Guo Luxuan, Ji Yue, Sun Tianhao, Liu Yang, Jiang Chen, Wang Guanran, Xing Haitao, Yang Bo, Xu Ao, Xian Xian, Yang Hongtao
First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, 300193 Tianjin, China.
National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, 300193 Tianjin, China.
Rev Cardiovasc Med. 2024 Jun 25;25(6):232. doi: 10.31083/j.rcm2506232. eCollection 2024 Jun.
Chronic heart failure (CHF) is a common complication and cause of death in dialysis patients. Although several clinical guidelines and expert consensus on heart failure (HF) in the general population have been issued in China and abroad, due to abnormal renal function or even no residual renal function (RRF) in dialysis patients, the high number of chronic complications, as well as the specificity, variability, and limitations of hemodialysis (HD) and peritoneal dialysis (PD) treatments, there are significant differences between dialysis patients and the general population in terms of the treatment and management of HF. The current studies are not relevant to all dialysis-combined HF populations, and there is an urgent need for high-quality studies on managing HF in dialysis patients to guide and standardize treatment. After reviewing the existing guidelines and literature, we focused on the staging and diagnosis of HF, management of risk factors, pharmacotherapy, and dialysis treatment in patients on dialysis. Based on evidence-based medicine and clinical trial data, this report reflects new perspectives and future trends in the diagnosis and treatment of HF in dialysis patients, which will further enhance the clinicians' understanding of HF in dialysis patients.
慢性心力衰竭（CHF）是透析患者常见的并发症和死亡原因。尽管国内外已发布了多项关于普通人群心力衰竭（HF）的临床指南和专家共识，但由于透析患者存在肾功能异常甚至无残余肾功能（RRF）、慢性并发症数量多，以及血液透析（HD）和腹膜透析（PD）治疗的特异性、变异性和局限性，透析患者与普通人群在HF的治疗和管理方面存在显著差异。目前的研究并不适用于所有合并HF的透析人群，迫切需要开展关于透析患者HF管理的高质量研究，以指导和规范治疗。在回顾现有指南和文献后，我们重点关注了透析患者HF的分期与诊断、危险因素管理、药物治疗及透析治疗。基于循证医学和临床试验数据，本报告反映了透析患者HF诊断与治疗的新观点和未来趋势，这将进一步增强临床医生对透析患者HF的认识。
