Cardiac and renal diseases are major public health burden in the Australian community with increasing to both the cost of health system and quality of life. The cardiorenal syndrome (CRS) is a condition characterised by kidney and heart failure where failure of one organ worsens the function of the other thus further accelerating the progressive failure of both, ultimately leading to increased cardiovascular morbidity and mortality. A close and bi-directional relationship between chronic kidney disease (CKD) and chronic heart failure (CHF) has been demonstrated. CKD is an important contributor to cardiovascular mortality which in turn is responsible for 40–50 per cent of all deaths. Conversely, coronary artery disease, left ventricular hypertrophy and CHF are major clinical cardiac disorders observed in CKD patients. Currently, mechanisms underlying this relationship remain uncertain.
While hemodynamic derangements (elevated venous pressure, elevated intra-abdominal pressure, low cardiac output, hypotension) could explain the adverse relationship between heart and kidneys during an acute failure of either one, the interpretation of the complex physiological, biochemical, and hormonal derangements (RAAS, natriuretic peptides) encompassing the chronic CRS remains poorly understood. In addition, despite advances in treatment and the identification of associated epidemiological risk factors, the number of HF-related deaths continues to steadily increase. Among cardiovascular diseases, CHF has a very high prevalence, increasing incidence, high mortality, and frequent hospitalisation and associated economic consequences on health care expenditure.
Novel strategies are urgently required to improve mortality, morbidity and quality of life.