Ronco Claudio, McCullough Peter, Anker Stefan D, Anand Inder, Aspromonte Nadia, Bagshaw Sean M, Bellomo Rinaldo, Berl Tomas, Bobek Ilona, Cruz Dinna N, Daliento Luciano, Davenport Andrew, Haapio Mikko, Hillege Hans, House Andrew A, Katz Nevin, Maisel Alan, Mankad Sunil, Zanco Pierluigi, Mebazaa Alexandre, Palazzuoli Alberto, Ronco Federico, Shaw Andrew, Sheinfeld Geoff, Soni Sachin, Vescovo Giorgio, Zamperetti Nereo, Ponikowski Piotr
Department of Nephrology, San Bortolo Hospital, Viale Rodolfi 37, Vicenza 36100, Italy.
Eur Heart J. 2010 Mar;31(6):703-11. doi: 10.1093/eurheartj/ehp507. Epub 2009 Dec 25.
A consensus conference on cardio-renal syndromes (CRS) was held in Venice Italy, in September 2008 under the auspices of the Acute Dialysis Quality Initiative (ADQI). The following topics were matter of discussion after a systematic literature review and the appraisal of the best available evidence: definition/classification system; epidemiology; diagnostic criteria and biomarkers; prevention/protection strategies; management and therapy. The umbrella term CRS was used to identify a disorder of the heart and kidneys whereby acute or chronic dysfunction in one organ may induce acute or chronic dysfunction in the other organ. Different syndromes were identified and classified into five subtypes. Acute CRS (type 1): acute worsening of heart function (AHF-ACS) leading to kidney injury and/or dysfunction. Chronic cardio-renal syndrome (type 2): chronic abnormalities in heart function (CHF-CHD) leading to kidney injury and/or dysfunction. Acute reno-cardiac syndrome (type 3): acute worsening of kidney function (AKI) leading to heart injury and/or dysfunction. Chronic reno-cardiac syndrome (type 4): chronic kidney disease leading to heart injury, disease, and/or dysfunction. Secondary CRS (type 5): systemic conditions leading to simultaneous injury and/or dysfunction of heart and kidney. Consensus statements concerning epidemiology, diagnosis, prevention, and management strategies are discussed in the paper for each of the syndromes.
2008年9月,在急性透析质量倡议组织(ADQI)的支持下,一场关于心肾综合征(CRS)的共识会议在意大利威尼斯召开。在对现有最佳证据进行系统文献综述和评估之后,讨论了以下主题:定义/分类系统;流行病学;诊断标准和生物标志物;预防/保护策略;管理与治疗。心肾综合征这一统称用于识别心脏和肾脏的一种病症,即一个器官的急性或慢性功能障碍可能诱发另一个器官的急性或慢性功能障碍。识别出了不同的综合征,并将其分为五个亚型。急性心肾综合征(1型):心功能急性恶化(AHF-ACS)导致肾损伤和/或功能障碍。慢性心肾综合征(2型):心功能慢性异常(CHF-CHD)导致肾损伤和/或功能障碍。急性肾心综合征(3型):肾功能急性恶化(AKI)导致心损伤和/或功能障碍。慢性肾心综合征(4型):慢性肾病导致心损伤、疾病和/或功能障碍。继发性心肾综合征(5型):导致心脏和肾脏同时损伤和/或功能障碍的全身性疾病。本文针对每种综合征讨论了有关流行病学、诊断、预防和管理策略的共识声明。