Figure 1. Pathophysiologic mechanisms underlying CRS-3. AKI is the initial insult in CRS-3 and has multiple potential etiologies. AKI may cause acute cardiac injury including heart failure, ischemia, and arrhythmia through both direct (e.g. SNS activation and RAAS) and indirect (e.g. volume overload, inflammation, oxidative stress, and mitochondrial dysfunction) effects.