Editorial: Preventing Cardio-renal Syndrome Rather than Treating It: Could Statins Play A Role?

Cardiorenal syndrome (CRS) is the umbrella term used to describe clinical conditions in which renal dysfunction accompanies cardiac failure or cardiac dysfunction accompanies renal failure [1,2].There are 5 types of CRS (Table 1).The rising prevalence of chronic kidney disease (CKD) and heart failure (HF), contributed to the increase of the incidence of CRS, which was further increased by the improved survival of patient with HF, CKD or both [3,4].The heterogeneous and complex pathophysiology of CRS makes effective patient management difficult.Established therapeutic strategies, such as diuretics, are often associated with resistance and limited clinical success [3,5].Fabian et al. [6] provide useful data about CRS.The percentage of patients with the syndrome is relatively high among patients admitted in an Internal Medicine Ward (1 in 7 patients).In CRS, HF and CKD shared a substantial number of risk factors [6], such as old age, arterial hypertension, diabetes mellitus (DM), and history of cardiovascular disease (CVD) [6].Despite the fact that Fabian et al. do not report mortality rates they support that "women with glomerular filtration rate (GFR) 30-44 ml/min/1.73m 2 and men with GFR 30-50 ml/min/1.73m 2 but without history of CVD had a hazard ratio for CVD of 1.51 that increased to 2.39 in those with CVD history.Worsening of renal function is also an independent predictor of mortality in acute decompensated heart failure (ADHF)."Moreover, it has been established that individuals with CKD are more likely to die of CVD than to develop kidney failure [7].Thus, given the poor prognosis of CRS [3,5] Fabian et al. suggest that prevention is a priority [8].