Emerging Individualized Approaches in the Management of Acute Cardiorenal Syndrome With Renal Assist Devices
Recommended Citation
Martens P, Burkhoff D, Cowger JA, Jorde UP, Kapur NK, and Tang WHW. Emerging Individualized Approaches in the Management of Acute Cardiorenal Syndrome With Renal Assist Devices. JACC Heart Fail 2023.
Document Type
Article
Publication Date
10-1-2023
Publication Title
JACC Heart Fail
Abstract
Growing insights into the pathophysiology of acute cardiorenal syndrome (CRS) in acute decompensated heart failure have indicated that not every rise in creatinine is associated with adverse outcomes. Detection of persistent volume overload and diuretic resistance associated with creatinine rise may identify patients with true acute CRS. More in-depth phenotyping is needed to identify pathologic processes in renal arterial perfusion, venous outflow, and microcirculatory-interstitial-lymphatic axis alterations that can contribute to acute CRS. Recently, various novel device-based interventions designed to target different pathophysiologic components of acute CRS are in early feasibility and proof-of-concept studies. However, appropriate trial endpoints that reflect improvement in cardiorenal trajectories remain elusive and highly debated. In this review the authors describe the variety of physiological derangements leading to acute CRS and the opportunity to individualize the management of acute CRS with novel renal assist devices that can target specific components of these alterations.
Medical Subject Headings
Humans; Cardio-Renal Syndrome; Heart Failure; Creatinine; Microcirculation; Kidney
PubMed ID
37676211
ePublication
ePub ahead of print
Volume
11
Issue
10
First Page
1289
Last Page
1303
