Cardio-Renal Syndrome: Review and New Perspectives

Cardio-renal syndrome (CRS) is a term referring to a bidirectional group of disorders in which there is a concomitant compromise of both organs, the heart and the kidney, leading to a significant increase in morbidity and mortality. In recent years, numerous publications have addressed this complex entity from different points of view. For better understanding, five subtypes have been established: depending on its form of presentation, acute or chronic; the organ initially affected; and whether there is another responsible systemic disease. CRS represents a complex interaction between both organs with several neurohormonal, inflammatory, and hemodynamic pathophysiological mechanisms involved. Because of its heterogeneous presentation and complex management, CRS requires a multidisciplinary approach targeting multiple pathogenic mechanisms. Throughout this review, we will analyze all relevant aspects of CRS from its classification to current diagnosis and treatment. Accordingly, this review provides a holistic overview of cardio-renal syndrome, emphasizing integrated pathophysiological mechanisms, contemporary diagnostic approaches, and their relevance for clinical management.