Division of Cardiology, Department of Medicine, Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada; Department of Critical Care Medicine, University of Alberta, Edmonton, Alberta, Canada
Michelle M. Graham, MD, FRCPC, FCCS
Division of Cardiology, Department of Medicine, Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada
Ashani Lecamwasam, MBBS, FRACP
School of Medicine, Faculty of Health, Deakin University, Geelong, Victoria, Australia; Department of Nephrology, Northern Health, Epping, Victoria, Australia; Epworth UroRenal and Vascular Clinical Institute, Internal Medicine Clinical Institute, Victoria, Australia
Adam Romanovsky, MD
Department of Critical Care Medicine, University of Alberta, Edmonton, Alberta, Canada; Division of Nephrology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
Shelley Duggan, MD
Department of Critical Care Medicine, University of Alberta, Edmonton, Alberta, Canada; Division of Nephrology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
Sean Bagshaw, MD
Department of Critical Care Medicine, University of Alberta, Edmonton, Alberta, Canada
Janek Manoj Senaratne, MD, MSc, FRCPC, FACC
Division of Cardiology, Department of Medicine, Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada; Department of Critical Care Medicine, University of Alberta, Edmonton, Alberta, Canada; Corresponding author: Dr Janek Manoj Senaratne, 2939-66 Street NW, Edmonton, Alberta, T6K 4C1, Canada. Tel.: +1-780-463-2184; fax: +1-780-450-8359.
A complex interaction occurs between cardiac and renal function. They are intricately tied together, and a range of disorders in both the heart and kidneys can alter the function of the other. The pathophysiology is complex, and these conditions are termed cardiorenal syndromes. They can be acute and/or chronic in nature, they result in and from hemodynamic consequences, systemic congestion, and metabolic abnormalities, and they lead to dysfunction of both the heart and kidneys. The aim of this article is to provide a review for cardiologists and intensivists who are treating patients for whom cardiac and renal interactions may complicate their picture. We review acute kidney injuries, management of the complications of renal dysfunction, renal replacement therapy, and cardiorenal syndromes. Résumé: Il existe une interaction complexe entre la fonction cardiaque et la fonction rénale. Elles sont étroitement liées, et un éventail de troubles cardiaques et rénaux peuvent altérer la fonction de l’autre. Ces maladies dont la physiopathologie est complexe sont appelées syndromes cardiorénaux. Elles peuvent être aiguës et/ou chroniques de nature, elles entraînent des conséquences hémodynamiques, une congestion systémique et des anomalies métaboliques, ou résultent de celles-ci, et elles mènent à la dysfonction du cœur ou des reins. L’objectif du présent article est d’offrir une revue aux cardiologues et aux intensivistes qui traitent des patients dont les interactions cardiaques et rénales peuvent compliquer leur tableau. Nous passons en revue les atteintes rénales aiguës, la prise en charge des complications de la dysfonction rénale, le traitement de substitution rénale et les syndromes cardiorénaux.
