Mattinzoli Deborah, Molinari Paolo, Romero-González Gregorio, Bover Jordi, Cicero Elisa, Pesce Francesco, Abinti Matteo, Conti Costanza, Castellano Giuseppe, Alfieri Carlo
Department of Nephrology, Dialysis and Renal Transplantation, Fondazione IRCCS Ca' Granda Ospedale Policlinico, Milan, Italy.
Post-Graduate School of Specialization in Nephrology, University of Milan, Milan, Italy.
Clin Kidney J. 2023 Apr 25;16(10):1555-1562. doi: 10.1093/ckj/sfad093. eCollection 2023 Oct.
Cardio-renal syndrome is a clinical condition that has recently been well defined. In acute kidney disease, this interaction might trigger chronic processes determining the onset of cardiovascular events and the progression of chronic kidney disease. Moreover, the high mortality rate of acute kidney injury (AKI) is also linked to the fact that this condition is often complicated by dysfunctions of other organs such as lungs or heart, or is associated with septic episodes. In this context the role and the potential link between bone, heart and kidney is becoming an important topic of research. The aim of this review is to describe the cardiac alterations in the presence of AKI (cardiorenal syndrome type 3) and explore how bone can interact with heart and kidney in determining and influencing the trend of AKI in the short and long term. The main anomalies of mineral metabolism in patients with AKI will be reported, with specific reference to the alterations of fibroblast growth factor 23 and Klotho as a link between the bone-kidney-heart axis.
心肾综合征是一种最近已得到明确界定的临床病症。在急性肾疾病中，这种相互作用可能引发慢性病变，从而决定心血管事件的发生以及慢性肾病的进展。此外，急性肾损伤（AKI）的高死亡率还与以下事实相关：这种病症常常并发其他器官（如肺或心脏）的功能障碍，或与脓毒症发作有关。在此背景下，骨骼、心脏和肾脏之间的作用及潜在联系正成为一个重要的研究课题。本综述的目的是描述急性肾损伤（3型心肾综合征）时的心脏改变，并探讨骨骼如何在短期和长期内与心脏及肾脏相互作用，从而决定和影响急性肾损伤的发展趋势。将报告急性肾损伤患者矿物质代谢的主要异常情况，特别提及成纤维细胞生长因子23和Klotho的改变，作为骨 - 肾 - 心轴之间的联系。
