Division of Nephrology, Memorial University of Newfoundland, 300 Prince Phillip Drive, St John's, NL, Canada.
Nat Rev Nephrol. 2009 Nov;5(11):641-9. doi: 10.1038/nrneph.2009.156. Epub 2009 Sep 29.
The kidney and heart have essential roles in maintaining blood volume homeostasis and in the regulation of systemic blood pressure. Acute or chronic dysfunction in either the heart or kidneys can induce dysfunction in the other organ, resulting in the so-called cardiorenal syndromes, which are classified into five different types. Abrupt worsening of cardiac function predisposes an individual to acute kidney injury from renal hypoperfusion or renal congestion. Progressive, sometimes permanent, chronic kidney impairment can result from chronic renal hypoperfusion or congestion. Heart failure is common in patients with acute kidney injury. Chronic kidney disease predisposes individuals to atherosclerotic, arteriosclerotic and cardiomyopathic disease. Finally, both cardiac and renal disease can also occur secondary to systemic conditions, such as diabetes or autoimmune disease. This Review examines the mechanisms presiding over the first four types of cardiorenal syndromes. These mechanisms provide a template that accounts for the heart-kidney interactions that occur in patients whose concomitant cardiac and renal conditions result from a third cause.
肾脏和心脏在维持血容量平衡和调节全身血压方面起着重要作用。心脏或肾脏的急性或慢性功能障碍可导致另一个器官的功能障碍，从而导致所谓的心肾综合征，可分为五种不同类型。心脏功能的突然恶化可导致肾脏灌注不足或充血引起的急性肾损伤。慢性、有时是永久性的慢性肾脏损害可由慢性肾脏灌注不足或充血引起。心力衰竭在急性肾损伤患者中很常见。慢性肾脏病使个体易患动脉粥样硬化、动脉硬化和心肌病。最后，心脏和肾脏疾病也可能继发于全身性疾病，如糖尿病或自身免疫性疾病。本综述探讨了前四种心肾综合征的发病机制。这些机制为伴有心脏和肾脏疾病的患者的心脏-肾脏相互作用提供了一个模板，这些患者的心脏和肾脏疾病是由第三种原因引起的。
