The pathophysiology of chronic cardiorenal disease based on central hemodynamics

As patients with chronic kidney disease (CKD) and chronic heart failure (CHF) increase, there is concern about a future heart failure pandemic. Deterioration of renal function is an independent prognostic factor for CHF after decongestion. Interactions between renal disease and cardiac disease are increasing, including nephrosclerosis and heart failure with preserved ejection fraction (HFpEF), which are both derived from augmentation of central pulse pressure by age-related arterial stiffening. Thus, it is necessary to treat multiple underlying diseases of cardiorenal syndrome simultaneously. However, an effective therapeutic strategy for HFpEF has not been established. This review reconsiders the pathophysiology of chronic cardiorenal disease related to arterial stiffening from the viewpoint of central hemodynamics and explores treatment options