Cardiorenal syndrome: issues of pathogenesis and diagnosis

The combined disorders in a human’s body related to functioning of such vital organs as heart and kidney with development and progress of concomitant hemodynamic disorders is called as cardiorenal syndrome. In early studies, insufficient cardiac pump function with subsequent renal dysfunction was considered as the main pathophysiologic component of cardiorenal syndrome. At the current stage of studying this syndrome, there is a greater understanding of the mechanisms of its development, however, there are also insufficiently studied aspects, since multiple systems of the human body can influence its occurrence and course. This review aims to analyze scientific publications covering the studied etiological factors, pathophysiological mechanisms, and pathogenesis of type 2 cardiorenal syndrome, as well as current issues in diagnosis and treatment of chronic kidney disease associated with chronic heart failure. The objective of the review is to analyze current data on pathogenetic mechanisms, diagnostic approaches and treatment strategies for type 2 cardiorenal syndrome, focusing on novel biomarkers and therapeutic methods. The literature review was conducted according to: Systematic analysis of publications in international databases (PubMed, Scopus, Web of Science). Priority to clinical guidelines and meta-analyses. Critical evaluation of evidence base. Emphasis on studies with clear diagnostic criteria of type 2 cardiorenal syndrome. Inclusion of both fundamental and clinical research The analysis covers publications from 2018-2023, including some seminal earlier works that have fundamental importance for understanding of pathogenesis. Special attention was given to studies conducted for the period of 2020-2023 and reflecting modern diagnostic and therapeutic advances.