CARDIORENAL SYNDROME: CURRENT CONCEPTS, DIAGNOSTIC CHALLENGES AND MANAGEMENT
Cardiorenal syndrome represents a complex bidirectional disorder in which acute or chronic dysfunction of the heart and kidneys contributes to the progressive impairment of the other organ. The increasing global prevalence of heart failure, chronic kidney disease, diabetes mellitus, and hypertension has made CRS one of the most significant clinical challenges in cardiovascular and renal medicine. Despite substantial advances in diagnostic techniques and therapeutic strategies, CRS remains associated with high morbidity, mortality, prolonged hospitalization, and increased healthcare costs. The syndrome is characterized by intricate pathophysiological interactions involving hemodynamic abnormalities, neurohormonal activation, venous congestion, endothelial dysfunction, systemic inflammation, oxidative stress, and metabolic disturbances. Early diagnosis remains difficult because conventional biomarkers often fail to detect subclinical organ injury, while overlapping clinical manifestations complicate differentiation between primary cardiac and renal dysfunction. Recent advances in imaging modalities, novel biomarkers, and artificial intelligence-assisted risk prediction have improved diagnostic accuracy.