Can Transcatheter Aortic Valve Replacement Cure Cardiorenal Syndrome?

Cardiorenal syndrome can be challenging to diagnose, but the combination of heart failure and worsening kidney function portends a worse prognosis than either individual diagnosis. 1 Additionally, heart failure treatments, including diuretics and neurohormonal antagonists, frequently exacerbate chronic kidney disease (CKD), and the focus of increased hydration and limiting insults to the renal system in treating CKD leads to worsening heart failure. Therefore, cardiorenal syndrome is a vicious cycle, and the diagnosis that may contribute most to the interplay of worsening cardiorenal function is aortic stenosis (AS). Worsening kidney function leads to progressive AS, 2 and worsening severity of AS leads to decreased cardiac output, decreased kidney perfusion, and increased venous congestion, which leads to further deterioration in kidney function. Therefore, given that AS is a progressive intertwined death spiral of both the heart and the kidney, it may be reasonable to posit that correcting AS through aortic valve replacement could improve kidney function and arrest, if not reverse, cardiorenal syndrome. While we would assume that transcatheter aortic valve replacement