Cardiovascular Consequences of Acute Kidney Injury- A NEJM r
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Acute kidney injury is generally characterized by an abrupt rise in the serum creatinine level, decreased urinary output, or both. Advances in critical care and renal replacement therapies have provided tools that can support patients through most of the immediate complications of acute kidney injury, such as uremia or hyperkalemia, which could be rapidly fatal. Yet mortality from acute kidney injury remains high.

Up to 60% of patients with severe acute kidney injury who are admitted to an intensive care unit (ICU) die from the disorder; the long-term risk of death associated with acute kidney injury is also increased. Acute kidney injury is associated with an increased risk of chronic and endstage kidney disease and has adverse effects on other organ systems, including the heart.

Likewise, patients with chronic kidney disease are at high risk for acute kidney injury and adverse cardiovascular sequelae. Accumulating evidence supports the notion that cardiovascular damage due to acute kidney injury leads to other poor outcomes, independent of or intertwined with the risks associated with the development of chronic kidney disease. Interactions between cardiac and kidney diseases have been classified as cardiorenal syndromes.

A current classification includes five types of cardiorenal syndromes: acute cardiac impairment leading to acute kidney injury (type 1), chronic cardiac impairment leading to kidney impairment (type 2), acute kidney injury leading to cardiac impairment (type 3), chronic kidney disease leading to cardiac impairment (type 4), and systemic conditions leading to both cardiac and kidney impairment (type 5).

This review discusses the current understanding of the cardiovascular consequences of acute kidney injury (i.e., type 3 cardiorenal syndrome). It also discusses potential preventive strategies that target acute and recovery phases, with the aim of reducing the risk of subsequent adverse clinical events.

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