• Matthieu Legrand, Alexandre Mebazaa, Claudio Ronco, and James L Januzzi.
• 1AP-HP, Groupe Hospitalier St-Louis-Lariboisière, Department of Anesthesiology and Critical Care and Burn Unit, Hôpitaux universitaires St-Louis-Lariboisière, Paris, France. 2Université Paris Diderot, Paris, France. 3Inserm UMR942, Paris, France. 4Department of Nephrology Dialysis and Transplantation, San Bortolo Hospital, Vicenza, Italy. 5Division of Cardiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
• Crit. Care Med. 2014 Sep 1; 42 (9): 2109-17.

ObjectiveTo review and describe diagnostic and prognostic value of biomarkers of renal function and renal injury in the cardiorenal syndrome complicating acutely decompensated heart failure.Data SourcesPubMed search and review of relevant medical literature.Study SelectionTwo reviewers screened and selected studies in English with diagnostic or prognostic assessment of biomarkers of renal injury.Data ExtractionNarrative review of the medical literature.Data SynthesisCardiorenal syndrome has a complex pathophysiology and has a generally poor prognosis in patients with acutely decompensated heart failure. Among the methods to recognize risk for cardiorenal syndrome may be the use of circulating or urinary biomarkers, which may allow for more accurate early diagnosis and risk stratification; use of biomarkers may provide important pathophysiologic understanding beyond risk prediction. However, different phenotypes of patients with acute renal dysfunction may be present, which has ramifications with respect to response to treatment strategies. Addition of biomarkers of renal injury may provide additional prognostic value to biomarkers of renal or cardiac function, but more data are needed.ConclusionsBiomarkers reflecting renal function and injury are likely to better phenotype subgroups of patients with cardiorenal syndrome and to provide unique prognostic information. Future studies are needed relative to strategies using such biomarkers to guide care of affected patients.

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