Biomedicines · Oct 6, 2026

Cardiorenal Syndrome: From Hemodynamic and Humoral Pathophysiology to New Frontiers in Modulation and Enabling Therapy-Part 2

By Mauriello A, Cetoretta V, Del Giudice C et al.

The therapeutic landscape of cardiorenal syndrome (CRS) has evolved significantly, transitioning from historical cornerstones like angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) to modern neurohormonal modulation with angiotensin receptor-neprilysin inhibitors (ARNIs). This second part of this narrative review analyzes the pivotal pharmacological roles of sodium-glucose cotransporter-2 (SGLT2) inhibitors, glucagon-like peptide-1 (GLP-1) receptor agonists, and finerenone, which target the hemodynamic, metabolic, and inflammatory-fibrotic axes, respectively, alongside the essential utility of novel potassium binders. Ultimately, the management of CRS is shifting toward an integrated cardiovascular-renal-metabolic paradigm, where the future lies in a personalized, biomarker-guided "quadruple cardiorenal therapy" that moves beyond a single-organ focus to optimize patient outcomes.

doi.org/10.3390/biomedicines14102257 Open access PubMed 42940063 Interventions