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慢性肾脏病患者心力衰竭的评估和管理。

Assessment and management of heart failure in patients with chronic kidney disease.

机构信息

University Cardiologic Unit, Interdisciplinary Department of Medicine, Polyclinic University Hospital, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70121, Bari, Italy.

Department of Precision and Regenerative Medicine and Ionian Area, University of Bari Aldo Moro, 70124, Bari, Italy.

出版信息

Heart Fail Rev. 2024 Mar;29(2):379-394. doi: 10.1007/s10741-023-10346-x. Epub 2023 Sep 20.

Abstract

Heart failure (HF) and chronic kidney disease (CKD) are two pathological conditions with a high prevalence in the general population. When they coexist in the same patient, a strict interplay between them is observed, such that patients affected require a clinical multidisciplinary and personalized management. The diagnosis of HF and CKD relies on signs and symptoms of the patient but several additional tools, such as blood-based biomarkers and imaging techniques, are needed to clarify and discriminate the main characteristics of these diseases. Improved survival due to new recommended drugs in HF has increasingly challenged physicians to manage patients with multiple diseases, especially in case of CKD. However, the safe administration of these drugs in patients with HF and CKD is often challenging. Knowing up to which values ​​of creatinine or renal clearance each drug can be administered is fundamental. With this review we sought to give an insight on this sizable and complex topic, in order to get clearer ideas and a more precise reference about the diagnostic assessment and therapeutic management of HF and CKD.

摘要

心力衰竭(HF)和慢性肾脏病(CKD)是两种在普通人群中患病率较高的病理状况。当它们同时存在于同一患者中时,会观察到它们之间的严格相互作用,因此需要对受影响的患者进行临床多学科和个性化管理。HF 和 CKD 的诊断依赖于患者的体征和症状,但还需要其他一些工具,如基于血液的生物标志物和成像技术,以澄清和区分这些疾病的主要特征。由于 HF 中推荐的新药的生存率提高,医生越来越需要管理患有多种疾病的患者,特别是在 CKD 的情况下。然而,HF 和 CKD 患者中这些药物的安全给药通常具有挑战性。了解每种药物可以在肌酐或肾清除率达到多少值时给药非常重要。通过这篇综述,我们试图深入了解这个庞大而复杂的主题,以便更清楚地了解并更准确地参考 HF 和 CKD 的诊断评估和治疗管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5ea0/10942934/b0064ee91e6b/10741_2023_10346_Fig1_HTML.jpg

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