cardiorenal syndrome in acute heart failure syndromes在急性心力衰竭综合征cardiorenal综合症.pdfVIP

SAGE-Hindawi Access to Research International Journal of Nephrology Volume 2011, Article ID 293938, 10 pages doi:10.4061/2011/293938 Research Article Cardiorenal Syndrome in Acute Heart Failure Syndromes Mohammad Sarraf1 and Robert W. Schrier2 1 University of Minnesota, USA 2 University of Colorado, USA Correspondence should be addressed to Robert W. Schrier, robert.schrier@ Received 22 November 2010; Accepted 9 January 2011 ´ Academic Editor: Alejandro Martın-Malo Copyright © 2011 M. Sarraf and R. W. Schrier. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Impaired cardiac function leads to activation of the neurohumoral axis, sodium and water retention, congestion and ultimately impaired kidney function. This sequence of events has been termed the Cardiorenal Syndrome. This is different from the increase in cardiovascular complications which occur with primary kidney disease, that is, the so-called Renocardiac Syndrome. The present review discusses the pathogenesis of the Cardiorenal Syndrome followed by the benefits and potential deleterious effects of pharmacological agents that have been used in this setting. The agents discussed are diuretics, aquaretics, natriuretic peptides, vasodilators, inotropes and adenosine α1 receptor antagonists. The potential role of ultrafiltration is also briefly discussed. 1. Introduction 2. Pathophysiology Patients with acute heart failure syndromes (AHFS) are As noted above, the hallmark of AHFS is c