If you don't remember your password, you can reset it by entering your email address and clicking the Reset Password button. You will then receive an email that contains a secure link for resetting your password
If the address matches a valid account an email will be sent to __email__ with instructions for resetting your password
Cross-talk between the kidneys and the heart has long been appreciated. The kidneys are referred to in the Talmud—the central text of Judaism, written during approximately the 4th century AD—as the organs that “give the heart advice and counsel.”
During the Middle Ages, the Italian physician Gentile da Foligno referred to heart disease as one of the major conditions that affected the color and output of urine.
In the 19th century the English physician, Richard Bright, observed that cardiac hypertrophy was a common disorder in patients suffering from chronic kidney disease (CKD).
Today, the pathophysiology that underlies the complex and bidirectional nature of heart–kidney interactions is increasingly well understood, and is referred to as the cardiorenal syndrome.
However, the heart is only one of many organs that affects, and is affected by, the kidneys. Numerous interactions have been documented between the kidneys and remote organ systems in CKD. Notable examples include the following: (1) impaired iron absorption/utilization and decreased production of erythropoietin, which contributes to anemia; (2) dysregulated mineral metabolism, which contributes to renal osteodystrophy and cardiovascular disease; (3) impaired immunity, which increases susceptibility to infection; (4) dysfunctional platelets, which increase bleeding risk; and (5) water and salt retention, which affects all organs, particularly the heart and lungs.
As in CKD, important cross-talk also occurs between the kidneys and remote organ systems in the setting of acute kidney injury (AKI). These interactions often are bidirectional. For example, portal hypertension, a nearly universal complication of advanced cirrhosis, causes renal arteriolar vasoconstriction,
Figure 1Cross-talk between the kidneys and remote organ systems in AKI. Abbreviations: 1,25D, 1,25-dihydroxyvitamin D; ARDS, acute respiratory distress syndrome; Ca, calcium; FGF23, fibroblast growth factor 23; PO4, phosphate, PTH, parathyroid hormone.
In this issue of Seminars in Nephrology, we have invited leading experts, including basic, translational, and patient-oriented research and clinician scientists, to provide a comprehensive discussion of cross-talk between the kidneys and remote organ systems in AKI. We hope that their contributions will generate enthusiasm for continued research in this important area, and that investigation into these interconnected pathways ultimately will translate into new opportunities for therapeutic intervention in AKI.
REFERENCES
Kottek SS.
"The kidneys give advice": some thoughts on nephrology in the Talmud and Midrash.
Financial support: This work was supported by grant K23DK106448 from the National Institute of Diabetes and Digestive Kidney Diseases (D.E.L.), and was supported by an American Society of Nephrology Foundation for Kidney Research Carl W. Gottschalk Research Scholar Grant (D.E.L.).
30161-X&id=gr1.jpg){kind=link}