Division of Nephrology, Department of Medicine, Duke University, Durham, NC 27705.
Division of Nephrology, Department of Medicine, Duke University, Durham, NC 27705.
Adv Chronic Kidney Dis. 2018 Sep;25(5):454-467. doi: 10.1053/j.ackd.2018.08.010.
Chronic diseases of the heart and of the kidneys commonly coexist in individuals. Certainly combined and persistent heart and kidney failure can arise from a common pathologic insult, for example, as a consequence of poorly controlled hypertension or of severe diffuse arterial disease. However, strong evidence is emerging to suggest that cross talk exists between the heart and the kidney. Independent processes are set in motion when kidney function is chronically diminished, and these processes can have distinct adverse effects on the heart. The complex chronic heart condition that results from chronic kidney disease (CKD) has been termed cardiorenal syndrome type 4. This review will include an updated description of the cardiac morphology in patients who have CKD, an overview of the most likely CKD-sourced culprits for these cardiac changes, and the potential therapeutic strategies to limit cardiac complications in patients who have CKD.
心脏和肾脏的慢性疾病在个体中通常同时存在。当然，共同的病理损伤可能导致联合和持续的心肾衰竭，例如，控制不佳的高血压或严重弥漫性动脉疾病的结果。然而，越来越多的证据表明心脏和肾脏之间存在相互作用。当肾功能慢性减退时，独立的过程就会启动，这些过程对心脏有明显的不良影响。由慢性肾脏病（CKD）引起的复杂慢性心脏疾病被称为心脏-肾脏综合征 4 型。本综述将包括对 CKD 患者心脏形态的最新描述，概述这些心脏变化最可能的 CKD 来源罪魁祸首，以及限制 CKD 患者心脏并发症的潜在治疗策略。
