression of CRS in AHF patients. Present biomarkers, such as serum creatinine (sCr), cystatin C (CysC), glomerular filtration rate (GFR), blood urea nitrogen (BUN), serum and/or urine neutrophil gelatinase-associated lipocalin (NGAL), B-type natriuretic peptide (BNP), and NT-proBNP, are clinically used to diagnose AKI stages in CRS patients but are limitedly sensitive to the early detection of the pathology. Therefore, the need for protein biomarkers is emerging for early intervention in CRS progression. Here, we summarized the cardio-renal nexus in acute CRS, with an emphasis on the present clinicopathological biomarkers and their limitations. The objective of this review is to highlight the need for novel proteomic biomarkers that will curb the burgeoning concern and direct future research trials.https://www.frontiersin.org/articles/10.3389/fphar.2023.1152055/fullcardiorenal syndromeheart failurefibrosisproteomicsbiomarkerskidney failure
spellingShingle Abhi Dutta
Abhi Dutta
Shubham Saha
Shubham Saha
Ajay Bahl
Anupam Mittal
Trayambak Basak
Trayambak Basak
A comprehensive review of acute cardio-renal syndrome: need for novel biomarkers
Frontiers in Pharmacology
cardiorenal syndrome
heart failure
fibrosis
proteomics
biomarkers
kidney failure
title A comprehensive review of acute cardio-renal syndrome: need for novel biomarkers
title_full A comprehensive review of acute cardio-renal syndrome: need for novel biomarkers
title_fullStr A comprehensive review of acute cardio-renal syndrome: need for novel biomarkers
title_full_unstemmed A comprehensive review of acute cardio-renal syndrome: need for novel biomarkers
title_short A comprehensive review of acute cardio-renal syndrome: need for novel biomarkers
title_sort comprehensive review of acute cardio renal syndrome need for novel biomarkers
topic cardiorenal syndrome
heart failure
fibrosis
proteomics
biomarkers
kidney failure
url https://www.frontiersin.org/articles/10.3389/fphar.2023.1152055/full
work_keys_str_mv AT abhidutta acomprehensivereviewofacutecardiorenalsyndromeneedfornovelbiomarkers
AT abhidutta acomprehensivereviewofacutecardiorenalsyndromeneedfornovelbiomarkers
AT shubhamsaha acomprehensivereviewofacutecardiorenalsyndromeneedfornovelbiomarkers
AT shubhamsaha acomprehensivereviewofacutecardiorenalsyndromeneedfornovelbiomarkers
AT ajaybahl acomprehensivereviewofacutecardiorenalsyndromeneedfornovelbiomarkers
AT anupammittal acomprehensivereviewofacutecardiorenalsyndromeneedfornovelbiomarkers
AT trayambakbasak acomprehensivereviewofacutecardiorenalsyndromeneedfornovelbiomarkers
AT trayambakbasak acomprehensivereviewofacutecardiorenalsyndromeneedfornovelbiomarkers
AT abhidutta comprehensivereviewofacutecardiorenalsyndromeneedfornovelbiomarkers
AT abhidutta comprehensivereviewofacutecardiorenalsyndromeneedfornovelbiomarkers
AT shubhamsaha comprehensivereviewofacutecardiorenalsyndromeneedfornovelbiomarkers
AT shubhamsaha comprehensivereviewofacutecardiorenalsyndromeneedfornovelbiomarkers
AT ajaybahl comprehensivereviewofacutecardiorenalsyndromeneedfornovelbiomarkers
AT anupammittal comprehensivereviewofacutecardiorenalsyndromeneedfornovelbiomarkers
AT trayambakbasak comprehensivereviewofacutecardiorenalsyndromeneedfornovelbiomarkers
AT trayambakbasak comprehensivereviewofacutecardiorenalsyndromeneedfornovelbiomarkers