Via practica 5/2018
Cardiorenal syndromes from nephrologist`s perspective
Prevalence of chronic kidney disease (CKD) is 10 % in the whole population and 23.1 % in the age group over 70 years. The predisposing factors for CKD are also the major risk factors for CV diseases, whose mortality also contributes substantially to the mortality and morbidity of CKD patients. The major predisposing factors for CKD include diabetes mellitus; arterial hypertension (AH); cardiovascular (CV) disease – ischemic heart disease, peripheral arterial disease of the lower limbs, stroke, or signs of atherosclerotic cerebral circulation impairment, occurrence of CKD in family members. The risk factors for CKD progression include proteinuria, AH, high protein intake, calcium phosphate metabolism disorders, anemia, hyperinsulinemia and insulin sensitivity, hyperlipoproteinemia, oxidative stress, obesity. By influencing these risk factors, it is possible to significantly slow the progression of renal disease and consequently to reduce the morbidity and mortality of cardiovascular diseases as the diseases of these two systems are significantly interrelated. An example is albuminuria, which is a risk factor for both CKD progression and CV mortality independently of glomerular filtration. Similarly, chronic heart damage can lead to kidney damage, and acute dysfunctions of these two organs can affect their affects. Impaired renal function is reported in 14–45 % of hospitalized patients with acute decompensated heart failure. Based on these facts, cardiorenal and renocardial syndromes were introduced in 2004, which clearly demonstrate the interrelated relationship between the heart and kidneys in the pathogenesis of their disability.
Keywords: chronic kidney disease, cardiorenal syndrome, renocardial syndrome, heart failure, acute kidney injury
