Pediatric Cardiorenal Syndromes

Abstract

Cardiorenal syndrome (CRS) describes a specific acute and chronic clinical picture in which the heart or the kidney are primarily dysfunctioning and secondarily affect each other. CRS is classified into five classes: acute (I) and chronic (II) CRS, acute (III) and chronic (IV) reno-cardiac syndromes, and secondary dysfunction (V) of both heart and kidneys (i.e. during systemic clinical syndromes as sepsis, diabetes, auto-immune conditions, etc.). Pediatric CRS (pCRS) are currently well established conditions, with peculiar aspects with respect to adult patients. Acute CRS (type I) in infants generally relates to patients undergoing cardiopulmonary bypass, whereas CRS type 2 (CRS II) is related to children with chronic heart dysfunction, such as dilated cardiomyopathy. The prevalence, risk factors and outcomes of CRS in children is less described. The present chapter will specifically detail epidemiology, risk factors, therapeutic options and outcomes of CRS I and II, in order to highlight all the clinical conditions that secondarily affect renal function due to heart failure.