Renal dysfunction in acute heart failure: epidemiology, mechanisms and assessment
Renal dysfunction in acute heart failure: epidemiology, mechanisms and assessment
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DOI：
10.1007/s10741-011-9265-z
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发表时间：
2012-03-01
影响因子：
4.6
通讯作者：
Dei Cas, Livio
中科院分区：
文献类型：
--
作者：
Carubelli, Valentina;Metra, Marco;Dei Cas, Livio
心衰患者经常出现肾功能不全和/或恶化，这与护理费用、并发症和死亡率增加有关。心肾综合征可以定义为心衰患者出现或发展为肾功能不全。其机制可能与心排血量低、静脉充血和肾静脉压升高、神经激素和炎症激活以及腺苷释放等局部改变有关。许多药物，包括利尿剂，可能通过激活其中一些机制而导致肾功能恶化。肾损害通常由肌酐和血尿素氮水平升高来定义。然而，这些变化可能与肾损伤或预后无关。新的肾损伤生物标志物似乎很有希望，但仍需要验证。因此，尽管有流行病学证据，我们仍然缺乏令人满意的工具来评估肾脏损伤和功能及其预后意义。
Renal dysfunction is often present and/or worsens in patients with heart failure and this is associated with increased costs of care, complications and mortality. The cardiorenal syndrome can be defined as the presence or development of renal dysfunction in patients with heart failure. Its mechanisms are likely related to low cardiac output, increased venous congestion and renal venous pressure, neurohormonal and inflammatory activation and local changes, such as adenosine release. Many drugs, including loop diuretics, may contribute to worsening renal function through the activation of some of these mechanisms. Renal damage is conventionally defined by the increase in creatinine and blood urea nitrogen blood levels. However, these changes may be not related with renal injury or prognosis. New biomarkers of renal injury seem promising but still need to be validated. Thus, despite the epidemiological evidence, we are still lacking of satisfactory tools to assess renal injury and function and its prognostic significance.