Cardiorenal syndrome
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Synopsis

A condition that outlines the complicated interactions between heart and kidney function, in which primary disease of one organ results in dysfunction of the other. This relationship has been noted for decades but was not consistently defined. At this time, 5 subtypes of cardiorenal syndrome (CRS) are recognized.
In CRS types 1 and 2, the primary organ dysfunction is cardiac, which results in decline in renal function. CRS1 denotes acute heart failure, and CRS2 involves chronic heart failure. CRS types 3 and 4 refer to acute and chronic primary renal dysfunction resulting in heart failure. Type 5 CRS is distinct from all of these, in which an acute or chronic systemic disorder (such as sepsis) results in both renal and cardiac dysfunction.
In CRS types 1 and 2, the primary organ dysfunction is cardiac, which results in decline in renal function. CRS1 denotes acute heart failure, and CRS2 involves chronic heart failure. CRS types 3 and 4 refer to acute and chronic primary renal dysfunction resulting in heart failure. Type 5 CRS is distinct from all of these, in which an acute or chronic systemic disorder (such as sepsis) results in both renal and cardiac dysfunction.
Codes
ICD10CM:
I13.10 – Hypertensive heart and chronic kidney disease without heart failure, with stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease
SNOMEDCT:
445236007 – Cardiorenal syndrome
I13.10 – Hypertensive heart and chronic kidney disease without heart failure, with stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease
SNOMEDCT:
445236007 – Cardiorenal syndrome
Differential Diagnosis & Pitfalls
Differential diagnosis of acute kidney injury in the setting of congestive heart failure:
- Acute tubular necrosis – either toxic or ischemic
- Volume depletion in the setting of aggressive diuresis
- Renal atheroembolic disease – suspect if there was recent angiography or cardioversion
- Interstitial nephritis
Best Tests
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References
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Last Updated:09/15/2016