Silverberg D S, Wexler D, Blum B, Iaina A
Department of Nephrology, Tel Aviv Medical Center, Israel.
Blood Purif. 2003;21(1):124-30. doi: 10.1159/000067856.
Anemia is seen in chronic kidney insufficiency (CKI), dialysis patients, congestive heart failure (CHF), and renal transplantation. Anemia can lead to progressive cardiac damage as well as progressive renal damage. It is not generally appreciated that CHF itself may be a very common contributor to both the production of anemia as well as to the progression of the renal failure. Correction of the anemia with erythropoietin and, as necessary, intravenous iron, may prevent the deterioration of both the heart and the kidneys. We suggest that there is a triangular relationship, a vicious circle, between CHF, CKI and anemia where each of these three can both cause and be caused by the other. We call this syndrome the cardio-renal anemia (CRA) syndrome. All physicians, especially cardiologists and internists who treat CKI and CHF, should be made aware of the dangers of anemia in CKI and CHF and should work with nephrologists to correct it.
贫血见于慢性肾功能不全（CKI）、透析患者、充血性心力衰竭（CHF）及肾移植患者。贫血可导致进行性心脏损害和进行性肾脏损害。人们通常没有认识到，CHF本身可能是导致贫血以及肾衰竭进展的一个非常常见的因素。使用促红细胞生成素并在必要时静脉补铁纠正贫血，可能会预防心脏和肾脏功能恶化。我们认为，CHF、CKI和贫血之间存在一种三角关系，即恶性循环，这三者中的每一个都既可以导致其他两者，又可以由其他两者导致。我们将这种综合征称为心肾贫血（CRA）综合征。所有医生，尤其是治疗CKI和CHF的心脏病专家和内科医生，都应该意识到CKI和CHF患者贫血的危险性，并应与肾病专家合作纠正贫血。
