Cardiorenal Nexus: A Review With Focus on Combined Chronic Heart and Kidney Failure, and Insights From Recent Clinical Trials
The cardiorenal nexus encompasses a bidirectional relationship between the heart and the kidneys. Chronic abnormalities in cardiac function can lead to progressive kidney disease, and chronic kidney disease can lead to progressively decreasing cardiac function and increasing risk of cardiovascular d...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-06-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.121.024139 |
| _version_ | 1797810189715374080 |
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| author | Peter A. McCullough Alpesh Amin Kevin M. Pantalone Claudio Ronco |
| author_facet | Peter A. McCullough Alpesh Amin Kevin M. Pantalone Claudio Ronco |
| author_sort | Peter A. McCullough |
| collection | DOAJ |
| description | The cardiorenal nexus encompasses a bidirectional relationship between the heart and the kidneys. Chronic abnormalities in cardiac function can lead to progressive kidney disease, and chronic kidney disease can lead to progressively decreasing cardiac function and increasing risk of cardiovascular disease, including heart failure. About 15% of US adults have chronic kidney disease, 2% have heart failure, and 9% have cardiovascular disease. Prevalence rates of chronic kidney disease, cardiovascular disease, and associated morbidities such as type 2 diabetes are expected to increase with an aging population. Observational studies provide evidence for the cardiorenal nexus. Follow‐up data from placebo arms of clinical trials in chronic kidney disease or cardiovascular disease show higher rates of renal and cardiovascular outcome events in patient subgroups with type 2 diabetes than in those without type 2 diabetes. The cardiorenal syndromes develop along an interlinked pathophysiological trajectory that requires a holistic, collaborative approach involving a multidisciplinary team. There is now a compendium of treatment options. Greater understanding of the underlying pathophysiology of the cardiorenal nexus will support optimization of the management of these interlinked disease states. |
| first_indexed | 2024-03-13T07:04:31Z |
| format | Article |
| id | doaj.art-79f0ed82b56b4e17bb5734f6a08b4cd9 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-03-13T07:04:31Z |
| publishDate | 2022-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-79f0ed82b56b4e17bb5734f6a08b4cd92023-06-06T12:11:52ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802022-06-01111110.1161/JAHA.121.024139Cardiorenal Nexus: A Review With Focus on Combined Chronic Heart and Kidney Failure, and Insights From Recent Clinical TrialsPeter A. McCullough0Alpesh Amin1Kevin M. Pantalone2Claudio Ronco3Truth for Health Foundation Tucson AZDepartment of Medicine University of California Irvine School of Medicine Orange CAEndocrinology and Metabolism Institute Cleveland Clinic Cleveland OHInternational Renal Research Institute of Vicenza ItalyThe cardiorenal nexus encompasses a bidirectional relationship between the heart and the kidneys. Chronic abnormalities in cardiac function can lead to progressive kidney disease, and chronic kidney disease can lead to progressively decreasing cardiac function and increasing risk of cardiovascular disease, including heart failure. About 15% of US adults have chronic kidney disease, 2% have heart failure, and 9% have cardiovascular disease. Prevalence rates of chronic kidney disease, cardiovascular disease, and associated morbidities such as type 2 diabetes are expected to increase with an aging population. Observational studies provide evidence for the cardiorenal nexus. Follow‐up data from placebo arms of clinical trials in chronic kidney disease or cardiovascular disease show higher rates of renal and cardiovascular outcome events in patient subgroups with type 2 diabetes than in those without type 2 diabetes. The cardiorenal syndromes develop along an interlinked pathophysiological trajectory that requires a holistic, collaborative approach involving a multidisciplinary team. There is now a compendium of treatment options. Greater understanding of the underlying pathophysiology of the cardiorenal nexus will support optimization of the management of these interlinked disease states.https://www.ahajournals.org/doi/10.1161/JAHA.121.024139cardiorenal nexuscardiorenal syndromescardiovascular diseasechronic kidney diseaseheart failuretype 2 diabetes |
| spellingShingle | Peter A. McCullough Alpesh Amin Kevin M. Pantalone Claudio Ronco Cardiorenal Nexus: A Review With Focus on Combined Chronic Heart and Kidney Failure, and Insights From Recent Clinical Trials Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease cardiorenal nexus cardiorenal syndromes cardiovascular disease chronic kidney disease heart failure type 2 diabetes |
| title | Cardiorenal Nexus: A Review With Focus on Combined Chronic Heart and Kidney Failure, and Insights From Recent Clinical Trials |
| title_full | Cardiorenal Nexus: A Review With Focus on Combined Chronic Heart and Kidney Failure, and Insights From Recent Clinical Trials |
| title_fullStr | Cardiorenal Nexus: A Review With Focus on Combined Chronic Heart and Kidney Failure, and Insights From Recent Clinical Trials |
| title_full_unstemmed | Cardiorenal Nexus: A Review With Focus on Combined Chronic Heart and Kidney Failure, and Insights From Recent Clinical Trials |
| title_short | Cardiorenal Nexus: A Review With Focus on Combined Chronic Heart and Kidney Failure, and Insights From Recent Clinical Trials |
| title_sort | cardiorenal nexus a review with focus on combined chronic heart and kidney failure and insights from recent clinical trials |
| topic | cardiorenal nexus cardiorenal syndromes cardiovascular disease chronic kidney disease heart failure type 2 diabetes |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.121.024139 |
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