Alscher M D, Sechtem U
Abteilung für Allgemeine Innere Medizin und Nephrologie, Robert-Bosch-Krankenhaus Stuttgart, Auerbachstraße 110, Stuttgart, Germany.
Internist (Berl). 2012 Mar;53(3):309-17; quiz 318. doi: 10.1007/s00108-011-2981-6.
The cardiorenal syndrome describes the frequent clinical situation in which therapy of a patient with acute cardiac decompensation is limited by a decline of renal function. This is frequently associated with preexisting chronic renal insufficiency. It is important to be aware of this potentially fatal constellation and perform diuretic therapy slowly and carefully in order to avoid inadequate volume depletion. This may require surveillance in an intensive care unit. Ultrafiltration is an alternative to diuretic therapy which may permit greater fluid loss when beginning therapy and better control of volume reduction once heart failure symptoms improve. The individual treatment of patients with cardiorenal syndrome requires a close cooperation between cardiologists and nephrologists.
心肾综合征描述了一种常见的临床情况,即急性心功能不全患者的治疗因肾功能下降而受到限制。这通常与先前存在的慢性肾功能不全有关。认识到这种潜在的致命组合并缓慢而谨慎地进行利尿治疗非常重要,以避免液体量减少不足。这可能需要在重症监护病房进行监测。超滤是利尿治疗的一种替代方法,在开始治疗时可能允许更多的液体丢失,并且一旦心力衰竭症状改善,能更好地控制液体量减少。心肾综合征患者的个体化治疗需要心脏病专家和肾病专家密切合作。