Institute do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
Clinics (Sao Paulo). 2013;68(3):401-9. doi: 10.6061/clinics/2013(03)r01.
Renal dysfunction is common during episodes of acute decompensated heart failure, and historical data indicate that the mean creatinine level at admission has risen in recent decades. Different mechanisms underlying this change over time have been proposed, such as demographic changes, hemodynamic and neurohumoral derangements and medical interventions. In this setting, various strategies have been proposed for the prevention of renal dysfunction with heterogeneous results. In the present article, we review and discuss the main aspects of renal dysfunction prevention according to the different stages of heart failure.
肾功能障碍在急性失代偿性心力衰竭发作期间很常见，历史数据表明，近年来入院时的平均肌酐水平有所上升。对于这种随时间变化的现象，提出了不同的机制，如人口统计学变化、血流动力学和神经激素紊乱以及医疗干预。在这种情况下，已经提出了各种预防肾功能障碍的策略，但结果存在差异。在本文中，我们根据心力衰竭的不同阶段，回顾和讨论了预防肾功能障碍的主要方面。
