Cardiorenal syndrome has attracted an enormous amount of attention, particularly in the last decade. A lot of research has been conducted in pathophysiology, haemodynamic manifestations, therapeutic options, and clinical outcomes.1,2 In practice, however, cardiorenal syndrome remains clinically challenging for both cardiologists and nephrologists. Cardiorenal syndrome covers a wide range of structural and functional disorders of both the heart and kidneys. Typically, the acute or chronic dysfunction in one organ induces acute or chronic dysfunction in the other. The interaction between the two organs may well be in multiple interfaces, such as haemodynamic cross-talk between the failing heart and the response of the kidneys and vice versa, alterations in neurohormonal markers, as well as inflammatory molecular characteristics.2 Much of the credit for the initial description of cardiorenal syndrome is attributed to Robert Bright who, in 1836, described the interdependent relationship between the kidney and the heart based on his observations on significant cardiac structural changes seen in patients with advanced kidney disease.3 The formal definition of cardiorenal syndrome and its classifications were established more recently,1,2,4 although uncertainty remains still. The classification appears to be attractive and easily applicable in clinical practice, but its value in aiding treatment or prevention strategy has yet to be ascertained.4


For UK healthcare professionals only


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