Wallbach Manuel, von Haehling Stephan, Koziolek Michael
Klinik für Nephrologie und Rheumatologie, Universitätsmedizin Göttingen, Deutsches Zentrum für Herz-Kreislauf-Forschung, Robert-Koch-Straße 40, 37075, Göttingen, Deutschland.
Klinik für Kardiologie und Pneumologie, Universitätsmedizin Göttingen, Deutsches Zentrum für Herz-Kreislauf-Forschung, Robert-Koch-Straße 40, 37075, Göttingen, Deutschland.
Inn Med (Heidelb). 2025 May 20. doi: 10.1007/s00108-025-01894-5.
Congestive nephropathy (CN) is an entity of the cardiorenal syndrome that essentially arises from venous congestion and neurohormonal activation. The most common underlying causes include heart failure, pulmonary arterial hypertension, isolated tricuspid valve insufficiency and congenital heart defects. Currently, there are no universally accepted diagnostic criteria; however, the most suitable method appears to be the recording of intrarenal venous blood flow using Doppler sonography. A distinction can be made between continuous venous flow (no congestion) and discontinuous flow patterns, categorized as pulsatile (mild), biphasic (moderate) and monophasic (severe congestion). The venous impedance index (VII) and the renal venous stasis index (RVSI) are additional Doppler sonographic criteria for detecting CN. Evidence supports the efficacy of loop diuretics and/or the administration of sodium-glucose cotransporter 2 (SGLT2) inhibitors in the management of venous congestion.
充血性肾病（CN）是心肾综合征的一种类型，主要由静脉淤血和神经激素激活引起。最常见的潜在病因包括心力衰竭、肺动脉高压、孤立性三尖瓣关闭不全和先天性心脏缺陷。目前，尚无普遍接受的诊断标准；然而，最合适的方法似乎是使用多普勒超声记录肾内静脉血流。可以区分连续静脉血流（无淤血）和不连续血流模式，后者分为搏动性（轻度）、双相性（中度）和单相性（严重淤血）。静脉阻抗指数（VII）和肾静脉淤滞指数（RVSI）是检测CN的其他多普勒超声标准。有证据支持袢利尿剂和/或给予钠-葡萄糖协同转运蛋白2（SGLT2）抑制剂在治疗静脉淤血方面的疗效。
