What is cardiorenal syndrome in anemia of chronic disease and renal failure?

Updated: Nov 27, 2018
  • Author: Edgar V Lerma, MD, FACP, FASN, FAHA, FASH, FNLA, FNKF; Chief Editor: Emmanuel C Besa, MD  more...
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Answer

Answer

Silverberg et al described the "cardiorenal syndrome," which refers to a vicious cycle, whereby decreased kidney function, as seen in chronic kidney disease, leads to decreased erythropoietin production and, thence, anemia. [34]

Anemia, if severe, leads to a compensatory left ventricular hypertrophy (LVH). Such compensatory LVH eventually leads to precipitation of congestive heart failure (CHF), which causes a decline in blood perfusion to the kidneys, resulting in further kidney damage. Levin et al estimated that for every 1-g decrease in hemoglobin concentration, there is an increased 6% risk of LVH in patients with chronic kidney disease. [35] Foley et al estimated that such a 1-g decrease in hemoglobin concentration also translated into a 42% increase in left ventricular dilatation in patients with stage 5 chronic kidney disease.


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