The cardiorenal syndrome involves a combination of cardiac and renal failure, resulting in decompensation of the circulatory system.
Features of the cardiorenal syndrome:
(1) initial presence with heart or renal failure
(2) decompensation in the other organ's function
The typical patient is hospitalized for heart failure and then is found to be resistant to diuretics.
Patients at risk (Boerrigter and Burnett):
(1) history of heart failure
(2) history of diabetes mellitus
(3) serum creatinine on admission >= 1.5 mg/dL
(4) systolic blood pressure on admission > 160 mm Hg
(5) therapy with calcium channel blockers
(6) requirement for a higher dose of loop diuretic
• A lower serum creatinine threshhold may be appropriate in an older patient.
Forman et al developed a score based on the following point assignment:
history of previous episodes of CHF
history of diabetes mellitus
systolic blood pressure
<= 160 mm Hg
> 160 mm Hg
< 1.5 mg/dL
1.5 - 2.49 mg/dL
>= 2.5 mg/dL
total score =
= SUM(points for all 4 parameters)
• minimum score: 0
• maximum score: 6
• The higher the score the greater the risk of worsening renal function.
Probability of Worsening Renal Function
4 - 6
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Purpose: To identify a patient at risk for the cardiorenal syndrome.
Specialty: Nephrology, Clinical Laboratory, Cardiology
Objective: risk factors, clinical diagnosis, including family history for genetics, severity, prognosis, stage