Pathophysiologie des kardiorenalen Syndroms

ZUSAMMENFASSUNG

Das kardiorenale Syndrom beschreibt die bidirektionale Interaktion zwischen Herz- und Nierenerkrankungen. Eine akute oder chronische Dysfunktion sowohl des Herzens als auch der Nieren kann eine Dysfunktion des jeweils anderen Organs verursachen. Pathophysiologisch spielen bei der akuten Schädigung v. a. hämodynamische Veränderungen und insbesondere die Rechtsherzinsuffizienz (Rückwärtsversagen) mit renal- venöser Stauung und Abnahme des transglomerulären Gradienten eine Rolle. In der Chronifizierung gewinnen v. a. die Hypervolämie und, vermittelt über die neurohormonelle Aktivierung der Renin-Angiotensin-Aldosteron-Achse, die glomeruläre und myokardiale Sklerosierung an Bedeutung.

• Literatur

• 1 Ronco C, Haapio M, House AA. et al. Cardiorenal syndrome. J Am Coll Cardiol 2008; 52: 1527-1539 doi:10.1016/j.jacc.2008.07.051
• 2 Bagshaw SM, Cruz DN, Aspromonte N. et al. Epidemiology of cardio-renal syndromes: workgroup statements from the 7th ADQI Consensus Conference. Nephrol Dial Transplant 2010; 25: 1406-1416 doi:10.1093/ndt/gfq066
• 3 McCullough PA. Cardiorenal syndromes: pathophysiology to prevention. Int J Nephrol 2010; 2011: 762590 doi:10.4061/2011/762590
• 4 Ronco C, Ronco F. Cardio-renal syndromes: a systematic approach for consensus definition and classification. Heart Fail Rev 2012; 17: 151-160 doi:10.1007/s10741-010-9224-0
• 5 Ponikowski P, Voors AA, Anker SD. et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC)Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J 2016; 37: 2129-2200 doi:10.1093/eurheartj/ehw128
• 6 Section 2: AKI Definition.. Kidney Int Suppl (2011) 2012; 2: 19-36 doi:10.1038/kisup.2011.32
• 7 Damman K, Navis G, Voors AA. et al. Worsening renal function and prognosis in heart failure: systematic review and meta-analysis. J Card Fail 2007; 13: 599-608 doi:10.1016/j.cardfail.2007.04.008
• 8 Jentzer JC, Chawla LS. A Clinical Approach to the Acute Cardiorenal Syndrome. Crit Care Clin 2015; 31: 685-703 doi:10.1016/j.ccc.2015.06.006
• 9 McCullough PA, Kellum JA, Haase M. et al. Pathophysiology of the cardiorenal syndromes: executive summary from the eleventh consensus conference of the Acute Dialysis Quality Initiative (ADQI). Contrib Nephrol 2013; 182: 82-98 doi:10.1159/000349966
• 10 Kimmel M, Kuhlmann U. Pathophysiologie. In Kuhlmann U, Böhler J, Luft FC, Kunzendorf U, Alscher MD. Hrsg Nephrologie: Pathophysiologie – Klinik – Nierenersatzverfahren. 6. Aufl.. Stuttgart: Thieme; 2015. doi:10.1055/b-003-124668
• 11 Ronco C, Cicoira M, McCullough PA. Cardiorenal syndrome type 1: pathophysiological crosstalk leading to combined heart and kidney dysfunction in the setting of acutely decompensated heart failure. J Am Coll Cardiol 2012; 60: 1031-1042 doi:10.1016/j.jacc.2012.01.077
• 12 Di Lullo L, Bellasi A, Barbera V. et al. Pathophysiology of the cardio-renal syndromes types 1–5: An uptodate. Indian Heart J 2017; 69: 255-265 doi:10.1016/j.ihj.2017.01.005
• 13 Testani JM, Kimmel SE, Dries DL. et al. Prognostic importance of early worsening renal function after initiation of angiotensin-converting enzyme inhibitor therapy in patients with cardiac dysfunction. Circ Heart Fail 2011; 4: 685-691 doi:10.1161/circheartfailure.111.963256
• 14 Mullens W, Abrahams Z, Francis GS. et al. Importance of venous congestion for worsening of renal function in advanced decompensated heart failure. J Am Coll Cardiol 2009; 53: 589-596 doi:10.1016/j.jacc.2008.05.068
• 15 Ismail Y, Kasmikha Z, Green HL. et al. Cardio-renal syndrome type 1: epidemiology, pathophysiology, and treatment. Semin Nephrol 2012; 32: 18-25 doi:10.1016/j.semnephrol.2011.11.003
• 16 Costa VM, Carvalho F, Bastos ML. et al. Contribution of catecholamine reactive intermediates and oxidative stress to the pathologic features of heart diseases. Curr Med Chem 2011; 18: 2272-2314 doi:0929–8673/11 $58.00 + .00
• 17 Feltes CM, Van Eyk J, Rabb H. Distant-organ changes after acute kidney injury. Nephron Physiol 2008; 109: p80-p84 doi:10.1159/000142940
• 18 Kajstura J, Cigola E, Malhotra A. et al. Angiotensin II induces apoptosis of adult ventricular myocytes in vitro. J Mol Cell Cardiol 1997; 29: 859-870 doi:10.1006/jmcc.1996.0333
• 19 Li L, Lee EW, Ji H. et al. Neuropeptide Y-induced acceleration of postangioplasty occlusion of rat carotid artery. Arterioscler Thromb Vasc Biol 2003; 23: 1204-1210 doi:10.1161/01.Atv.0000071349.30914.25
• 20 Virzi GM, Torregrossa R, Cruz DN. et al. Cardiorenal Syndrome Type 1 May Be Immunologically Mediated: A Pilot Evaluation of Monocyte Apoptosis. Cardiorenal Med 2012; 2: 33-42 doi:000335499
• 21 Virzi GM, Clementi A, de Cal M. et al. Oxidative stress: dual pathway induction in cardiorenal syndrome type 1 pathogenesis. Oxid Med Cell Longev 2015; 2015: 391790 doi:10.1155/2015/391790
• 22 Stevens PE, Levin A. Evaluation and management of chronic kidney disease: synopsis of the kidney disease: improving global outcomes 2012 clinical practice guideline. Ann Intern Med 2013; 158: 825-830 doi:10.7326/0003-4819-158-11-201306040-00007
• 23 Inker LA, Astor BC, Fox CH. et al. KDOQI US commentary on the 2012 KDIGO clinical practice guideline for the evaluation and management of CKD. Am J Kidney Dis 2014; 63: 713-735 doi:10.1053/j.ajkd.2014.01.416
• 24 Schiffrin EL, Lipman ML, Mann JF. Chronic kidney disease: effects on the cardiovascular system. Circulation 2007; 116: 85-97 doi:10.1161/circulationaha.106.678342
• 25 Tonelli M, Wiebe N, Culleton B. et al. Chronic kidney disease and mortality risk: a systematic review. J Am Soc Nephrol 2006; 17: 2034-2047 doi:10.1681/asn.2005101085
• 26 Remuzzi G, Cattaneo D, Perico N. The aggravating mechanisms of aldosterone on kidney fibrosis. J Am Soc Nephrol 2008; 19: 1459-1462 doi:10.1681/asn.2007101079
• 27 Herzog CA, Asinger RW, Berger AK. et al. Cardiovascular disease in chronic kidney disease. A clinical update from Kidney Disease: Improving Global Outcomes (KDIGO). Kidney Int 2011; 80: 572-586 doi:10.1038/ki.2011.223
• 28 Ibrahim NE, Januzzi Jr JL. Beyond Natriuretic Peptides for Diagnosis and Management of Heart Failure. Clin Chem 2017; 63: 211-222 doi:10.1373/clinchem.2016.259564
• 29 Ketteler M, Block GA, Evenepoel P. et al. Executive summary of the 2017 KDIGO Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD) Guideline Update: what’s changed and why it matters. Kidney Int 2017; 92: 26-36 doi:10.1016/j.kint.2017.04.006
• 30 Lai S, Ciccariello M, Dimko M. et al. Cardio-Renal Syndrome Type 4: The Correlation Between Cardiorenal Ultrasound Parameters. Kidney Blood Press Res 2016; 41: 654-662 doi:10.1159/000447934
• 31 Grabner A, Faul C. The role of fibroblast growth factor 23 and Klotho in uremic cardiomyopathy. Curr Opin Nephrol Hypertens 2016; 25: 314-324 doi:10.1097/MNH.0000000000000231
• 32 Chan CT, Levin NW, Chertow GM. et al. Determinants of cardiac autonomic dysfunction in ESRD. Clin J Am Soc Nephrol 2010; 5: 1821-1827 doi:10.2215/cjn.03080410
• 33 Tumlin JA, Costanzo MR, Chawla LS. et al. Cardiorenal syndrome type 4: insights on clinical presentation and pathophysiology from the eleventh consensus conference of the Acute Dialysis Quality Initiative (ADQI). Contrib Nephrol 2013; 182: 158-173 doi:10.1159/000349972
• 34 MacRae JM, Pandeya S, Humen DP. et al. Arteriovenous fistula-associated high-output cardiac failure: a review of mechanisms. Am J Kidney Dis 2004; 43: e17-e22
• 35 Mehta RL, Rabb H, Shaw AD. et al. Cardiorenal syndrome type 5: clinical presentation, pathophysiology and management strategies from the eleventh consensus conference of the Acute Dialysis Quality Initiative (ADQI). Contrib Nephrol 2013; 182: 174-194 doi:10.1159/000349970
• 36 Soni SS, Ronco C, Pophale R. et al. Cardio-renal syndrome type 5: epidemiology, pathophysiology, and treatment. Semin Nephrol 2012; 32: 49-56 doi:10.1016/j.semnephrol.2011.11.007
• 37 Chelazzi C, Villa G, De Gaudio AR. Cardiorenal syndromes and sepsis. Int J Nephrol 2011; 2011: 652967 doi:10.4061/2011/652967