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作 者:钟忠 陈崴[1,2] ZHONG Zhong;CHEN Wei(Department of Nephrology,The First Affiliated Hospital,Sun Yat-sen University,Guangzhou 510080,China;NHC Key Laboratory of Clinical Nephrology(Sun Yat-Sen University)and Guangdong Provincial Key Laboratory of Nephrology,Guangzhou 510080,China)
机构地区:[1]中山大学附属第一医院肾内科,广州510080 [2]国家卫生健康委员会肾脏病临床研究重点实验室(中山大学),广东省肾脏病重点实验室,广州510080
出 处:《中国血液净化》2023年第3期165-168,173,共5页Chinese Journal of Blood Purification
基 金:国家卫生健康委员会肾脏病临床研究重点实验室;广东省肾脏病重点实验室(2020B1212060028)。
摘 要:心脏与肾脏之间存在着密切的相互作用。心肾综合征是指心脏或肾脏其中一个器官出现急性或慢性功能不全而引起另一器官出现功能损害。贫血在慢性肾脏病和心力衰竭患者中均非常常见,三者相互影响,相互促进,形成一个恶性循环,因此称之为心肾贫血综合征(cardiorenal anemia syndrome,CRAS)。CRAS的发生主要与红细胞生成素缺乏、铁缺乏、氧化应激、炎症反应及骨矿物质代谢异常等机制相关。对于CRAS的患者需要综合管理,不仅要控制贫血,还要积极治疗心力衰竭、肾损伤及其它合并症。目前,对于CRAS的治疗主要集中在补充红细胞生成素和铁剂及新型低氧诱导因子-脯氨酰羟化酶抑制剂的使用。然而,关于CRAS的治疗仍有很多问题尚未解决,未来需要更多的大样本随机对照研究提供循证依据。There is a close interaction between the heart and the kidney.Cardiorenal syndrome encompasses a spectrum of disorders involving both the heart and kidney in which acute or chronic dysfunction in one organ may induce acute or chronic dysfunction in the other organ.Anemia is very common in patients with both chronic kidney disease and heart failure.They interact and promote each other,forming a vicious circle,so they called the term cardiorenal anemia syndrome(CRAS).The occurrence of CRAS is mainly related to erythropoietin deficiency,iron deficiency,oxidative stress,inflammation response,and abnormal bone mineral metabolism.Patients with CRAS require comprehensive management,not only to control anemia,but also to actively treat heart failure,kidney injury and other comorbidities.Currently,the treatment of CRAS mainly focuses on erythropoietin and iron supplementation and the use of new hypoxia-inducible factor prolyl hydroxylase inhibitors.However,there are still many unresolved problems regarding the treatment of CRAS,and more randomized controlled studies with large samples are needed to provide evidence-based medicine results in the future.
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