Update on type 2 cardiorenal syndrome

Abstract

Background: Cardiorenal syndrome type 2 is an “umbrella” term used to describe clinical conditions in which chronic cardiac failure through a chronological and causal relationship leads to renal dysfunction. The syndrome is associated with a significant morbidity and mortality, that is why it has recently become a matter of growing debate related to pathogenesis, diagnosis, treatment effectiveness and safety. Our aim was to review epidemiological and pathological mechanisms underlying cardiorenal syndrome, to focus on up-to-date diagnosis and treatment strategies. We performed literature search in the Pubmed database in July 2015. The 1st key word used for search was “cardiorenal syndrome type 2”; and the 2nd key word was “cardiorenal syndrome in heart failure”. Conclusions: Over the last decade, a significant advance in the understanding of the cardiorenal syndrome has been achieved. However, precise pathways remain to be clarified. Clinical management of these patients include diuretics, vasodilatators, ultrafiltration, all these modalities promise more rapid volume removal, but their ultimate impact on survival and renal function is unknown. Future research is necessary to improve diagnosis, severity grading, to differentiate type 2 and type 4 cardiorenal syndrome and to determine efficient treatment strategies. Because of the syndrome’s complexity and poor outcome, it is important that cardiologists, nephrologists and internists work together for a unique goal – protecting the patient with cardiorenal syndrome.