The Cardiorenal Syndrome: A Clinician's Guide to Pathophysiology and Management
Simply put, the cardiorenal syndrome represents a condition in which renal impairment occurs as a result of acute or chronic cardiac dysfunction. Impaired kidney function is very strongly associated with poor outcomes in patients with heart failure and often complicates treatment. The underlying pathophysiology of the cardiorenal syndrome is complex and heterogeneous. There have been recent advances in understanding the underlying relationship between the heart, kidneys, and the autonomic nervous system. However, there are no evidence-based treatment guidelines available to assist clinicians in the management of these challenging patients.
The publication of The Cardiorenal Syndrome: A Clinician's Guide to Pathophysiology and Management is very timely and represents a welcomed compilation of the body of knowledge related to this complex and clinically vexing condition. It provides the reader with an up-to-date understanding of the underlying epidemiology, pathophysiology, and currently available treatments for patients with cardiorenal syndrome. This textbook is oriented toward the practicing internist or cardiologist who makes clinical decisions for patients experiencing cardiorenal syndrome. It also is a valuable resource for clinical researchers who wish to have a comprehensive understanding of the clinical aspects of this condition and easy access to all the relevant references.
The book has 235 pages organized into 16 chapters. The contributing authors include an impressive list of leading clinicians and researchers in the field of heart failure and cardiorenal syndrome. It is hard to imagine assembling a more distinguished and knowledgeable panel of contributors.
Each chapter opens with an overview of the topic being covered. Text and figures are then divided into clearly separated subsections, making the book easier to read and it easier to find areas of particular interest. Each chapter ends with a clearly labeled conclusion and excellent, comprehensive references.
The first 2 chapters set the stage and provide background regarding the role of the kidney and the autonomic nervous system in the cardiorenal syndrome. In the first chapter, the eminent researcher and nephrologist Dr Robert Schrier describes the role of the kidney in heart failure. The second chapter provides a very provocative and contemporary view of the role of the renal nerves in the cardiorenal syndrome, encompassing some of the latest research involving renal denervation in humans. The next 3 chapters describe the diagnosis, prognosis, epidemiology, and hemodynamic considerations of the cardiorenal syndrome. The following chapters address the current understanding and ongoing clinical role of medications, including diuretics, angiotensin-converting enzyme inhibitors, inotropes, natriuretic peptides, and vasopressin and adenosine receptor antagonists. Mechanical treatment modalities such as ultrafiltration, renal cell therapy, renal replacement therapy and transplantation, cardiac transplantation, and mechanical circulatory support are discussed in subsequent chapters. The final chapter concludes with a practical clinical approach to the patient with cardiorenal syndrome that resonates with any clinician who encounters this condition on a regular basis.
In summary, The Cardiorenal Syndrome: A Clinician's Guide to Pathophysiology and Management is a wonderful, readable reference written by a panel of contributors unsurpassed in their expertise and experience dealing with the cardiorenal syndrome. It is ideally suited for the internist, cardiologist, or researcher with an interest in an up-to-date, well-referenced, clearly written guide to the cardiorenal syndrome.
Bradley Bart, MD
Hennepin County Medical Center
Dr Bart has received research funding from the National Institutes of Health and is an unpaid consultant for Gambro.
- © 2012 American Heart Association, Inc.