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Mechanisms of Kidney and Heart Cross-talk in Acute Kidney Injury

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Textbook of Cardiorenal Medicine

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Abstract

Acute kidney injury (AKI) is related to high mortality and morbidity. Experimental evidence has explained distant organ dysfunctions induced by AKI. It is revealed that the crosstalk between the kidney and heart, which has been known as cardiorenal syndrome, carries an important role in clinical outcomes; However the mechanisms by which AKI causes cardiac injury, are not well understood. Recent studies especially in animal models presented that AKI causes multiple distant organ failures including pulmonary, cardiac, hepatic, and neurologic dysfunction. We herein discussed the effects of AKI on cardiac injury. Different mechanisms are suggested to trigger cardiac injury by AKI including, Induction of systemic inflammation, sympathetic nervous system stimulation, renin-angiotensin-aldosterone system activation, increased oxidative stress, immunomodulation and mitochondrial fragmentation. Exact identification of these pathways will be essential in promoting targeted therapies to improve outcomes in AKI. This chapter updates the recent findings on distant cardiac effect of AKI. We will then discuss the long-term prognosis of cardiac injury triggered by AKI to further emphasize the importance of targeting currently known pathways to further improve the risks of cardiovascular disease in AKI patients.

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  1. Division of Nephrology and Center for Immunity, Inflammation and Regenerative Medicine, Department of Medicine, University of Virginia, Charlottesville, VA, USA

    Negiin Pourafshar & Mark D. Okusa

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  1. Negiin Pourafshar
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  2. Mark D. Okusa
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Correspondence to Mark D. Okusa .

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Editors and Affiliations

  1. Baylor University Medical Center, Texas A&M University, Dallas, TX, USA

    Peter A. McCullough

  2. Director, Department of Nephrology Dialysis and Transplantation, International Renal Research Institute (IRRIV), Ospedale San Bortolo Vicenza, Vicenza, Italy

    Claudio Ronco

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Pourafshar, N., Okusa, M.D. (2021). Mechanisms of Kidney and Heart Cross-talk in Acute Kidney Injury. In: McCullough, P.A., Ronco, C. (eds) Textbook of Cardiorenal Medicine. Springer, Cham. https://doi.org/10.1007/978-3-030-57460-4_18

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