Updates in management of cardiorenal syndrome

PURPOSE OF REVIEW: Cardiorenal syndrome is common, increasing in prevalence mainly due to increases in obesity, diabetes, hypertension and chronic kidney disease. The patients with cardiorenal syndrome are often frail and elderly suffering from poor quality of life, multiple hospital admissions, and death. There has been an increase in the number of evidence-based medications available for prevention and treatment of cardiorenal syndrome; however, implementation remains a challenge. RECENT FINDINGS: In ambulatory patients, we discuss emerging evidence-based therapies such as nonsteroidal mineralocorticoid antagonists and glucagon-like peptide-1 receptor agonists for cardiorenal syndrome across all stages of chronic kidney disease, alongside the challenges of electrolyte imbalance and kidney function decline. In admitted patients, recent advances focus on optimization of volume status, including saline replacement during diuresis when appropriate and the use of adjuncts to loop diuretics (e.g. thiazide-type diuretics) to overcome diuretic resistance. SUMMARY: These findings highlight the growing range of novel therapies expanding the cardiorenal physician's armamentarium, offering greater flexibility in managing cardiorenal syndrome across its spectrum to improve outcomes and improve the quality of life of patients suffering from cardiorenal syndrome.