A Closer Review of Therapeutic Effects of Renal Denervation on the Cardiorenal Syndrome: The Role of Classical and Non-Classical Renin-Angiotensin System Axes

Abstract

The "Cardiorenal Syndrome (CRS)" includes a simultaneous heart-kidney dysfunction in such a way that damage in one organ subsequently leads to damage in another and vice versa. Although for the first time in a classification in 2008, two main groups called cardiorenal and reno-cardiac (based on the onset of the disease in each organ) were used for this term, but today there are five main classifications for it. Various factors take part in this syndrome pathophysiology, including endotoxemia, inflammatory processes, metabolic derangements, infections, imbalance in neurohormones secretion, venous congestion and immunological dysfunction. But the main cause of this syndrome' onset in many cases is over-activity of renal sympathetic nerves and subsequently increased interaction with the stimulated renin-angiotensin system (both classical and non-classical axes). Regarding this fact, today renal denervation is known as a useful therapeutic approach in solving the disorders of this syndrome, which its safety and efficacy have been proven in many experimental and clinical studies.