Department of Medicine, Section of Cardiology, University of Chicago Medicine, 5841 South Maryland Avenue, Chicago, IL 60637, USA.
Department of Medicine, Am. Heart Assoc. Comprehensive Hypertension Center, University of Chicago Medicine, 5841 South Maryland Avenue, MC1027, Chicago, IL 60637, USA.
Heart Fail Clin. 2019 Oct;15(4):455-461. doi: 10.1016/j.hfc.2019.06.006. Epub 2019 Jul 20.
The kidney is a regulatory organ and accommodates changes in cardiac function. There is cross-talk between the kidney and the heart. In heart failure, the kidney acts as a bystander but also contributes to several maladaptive processes. The pathophysiology of worsening kidney function and its association with prognosis are discussed, as are other aspects of how worsening kidney function contributes to increased cardiovascular risk. Data suggest that morbidity and mortality reduction in people with heart failure and kidney disease requires use of a renin angiotensin system blocker, beta blocker, and mineralocorticoid receptor antagonist, as well as an SGLT 2 inhibitor.
肾脏是一个调节器官，可以适应心脏功能的变化。肾脏和心脏之间存在相互作用。在心力衰竭中，肾脏既是旁观者，也是多种适应性不良过程的参与者。本文讨论了肾功能恶化的病理生理学及其与预后的关系，以及肾功能恶化如何增加心血管风险的其他方面。数据表明，心力衰竭和肾脏病患者的发病率和死亡率降低需要使用肾素-血管紧张素系统阻滞剂、β受体阻滞剂和盐皮质激素受体拮抗剂，以及 SGLT2 抑制剂。
