Renal Dysfunction: How to Think About That in Acute Coronary Syndromes

Curr Cardiol Rep. 2017 Aug 24;19(10):91. doi: 10.1007/s11886-017-0903-5.

Abstract

Purpose of review: Reduction of kidney function and heart disease frequently coexisted in the seam patient. The relation between renal and heart function is quite complex and bring out some unresolved questions about diagnosis (mostly related to the biomarkers levels interpretation), pharmacological therapy (mostly related to drugs kinetics and efficacy), and non-pharmacological therapy.

Recent findings: Patients with kidney dysfunction (KD) are frequently excluded and underrepresented in the large trials. It is well-known that coronary revascularization reduces mortality also in KD patients presenting with acute coronary syndrome. However, acute kidney injury (AKI), primarily related at contrast medium administration, is worse prognosis. For this reason, prevention, early diagnosis, and effective therapy of ACK are key elements in assistance of these patients. In this context, recently, some new biomarkers of renal function have been proposed. Frequently, patients with acute coronary syndromes and kidney disease are undertreated, worsening their prognosis. Undertreatment and comorbidities associated with renal dysfunction explain the higher mortality of these patients.

Keywords: Acute coronary syndromes; Biomarkers; CKD; Coronary angiography; GFR; Renal function.

Publication types

  • Review

MeSH terms

  • Acute Coronary Syndrome / complications*
  • Acute Coronary Syndrome / surgery
  • Acute Kidney Injury / chemically induced
  • Acute Kidney Injury / complications*
  • Acute Kidney Injury / mortality
  • Biomarkers / blood
  • Contrast Media / adverse effects
  • Humans
  • Percutaneous Coronary Intervention
  • Prognosis

Substances

  • Biomarkers
  • Contrast Media