Epidemiology and Management of Patients With Kidney Disease and Heart Failure With Preserved Ejection Fraction

IF 2.8 3区 医学 Q2 UROLOGY & NEPHROLOGY
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引用次数: 0

Abstract

Heart failure with preserved ejection fraction (HFpEF) comprises approximately one-half of all diagnoses of heart failure. There is significant overlap of this clinical syndrome with chronic kidney disease (CKD), with many shared comorbid conditions. The presence of CKD in patients with HFpEF is one of the most powerful risk factors for adverse clinical outcomes, including death and heart failure hospitalization. The pathophysiology linking HFpEF and CKD remains unclear, but it is postulated to consist of numerous bidirectional pathways, including endothelial dysfunction, inflammation, obesity, insulin resistance, and impaired sodium handling. The diagnosis of HFpEF requires certain criteria to be satisfied, including signs and symptoms consistent with volume overload caused by structural or functional cardiac abnormalities and evidence of increased cardiac filling pressures. There are numerous overlapping metabolic clinical syndromes in patients with HFpEF and CKD that can serve as targets for intervention. With an increasing number of therapies available for HFpEF and CKD as well as for obesity and diabetes, improved recognition and diagnosis are paramount for appropriate management and improved clinical outcomes in patients with both HFpEF and CKD.

肾病合并射血分数保留型心力衰竭患者的流行病学和管理。
射血分数保留型心力衰竭(HFpEF)约占所有心力衰竭诊断的二分之一。这种临床综合征与慢性肾脏病(CKD)有很大的重叠,有许多共同的合并症。高频心衰患者患有慢性肾脏病是导致不良临床结果(包括死亡和心衰住院)的最主要风险因素之一。HFpEF 和 CKD 之间的病理生理学联系仍不清楚,但推测它由许多双向途径组成,包括内皮功能障碍、炎症、肥胖、胰岛素抵抗和钠处理受损。高心衰的诊断需要满足一定的标准,包括与心脏结构或功能异常引起的容量超负荷相一致的体征和症状,以及心脏充盈压升高的证据。高频低氧血症和慢性肾脏病患者有许多重叠的代谢临床综合征,可作为干预目标。随着可用于治疗高频低氧血症和慢性肾脏病以及肥胖和糖尿病的疗法越来越多,提高识别和诊断能力对于同时患有高频低氧血症和慢性肾脏病的患者进行适当管理和改善临床预后至关重要。
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来源期刊
Seminars in nephrology
Seminars in nephrology 医学-泌尿学与肾脏学
CiteScore
5.60
自引率
0.00%
发文量
27
审稿时长
6-12 weeks
期刊介绍: Seminars in Nephrology is a timely source for the publication of new concepts and research findings relevant to the clinical practice of nephrology. Each issue is an organized compendium of practical information that serves as a lasting reference for nephrologists, internists and physicians in training.
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