Shrestha Kevin, Tang W H Wilson
Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, 9500 Euclid Avenue, Desk J3-4, Cleveland, OH 44195, USA.
Curr Heart Fail Rep. 2010 Dec;7(4):167-74. doi: 10.1007/s11897-010-0025-5.
The pathophysiologic interactions that link the heart and kidney are multiple and complex, and have been grouped under the umbrella term "cardiorenal syndrome." In the setting of acute decompensated heart failure, worsening renal function has been directly associated with poor clinical prognosis and complicates treatment. However, the pathophysiology underlying acute cardiorenal syndrome remains incompletely understood and treatment options remain limited. Traditionally, the development of worsening renal function in acute decompensated heart failure has been attributed to renal arterial underfilling due to reduced cardiac output or intravascular volume depletion. However, increasing data have expanded our understanding of the roles that venous congestion and intra-abdominal pressure play in driving renal injury, with important implications for therapeutic management and the development of novel renal-sparing therapies.
将心脏和肾脏联系起来的病理生理相互作用是多方面且复杂的，这些相互作用被统称为“心肾综合征”。在急性失代偿性心力衰竭的情况下，肾功能恶化与不良临床预后直接相关，并且使治疗变得复杂。然而，急性心肾综合征背后的病理生理学仍未被完全理解，治疗选择也仍然有限。传统上，急性失代偿性心力衰竭中肾功能恶化的发展归因于心输出量减少或血管内容量耗竭导致的肾动脉灌注不足。然而，越来越多的数据扩展了我们对静脉淤血和腹内压在导致肾损伤中所起作用的理解，这对治疗管理和新型肾脏保护疗法的开发具有重要意义。
