Crespo-Aznarez S, Campos-Sáenz de Santamaría A, Sánchez-Marteles M, Garcés-Horna V, Josa-Laorden C, Giménez-López I, Pérez-Calvo J I, Rubio-Gracia J
Internal Medicine Department, Hospital Clínico Universitario "Lozano Blesa", Avda. San Juan Bosco N° 15, 50009, Zaragoza, Spain.
Aragon Health Research Institute (IIS Aragón), Zaragoza, Spain.
Curr Heart Fail Rep. 2023 Oct;20(5):390-400. doi: 10.1007/s11897-023-00617-x. Epub 2023 Jul 29.
An efficient diuretic response is vital during cardiac decompensation in heart failure (HF) patients. The increase in intra-abdominal pressure (IAP) could be one of the keys for understanding cardiorenal syndrome and guiding diuretic treatment during hospitalization. In this review, we analyze the relationship between IAP and diuretic response in HF patients.
Increased IAP is associated with worsening renal function (WRF) in patients with advanced HF. Furthermore, the persistence of a rise in IAP after the first 72 h of intravenous diuretic treatment has been correlated with a worse diuretic response, a higher degree of congestion, and an impaired prognosis. The rise in IAP in HF patients has been associated with impaired renal function and a lower diuretic response. Nonetheless, more studies are needed to elucidate the actual role of IAP in congestive nephropathy and whether it may help guide diuretic therapy during acute decompensations.
在心衰（HF）患者发生心脏失代偿期间，有效的利尿反应至关重要。腹内压（IAP）升高可能是理解心肾综合征以及指导住院期间利尿治疗的关键因素之一。在本综述中，我们分析HF患者IAP与利尿反应之间的关系。
晚期HF患者IAP升高与肾功能恶化（WRF）相关。此外，静脉利尿治疗开始72小时后IAP持续升高与利尿反应较差、充血程度较高及预后受损相关。HF患者IAP升高与肾功能受损及利尿反应较低相关。尽管如此，仍需要更多研究来阐明IAP在充血性肾病中的实际作用以及它是否有助于指导急性失代偿期间的利尿治疗。
