Waldum Bård, Os Ingrid
Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
Cardiology. 2013;126(3):175-86. doi: 10.1159/000353261. Epub 2013 Sep 10.
Interactions between the heart and the kidneys are increasingly acknowledged among both cardiologists and nephrologists. The term cardiorenal syndrome now applies to the bidirectional nature of how disease in one organ system affects the function of the other organ system. Cardiovascular disease is a major threat to patients with chronic kidney disease, while renal dysfunction is prevalent in patients with cardiac disease and is a significant predictor of prognosis in cardiac patients. Still, renal patients with cardiac disease have largely been excluded from the clinical trials that have been the basis of modern cardiologic treatment. In this review, the current understanding of the pathophysiological mechanisms involved in the cardiorenal syndrome and potential therapeutic implications will be summarized from a nephrologist's point of view. Probably, fragile cardiorenal patients will benefit from an enhanced collaboration between cardiologists and nephrologists to secure the best treatment given under safe conditions.
心脏病学家和肾病学家越来越认识到心脏与肾脏之间的相互作用。心脏-肾脏综合征这一术语现在适用于一个器官系统的疾病如何影响另一个器官系统功能的双向性质。心血管疾病是慢性肾病患者的主要威胁,而肾功能不全在心脏病患者中很普遍,并且是心脏病患者预后的重要预测指标。然而,患有心脏病的肾病患者在很大程度上被排除在作为现代心脏病治疗基础的临床试验之外。在这篇综述中,将从肾病学家的角度总结对心脏-肾脏综合征所涉及的病理生理机制的当前理解以及潜在的治疗意义。或许,脆弱的心脏-肾脏患者将受益于心脏病学家和肾病学家之间加强合作,以确保在安全条件下给予最佳治疗。