Division of Nephrology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Division of Nephrology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Kidney Int. 2019 Nov;96(5):1066-1068. doi: 10.1016/j.kint.2019.07.003.
Renin-angiotensin-aldosterone system inhibitors have proven clinical benefit in management of patients with heart failure with reduced ejection fraction. However, there are no guidelines to manage decline in kidney function that occurs with initiation and titration of renin-angiotensin-aldosterone system agents during management of heart failure. We discuss the complex interplay of kidney function and heart failure in the presence of renin-angiotensin-aldosterone system agents and suggest a clinical algorithm for management of acute decline in kidney function.
肾素-血管紧张素-醛固酮系统抑制剂在治疗射血分数降低的心力衰竭患者方面已被证实具有临床益处。然而，目前尚无指南来管理心力衰竭管理期间起始和滴定肾素-血管紧张素-醛固酮系统药物时发生的肾功能下降。我们讨论了在肾素-血管紧张素-醛固酮系统药物存在的情况下肾功能和心力衰竭之间的复杂相互作用，并提出了一种用于管理急性肾功能下降的临床算法。
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