Cardiorenal Syndrome Flashcards
______ _______dysfunction and ______dysfunctional frequently coexist in the same individual
left ventricular ; renal
The pathophysiological basis for cardiorenal syndrome is that ___________
dysfunction in 1 organ lead to dysfuntion in the other organ
Renal disease is associated with low _____ _____ such as _____ where renal blood flow is ________
cardiac output; HF; decreased
Medications known to worsen renal function
Diuretics
What plays a critical role in HF and is a prominent factor in renal dysfunction?
Neurohormonal Stimulation
What are the two systems that preserve the integrity of the arterial circulation and maintenance of blood flow to the vital organs?
Renin-angiotensin-Aldosterone system
Sympathetic nervous system
The NH response is initially compensatory but if left untreated lead to ________and _______ kidney injury
progressive; irreversible
CRS Type I Acute worsening of the _____ leading to ______Injury/dysfunction.
Acute cardiorenal syndrome. heart function; kidney
CRS Type II ________abnormalities of the _____ leading to ______Injury/dysfunction.
Chronic Cardiorenal syndrome; Chronic; heart; kidney
CRS Type III : Acute worsening of the _______ leading to _____injury or dysfunction.
Acute Renocardiac syndrome: kidney; heart
CRS type IV: Chronic ________ leading to ______ injury or dysfunction
Kidney injury ; heart
CRS Type V: Secondary Cardiorenal syndrome defined as ______Conditions leading to simultateneous injury or dysfunction of _____ and ______
systemic;
Most common cause of CRS type I
nonadherence to dietary or medication regimens
In CRS Type I there is alterations in _____ ______ and _____ ____ _____ as well as _______ ________
Cardiac output: intra-cardiac filing pressures; peripheral vasoconstriction
T or F : In ACS or cardiogenic shock , the risk of CRS type I is high despite the use of inotropes, vasopressors.
True
What is the focus in CRS type 3?
prevention
Medications known to worsen renal function
ACE
Diuretics
ARBs
anti-hyperlipidemics
Patients with CKD are more likely to die of _________than to progress to dialysis
CVD
2 Stronger predictors for worsening renal function are:
Hypertension and Hypervolemia
Cautionary approach to the treatment of patients with CRS type I is to assume that _______ is a direct result of _____ ______ until otherwise identified
AKI; renal hypoperfusion
What help tailor appropriate therapy
Hemodynamic and volume status
Mainstay of therapy for CRS Type I
Loop diuretics
Vasodilators (nitrates and Nesiritide)
Target fluid removal rate of
500ml/hr
Concomittant HF and ______ insufficiency cause a shift in the diuretic “dose-response-curve” to address this challenge current guidelines advocate the use of ______doses of Loop diuretics or adding a ____ ______ that acts on a ___ ______ such as _______
higher; second loop diuretics; distal tubule; metolazone.
Vasodilators provide hemodynamic benefits by (Increasing or decreasing) both _____ preload and afterload, leading to improvement is ________ , ______ and _______
Decreasing; cardiac output, BP and stroke volume
