Makaritsis Konstantinos P, Liakopoulos Vassilios, Leivaditis Konstantinos, Eleftheriadis Theodoros, Stefanidis Ioannis
Department of Internal Medicine, School of Medicine, University of Thessaly, Larissa, Greece.
Ren Fail. 2006;28(7):527-35. doi: 10.1080/08860220600839522.
Congestive heart failure is the only major cardiovascular disease with an increasing incidence and prevalence in industrialized countries. Despite considerable progress in the clinical management of heart failure during the last 20 years, the prognosis is still worse than in many common types of cancer. The kidney is the main organ affected when cardiac function is compromised. In addition, the kidney significantly contributes to the development of the clinical syndrome of heart failure. Specific hemodynamic and neurohormonal abnormalities define the pathophysiology, clinical presentation, and prognosis of this disorder. In this setting, the kidney plays a dual role: the activation of the renin-angiotensin-aldosterone system and the regulation of sodium and water excretion. The kidney is generally intact in heart failure, but extrarenal stimuli alter its function to a point where mechanisms that are initially homeostatic become maladaptive. In this review article, the mechanisms involved in renal adaptation to heart failure are presented.
充血性心力衰竭是工业化国家中唯一发病率和患病率呈上升趋势的主要心血管疾病。尽管在过去20年中心力衰竭的临床管理取得了相当大的进展，但其预后仍比许多常见类型的癌症更差。肾脏是心功能受损时主要受影响的器官。此外，肾脏对心力衰竭临床综合征的发展也有显著影响。特定的血流动力学和神经激素异常决定了这种疾病的病理生理学、临床表现和预后。在这种情况下，肾脏发挥着双重作用：肾素-血管紧张素-醛固酮系统的激活以及钠和水排泄的调节。心力衰竭时肾脏通常是完好的，但肾外刺激会改变其功能，使最初具有稳态作用的机制变得适应不良。在这篇综述文章中，介绍了肾脏适应心力衰竭的相关机制。
