Soon after haemodialysis was introduced into clinical practice, a high risk of cardiac death was noted in end-stage renal disease. However, only in the last decade has it become clear that any renal ...injury, acute or chronic, is associated with high overall and cardiovascular lethality. The need for early recognition of kidney damage in cardiovascular pathology to assess risk and develop tactics for patient management contributed to the emergence of the concept of the “cardiorenal syndrome” (CRS). CRS is a pathophysiological disorder of the heart and kidneys in which acute or chronic dysfunction of one of these organs leads to acute or chronic dysfunction of the other. The beneficial effect of ultrafiltration as a component of renal replacement therapy (RRT) is due to the elimination of hyperhydration, which ultimately affects the improvement in cardiac contractile function. This review considers the theoretical background, current status of CRS, and future potential of RRT, focusing on the benefits of ultrafiltration as a therapeutic option.
It was concluded that depression (D) is an independent risk factor for cardiovascular diseases (CVD), and is not related to other previously determined cardiac risk factors. Compared with ...non-depressed patients, the risk of cardiac arrest increased in less severely depressed patients. D worsens the CVD prognosis by significantly increasing the risk of recurrent coronary heart disease (CHD). Some studies suggest that OS directly increases the risk of D in patients with CVD. Oxidative stress (OS) is considered an emergency mechanism that relates to both CVD and D pathophysiology. The common risk factors increase the production of OS and reduce antioxidant defences, thereby promoting the occurrence and development of interacted ischaemic CVD and D. At present, there is insufficient evidence that routine screening of D in patients with CHD will ultimately help improve the patient’s condition. This review reiterates the need for a multidisciplinary approach, which is necessary to understand, diagnose and then treat this frequent co-morbid condition of CHD and D. Assessment of OS markers could modify risk stratification, diagnosis and prevention and treatment of patients with both CHD and D, in patients with and without previous cardiac history.
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