Toward Precision Medicine in the Cardiorenal Syndrome

Adv Chronic Kidney Dis. 2018 Sep;25(5):418-424. doi: 10.1053/j.ackd.2018.08.017.

Abstract

Although the field of oncology has made significant steps toward individualized precision medicine, cardiology and nephrology still often use a "one size fits all" approach. This applies to the intersection of the heart-kidney interaction and the cardiorenal syndrome as well. Recent studies have shown that the prognostic implications of worsening renal function (WRF) in acute heart failure are variable; thus, there is a need to differentiate the implications of WRF to better guide precise care. This may best be performed with biomarkers that can give the clinician a real-time evaluation of the physiologic state at the time of developing WRF. This review will summarize current cardiac and renal biomarkers and their status in the evaluation of cardiorenal syndrome. Although we have made progress in our understanding of this syndrome, further investigation is needed to bring precision medicine into routine clinical practice for the care of patients with cardiorenal syndrome.

Keywords: Acute kidney injury; Cardiorenal syndrome; Precision medicine.

Publication types

  • Review

MeSH terms

  • Biomarkers / metabolism
  • Cardio-Renal Syndrome / classification
  • Cardio-Renal Syndrome / mortality
  • Cardio-Renal Syndrome / physiopathology*
  • Cardio-Renal Syndrome / therapy*
  • DNA-Binding Proteins / metabolism*
  • Disease Progression*
  • Female
  • Forecasting
  • Heart Function Tests
  • Humans
  • Kidney Function Tests
  • Male
  • Precision Medicine / trends*
  • Prognosis
  • Risk Assessment
  • Severity of Illness Index
  • Survival Analysis
  • Transcription Factors / metabolism*

Substances

  • Biomarkers
  • DNA-Binding Proteins
  • GFI1 protein, human
  • Transcription Factors