The Cardiorenal Anemia Syndrome. Part One: Epidemiology and Clinical Aspects

Authors

  • Rodolfo F. Rivera UO Nefrologia e Dialisi, Ospedale San Gerardo, ASST Monza, Monza
  • Maria Teresa Sciarrone Alibrandi UO Nefrologia, Dialisi e Ipertensione, IRCCS Ospedale San Raffaele, Milano
  • Luca Di Lullo UO Nefrologia e Dialisi, Ospedale L. Parodi- Delfino, Colleferro, Roma
  • Fulvio Floccari UO Nefrologia e Dialisi, Ospedale L. Parodi- Delfino, Colleferro, Roma
  • Antonio De Pascalis UO Nefrologia e Dialisi, Ospedale V. Fazzi, ASL Lecce, Lecce
  • Antonio Bellassi UO Nefrologia e Dialisi, Ospedale Sant'Anna, ASST-Lariana, Como
  • Claudio Ronco UO Nefrologia e Dialisi, Ospedale San Bortolo & International Renal Research Institute Vicenza (IRRIV), Vicenza

DOI:

https://doi.org/10.33393/gcnd.2017.674

Keywords:

Cardiorenal anemia syndrome (CRAS), Chronic kidney disease (CKD), Congestive heart failure (CHF)

Abstract

Anemia is a common complication associated with congestive heart failure (CHF) and chronic kidney disease (CKD), and is often reported as a component of the cardiorenal syndrome (CRS). The triad anemia, CHF and CKD has adverse prognostic implications that have led to the reformulation of the syndrome with the term “cardiorenal anemia syndrome” (CRAS). However, there is insufficient agreement about the definition of anemia in the CHF patient, probably due to the heterogeneity of the clinical criteria and the diversity of the patient populations in different studies. The evolution of drug therapy and technology (such as resynchronization of the left ventricle) has not stopped the increase in its incidence nor the associated health system costs. Unfortunately, the current guidelines do not provide specific recommendations for the adequate management of anemia in the cardiorenal patient. The pathophysiological mechanisms at the origin of anemia in CRS are complex and numerous. On the cardiovascular side the most important mechanisms are activation of the sympathetic and renin-angiotensin-aldosterone systems, antidiuretic hormone, and hemodilution, while those associated with CKD include reduction of the endogenous production of erythropoietin, chronic microinflammation, and iron deficiency. Consequently, anemia could represent a new clinical and therapeutic biomarker in CRS. A more comprehensive, 360-degree view, which stratifies the etiological, clinical and pathophysiological aspects, could significantly contribute to improving the prognosis of CRS patients. (Cardionephrology)

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Published

2017-09-12

How to Cite

Rivera, R. F., Alibrandi, M. T. S., Di Lullo, L., Floccari, F., De Pascalis, A., Bellassi, A., & Ronco, C. (2017). The Cardiorenal Anemia Syndrome. Part One: Epidemiology and Clinical Aspects. Giornale Di Clinica Nefrologica E Dialisi, 29(3), 196–202. https://doi.org/10.33393/gcnd.2017.674

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Section

Cardionephrology

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