Division of Cardiovascular Medicine, Department of Medicine, University of California San Diego, La Jolla, CA; and Division of Nephrology-Hypertension, Department of Medicine, University of California San Diego, San Diego, California.
Division of Cardiovascular Medicine, Department of Medicine, University of California San Diego, La Jolla, CA; and Division of Nephrology-Hypertension, Department of Medicine, University of California San Diego, San Diego, California.
Adv Chronic Kidney Dis. 2018 Sep;25(5):418-424. doi: 10.1053/j.ackd.2018.08.017.
Although the field of oncology has made significant steps toward individualized precision medicine, cardiology and nephrology still often use a "one size fits all" approach. This applies to the intersection of the heart-kidney interaction and the cardiorenal syndrome as well. Recent studies have shown that the prognostic implications of worsening renal function (WRF) in acute heart failure are variable; thus, there is a need to differentiate the implications of WRF to better guide precise care. This may best be performed with biomarkers that can give the clinician a real-time evaluation of the physiologic state at the time of developing WRF. This review will summarize current cardiac and renal biomarkers and their status in the evaluation of cardiorenal syndrome. Although we have made progress in our understanding of this syndrome, further investigation is needed to bring precision medicine into routine clinical practice for the care of patients with cardiorenal syndrome.
尽管肿瘤学领域在个体化精准医学方面取得了重大进展，但心脏病学和肾脏病学仍常常采用“一刀切”的方法。这同样适用于心脏-肾脏相互作用和心肾综合征的交叉领域。最近的研究表明，急性心力衰竭中肾功能恶化（WRF）的预后意义是可变的；因此，需要区分 WRF 的影响，以更好地指导精准治疗。这可能最好通过生物标志物来实现，这些标志物可以让临床医生在发生 WRF 时实时评估生理状态。这篇综述将总结当前心脏和肾脏生物标志物及其在心肾综合征评估中的地位。尽管我们在理解这种综合征方面已经取得了进展，但仍需要进一步的研究将精准医学纳入常规临床实践，以治疗心肾综合征患者。
