Pediatric cardiorenal syndrome

Document Type

Book Chapter

Publication Date

10-2025

Identifier

DOI: 10.1016/B978-0-443-13279-7.00067-5

Abstract

Complex interactions between the heart and kidneys maintain fine control of the day-to-day hemodynamic state in healthy people. Injury or dysfunction in either organ, therefore, leads to alterations in the system that start out as compensatory but could become maladaptive over time. Cardiorenal syndrome (CRS) is a state of bidirectional heart-kidney cross talk in which acute or chronic injury or dysfunction in one organ system contributes to acute or chronic injury or dysfunction in the other through hemodynamic, neurohormonal, immunologic, and biochemical feedback pathways. Type 1 CRS represents acute renal injury in the setting of low cardiac output, while type 2 CRS represents chronic kidney disease developing in the state of chronic heart failure and congestion. Type 3 CRS is the acute cardiac dysfunction in the setting of acute renal injury, while Type 4 CRS is the chronic cardiac dysfunction in patients with chronic kidney disease. Clinicians responsible for caring for children with cardiac and renal disease should be cognizant of the frequent occurrence of dual organ dysfunction and have a low threshold of further diagnostic studies, such as use of alternative filtration markers in types 1 and 2 CRS and early and timely echocardiographic studies with investigation for myocardial strain in types 3 and 4 CRS.

Journal Title

Heart Failure in the Child and Young Adult (Second Edition)

First Page

519

Last Page

530

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