Type 3 Cardiorenal Syndrome

Heart and kidney disease often coexist in the same patient, and studies have shown that cardiac disease can directly contribute to worsening kidney function and vice versa. Cardiorenal syndrome (CRS) is defined as a complex pathophysiological disorder of the heart and the kidneys in which acute or chronic dysfunction in one organ may induce acute or chronic dysfunction in the other organ. This has been classified into five subtypes based on the primary organ dysfunction (primum movens) (heart or kidney) and whether the organ dysfunction is acute or chronic. CRS type 1 (CRS-1) is characterized by an acute deterioration in cardiac function that leads to acute kidney injury (AKI); in CRS type 3 (CRS-3), AKI leads to acute cardiac injury and/or dysfunction, such as cardiac ischemic syndromes, congestive heart failure, or arrhythmias (Cruz, Adv Chronic Kidney Dis 20(1):56–66, 2013). This chapter will provide a detailed review of the epidemiology, pathophysiology, prevention strategies, and selected management aspects for CRS-3.