3rd Department of Internal Medicine, General University Hospital in Prague, First Faculty of Medicine, Charles University, Prague, Czech Republic.
Physiol Res. 2024 Apr 30;73(2):173-187. doi: 10.33549/physiolres.935110.
Sodium is the main osmotically active ion in the extracellular fluid and its concentration goes hand in hand with fluid volume. Under physiological conditions, homeostasis of sodium and thus amount of fluid is regulated by neural and humoral interconnection of body tissues and organs. Both heart and kidneys are crucial in maintaining volume status. Proper kidney function is necessary to excrete regulated amount of water and solutes and adequate heart function is inevitable to sustain renal perfusion pressure, oxygen supply etc. As these organs are bidirectionally interconnected, injury of one leads to dysfunction of another. This condition is known as cardiorenal syndrome. It is divided into five subtypes regarding timeframe and pathophysiology of the onset. Hemodynamic effects include congestion, decreased cardiac output, but also production of natriuretic peptides. Renal congestion and hypoperfusion leads to kidney injury and maladaptive activation of renin-angiotensin-aldosterone system and sympathetic nervous system. In cardiorenal syndromes sodium and water excretion is impaired leading to volume overload and far-reaching negative consequences, including higher morbidity and mortality of these patients. Keywords: Cardiorenal syndrome, Renocardiac syndrome, Volume overload, Sodium retention.
钠是细胞外液中主要的渗透活性离子，其浓度与液体量密切相关。在生理条件下，钠和液体量的内环境平衡是通过身体组织和器官的神经和体液相互联系来调节的。心脏和肾脏对于维持容量状态都至关重要。适当的肾功能是排泄调节量的水和溶质所必需的，而充足的心脏功能是维持肾灌注压、氧供应等所必需的。由于这些器官是双向相互关联的，一个器官的损伤会导致另一个器官的功能障碍。这种情况被称为心肾综合征。根据发病的时间框架和病理生理学，它分为五个亚型。血流动力学效应包括充血、心输出量减少，但也会产生利钠肽。肾脏充血和灌注不足会导致肾脏损伤以及肾素-血管紧张素-醛固酮系统和交感神经系统的适应性激活。在心肾综合征中，钠和水的排泄受到损害，导致容量超负荷，并产生广泛的负面后果，包括这些患者的发病率和死亡率更高。
心肾综合征、肾心综合征、容量超负荷、钠潴留。
