Una tipica manifestazione di Sindrome Cardio-Renale di Tipo 5: lo shock settico

Luca Di Lullo; Fulvio Floccari; Vincenzo Barbera; Antonio Granata; Antonio De Pascalis; Rossella Faiola; Moreno Malaguti; Alberto Santoboni; Rodolfo Rivera; Claudio Ronco

doi:10.33393/gcnd.2013.1047

Authors

Luca Di Lullo U.O.C. Nefrologia e Dialisi, Ospedale “L. Parodi-Delfino”, Colleferro, Roma
Fulvio Floccari U.O.C. Nefrologia e Dialisi, Ospedale “S. Paolo”, Civitavecchia, Roma
Vincenzo Barbera U.O.C. Nefrologia e Dialisi, Ospedale “L. Parodi-Delfino”, Colleferro, Roma
Antonio Granata U.O.C. Nefrologia e Dialisi, Ospedale “S. Giovanni di Dio”, Agrigento
Antonio De Pascalis U.O.C. Nefrologia, Dialisi e Trapianto, Ospedale “V. Fazzi”, Lecce
Rossella Faiola U.O.C. Nefrologia e Dialisi, Ospedale “L. Parodi-Delfino”, Colleferro, Roma
Moreno Malaguti U.O.C. Nefrologia e Dialisi, Ospedale “S. Paolo”, Civitavecchia, Roma
Alberto Santoboni U.O.C. Nefrologia e Dialisi, Ospedale “L. Parodi-Delfino”, Colleferro, Roma
Rodolfo Rivera Divisione di Nefrologia, Ospedale S. Gerardo”, Monza
Claudio Ronco International Renal Research Institute, Ospedale “S. Bortolo”, Vicenza

DOI:

https://doi.org/10.33393/gcnd.2013.1047

Keywords:

Type 5 cardiorenal syndrome, Sepsis, Acute kidney injury, Heart failure

Abstract

Type 5 cardiorenal syndrome (CRS) is a recently defined clinical syndrome for which complete epidemiological data is still missing. Type 5 CRS occurs when heart and kidneys are involved at once. The pathophysiology of type 5 CRS depends on the underlying disease. Acute type 5 CRS results from systemic processes, e.g. sepsis, infections, drugs, toxins, and connective tissue disorders such as lupus, Wegener's granulomatosis, and sarcoidosis. By contrast, the chronic type 5 CRS (i.e. cirrhotic liver disease) has a more insidious onset, as the kidney and cardiac dysfunction may develop slowly until reaching a crucial point leading to full decompensation. Diagnosis is based both on serological (biomarkers of acute cardiorenal disease, creatinine, and GFR levels) and imaging methods (echocardiography and abdominal ultrasound). Therapy is based on management of the underlying disease and treatment of cardiorenal complications (fluid therapy, drugs, and renal replacement therapy devices). (Cardionephrology)