Balint I, Vučak J, Bašić-Marković N, Klarić D, Šakić V Amerl
Acta Med Croatica. 2016 Dec;70(4-5):325-31.
Cardiorenal syndrome, a complex pathophysiological disorder of both the heart and kidneys, is a condition in which acute or chronic damage to one organ can lead to acute or chronic dysfunction of the other organ. Depending on primary organ dysfunction and disease duration, there are five different types of cardiorenal syndrome. Type 1 cardiorenal syndrome (acute cardiorenal syndrome) is defined as acute kidney injury caused by sudden decrease in heart function. Type 2 cardiorenal syndrome (chronic cardiorenal syndrome) refers to chronic kidney disease linked to chronic heart failure. Type 3 cardiorenal syndrome (acute renocardial syndrome) is caused by acute kidney injury that leads to heart failure. Type 4 cardiorenal syndrome (chronic renocardial syndrome) includes chronic heart failure due to chronic kidney disease. Type 5 cardiorenal syndrome (secondary cardiorenal syndrome) is reversible or irreversible condition marked by simultaneous heart and kidney insufficiency, as a result of multiorgan disease such as sepsis, diabetes mellitus, sarcoidosis, amyloidosis, etc. The pathophysiological patterns of cardiorenal syndrome are extremely complicated. Despite numerous publications, perplexed physiological, biochemical and hormonal disturbances as parts of the main pathogenic mechanisms of cardiorenal syndrome remain obscure. Even though there are guidelines for the treatment of patients with heart failure and chronic kidney disease, similar guidelines for the treatment of cardiorenal syndrome are lacking. In everyday practice, it is crucial to diagnose cardiorenal syndrome and use all diagnostic and therapeutic procedures available to prevent or alleviate kidney and heart failure.
心肾综合征是一种心脏和肾脏的复杂病理生理紊乱疾病,即一个器官的急性或慢性损伤会导致另一个器官的急性或慢性功能障碍。根据主要器官功能障碍和疾病持续时间,心肾综合征有五种不同类型。1型心肾综合征(急性心肾综合征)定义为因心功能突然下降导致的急性肾损伤。2型心肾综合征(慢性心肾综合征)指与慢性心力衰竭相关的慢性肾脏病。3型心肾综合征(急性肾心综合征)由导致心力衰竭的急性肾损伤引起。4型心肾综合征(慢性肾心综合征)包括由慢性肾脏病导致的慢性心力衰竭。5型心肾综合征(继发性心肾综合征)是一种可逆或不可逆的状态,其特征为心脏和肾脏同时出现功能不全,是由脓毒症、糖尿病、结节病、淀粉样变性等多器官疾病引起的。心肾综合征的病理生理模式极其复杂。尽管有大量出版物,但作为心肾综合征主要致病机制一部分的令人困惑的生理、生化和激素紊乱仍不清楚。即使有治疗心力衰竭和慢性肾脏病患者的指南,但缺乏治疗心肾综合征的类似指南。在日常实践中,诊断心肾综合征并使用所有可用的诊断和治疗程序来预防或减轻肾衰竭和心力衰竭至关重要。