Divisions of Nephrology, Department of Medicine, VA Puget Sound Health Care System and University of Washington, Seattle, WA 98108.
Division of Nephrology, Department of Medicine, Medical University of South Carolina, Charleston, SC 29425.
Am J Kidney Dis. 2022 Apr;79(4):601-612. doi: 10.1053/j.ajkd.2021.06.023. Epub 2021 Nov 17.
The lungs and kidneys are cooperative and interdependent organs that secure the homeostasis of the body. Volume and acid-base disorders sit at the nexus between these two systems. However, lung-kidney interactions affect the management of many other conditions, especially among critically ill patients. Therefore, management of one system cannot proceed without a thorough understanding of the physiology of the other. This installment of AJKD's Core Curriculum in Nephrology discusses the complex decision-making required in treating concomitant respiratory and kidney disorders. We cover systemic diseases of the pulmonary and glomerular capillaries, acute decompensated heart failure, management of acid-base disorders in acute respiratory distress syndrome and chronic obstructive pulmonary disease, and venous thromboembolism. Through a case-based approach, we weigh the factors affecting the risks and benefits of therapies to enable the reader to individualize treatment decisions in these challenging scenarios.
肺和肾是相互协作和相互依存的器官，它们共同维持着身体的内环境稳定。容量和酸碱平衡紊乱处于这两个系统的交汇点。然而，肺-肾相互作用会影响许多其他疾病的治疗，尤其是危重症患者。因此，在没有充分了解另一个系统生理学的情况下，不能对一个系统进行管理。本期 AJKD 的肾脏病学核心课程讨论了治疗同时存在的呼吸和肾脏疾病所需的复杂决策。我们涵盖了肺和肾小球毛细血管的系统性疾病、急性失代偿性心力衰竭、急性呼吸窘迫综合征和慢性阻塞性肺疾病中酸碱平衡紊乱的管理，以及静脉血栓栓塞症。通过基于案例的方法，我们权衡影响治疗风险和益处的因素，以使读者能够在这些具有挑战性的情况下做出个体化的治疗决策。
