Cardiorenal syndrome (CRS) type 1 is the development of acute kidney injury (AKI) in the patient with acute cardiac illness, most commonly acute decompensated heart failure (ADHF)
Multiple pathophysiological mechanisms result in CRS characterized by a rise in serum creatinine, oliguria, diuretic resistance, and worsening ADHF
There are a host of predisposing factors that create baseline risk for CRS (DM, HTN, HLD, OSA)
The final common pathway often results in bidirectional organ injury, drug resistance, and death
The combination of worsening renal function, volume overload, and diuretic refractoriness makes the management of CRS challenging
Current therapies although often ineffective include aggressive diuresis and positive inotropes
References
Ronco C, et al. Cardiorenal Syndrome Type I: Pathophysiological Crosstalk Leading to Combined Heart and Kidney Dysfunction in the Setting of Acutely Decompensated Heart Failure. JACC Vol. 60, No. 12, 2012
