JOURNAL ARTICLE

Cardio-renal syndromes: report from the consensus conference of the acute dialysis quality initiative

Claudio Ronco, Peter McCullough, Stefan D Anker, Inder Anand, Nadia Aspromonte, Sean M Bagshaw, Rinaldo Bellomo, Tomas Berl, Ilona Bobek, Dinna N Cruz, Luciano Daliento, Andrew Davenport, Mikko Haapio, Hans Hillege, Andrew A House, Nevin Katz, Alan Maisel, Sunil Mankad, Pierluigi Zanco, Alexandre Mebazaa, Alberto Palazzuoli, Federico Ronco, Andrew Shaw, Geoff Sheinfeld, Sachin Soni, Giorgio Vescovo, Nereo Zamperetti, Piotr Ponikowski
European Heart Journal 2010, 31 (6): 703-11
20037146
A consensus conference on cardio-renal syndromes (CRS) was held in Venice Italy, in September 2008 under the auspices of the Acute Dialysis Quality Initiative (ADQI). The following topics were matter of discussion after a systematic literature review and the appraisal of the best available evidence: definition/classification system; epidemiology; diagnostic criteria and biomarkers; prevention/protection strategies; management and therapy. The umbrella term CRS was used to identify a disorder of the heart and kidneys whereby acute or chronic dysfunction in one organ may induce acute or chronic dysfunction in the other organ. Different syndromes were identified and classified into five subtypes. Acute CRS (type 1): acute worsening of heart function (AHF-ACS) leading to kidney injury and/or dysfunction. Chronic cardio-renal syndrome (type 2): chronic abnormalities in heart function (CHF-CHD) leading to kidney injury and/or dysfunction. Acute reno-cardiac syndrome (type 3): acute worsening of kidney function (AKI) leading to heart injury and/or dysfunction. Chronic reno-cardiac syndrome (type 4): chronic kidney disease leading to heart injury, disease, and/or dysfunction. Secondary CRS (type 5): systemic conditions leading to simultaneous injury and/or dysfunction of heart and kidney. Consensus statements concerning epidemiology, diagnosis, prevention, and management strategies are discussed in the paper for each of the syndromes.

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