Cardiorenal syndrome (CRS) has evolved from a hemodynamic concept to a complex metabolic interplay, culminating in the 2023 definition of Cardiovascular-Kidney-Metabolic (CKM) syndrome. We analyzed the field's intellectual trajectory to guide future research.
Methods
We examined the 100 most-cited CRS articles (2003–2025) from the Web of Science. Using VOSviewer and CiteSpace, we mapped publication trends, collaborative networks, and keyword evolution to trace the shift from organ-centric to metabolic perspectives.
Results
Analysis reveals a bimodal trend: an initial peak driven by consensus definitions, followed by a recent wave focusing on metabolic integration. The United States and Italy were dominant contributors. Keyword analysis highlights a transition from hemodynamic terms to molecular mechanisms and metabolic risk factors (e.g., SGLT2 inhibitors), mirroring the conceptual expansion toward CKM.
Conclusion
High-impact research has shifted from phenomenological classification to mechanistic exploration of metabolic pathways. This evolution necessitates interdisciplinary collaboration and integrated therapeutic strategies targeting metabolic drivers, kidney injury, and cardiovascular remodeling to improve patient outcomes.
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