Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Policlinico Le Scotte, Viale Bracci 16, Siena, Italy.
Institute of Life Sciences, Scuola Superiore Sant'Anna, Pisa, Italy.
Heart Fail Rev. 2021 May;26(3):487-496. doi: 10.1007/s10741-020-10034-0. Epub 2020 Oct 2.
Cardiogenic shock (CS) is a life-threatening condition of poor end-organ perfusion, caused by any cardiovascular disease resulting in a severe depression of cardiac output. Despite recent advances in replacement therapies, the outcome of CS is still poor, and its management depends more on empirical decisions rather than on evidence-based strategies. By its side, acute kidney injury (AKI) is a frequent complication of CS, resulting in the onset of a cardiorenal syndrome. The combination of CS with AKI depicts a worse clinical scenario and holds a worse prognosis. Many factors can lead to acute renal impairment in the setting of CS, either for natural disease progression or for iatrogenic causes. This review aims at collecting the current evidence-based acknowledgments in epidemiology, pathophysiology, clinical features, diagnosis, and management of CS with AKI. We also attempted to highlight the major gaps in evidence as well as to point out possible strategies to improve the outcome.
心原性休克（CS）是一种由任何心血管疾病导致的心输出量严重降低，从而引起的终末器官灌注不良的危及生命的病症。尽管最近在替代疗法方面取得了进展，但 CS 的预后仍然很差，其治疗更多地依赖于经验决策，而不是基于循证策略。与此同时，急性肾损伤（AKI）是 CS 的常见并发症，导致心肾综合征的发生。CS 合并 AKI 描绘了更糟糕的临床情况，并预示着更差的预后。许多因素可导致 CS 患者的急性肾功能损害，无论是自然疾病进展还是医源性原因。本综述旨在收集 CS 合并 AKI 的流行病学、病理生理学、临床特征、诊断和治疗方面的最新循证共识。我们还试图强调证据中的主要空白，并指出可能改善预后的策略。
