What is new in cardiorenal syndrome? A narrative update

Juan S. Serna-Trejos, Servicio de Medicina Interna, Universidad Icesi, Cali, Colombia
Stefanya G. Bermúdez-Moyano, Servicio de Medicina Crítica y Cuidado intensivo, Hospital Universitario del Valle, Cali, Colombia
Carlos A. Castro-Galvis, Servicio de Medicina de Urgencias, Pontificia Universidad Javeriana, Cali, Colombia
María A. Londoño-Osorio, Servicio de Medicina Interna, Universidad Icesi, Cali, Colombia
Juan P. Lenis-González, Servicio de Medicina Interna, Universidad Icesi, Cali, Colombia
Juan C. Díaz-Beltrán, Servicio de Medicina Crítica y Cuidado Intensivo, Clínica Imbanaco, Cali, Colombia

Cardiorenal syndrome is characterized by the bidirectional interaction between cardiac and renal dysfunction, contributing to high morbidity and mortality. Understanding its pathophysiological mechanisms and the development of emerging therapies are essential to improve its clinical management. This narrative review analyzes recent advances in the management of cardiorenal syndrome, highlighting the role of biomarkers, emerging therapies, and the integration of translational science into its approach. A literature review was conducted in databases including Medline, PubMed, EMBASE, Cochrane Library, OVID, and ClinicalKey, including studies in English and Spanish. Classical and emerging cardiovascular and renal biomarkers with diagnostic and prognostic value supported by epidemiological data were identified. Innovative imaging strategies, such as venous excess ultrasound and bioelectrical impedance vector analysis, were also incorporated to assess congestion. In the therapeutic field, interventions with cardiorenal benefit were highlighted, including sodium-glucose cotransporter-2 inhibitors, glucagon-like peptide-1 receptor agonists, non-steroidal mineralocorticoid receptor antagonists, as well as tolvaptan and cardiac resynchronization therapy. The management of cardiorenal syndrome requires a multidisciplinary approach and the integration of new evidence-based therapeutic strategies, underscoring the need for future research to optimize its diagnosis and treatment.

Keywords: Cardio-renal syndrome. Reno-cardiac syndromes. Cardiorenal syndrome. Therapeutics. Translational science. Biomedical (MeSH/DeCS).