Zusammenfassung
Das kardiorenale Syndrom gliedert sich entsprechend dem führenden Schädigungsmechanismus (Niereninsuffizienz oder Herzinsuffizienz) in verschiedene Formen auf. Pathophysiologisch sind vor allem hämodynamische Faktoren, neurohumorale Mechanismen, die endotheliale Dysfunktion sowie inflammatorische Prozesse an der Entwicklung eines kardiorenalen/renokardialen Syndroms beteiligt. Therapeutisch stehen daher die Regulierung des Volumenhaushalts, die Blockade des RAAS und die Behandlung der eine Niereninsuffizienz begleitenden Probleme im Vordergrund. Zukünftig muss die Wichtigkeit der verschiedenen pathophysiologischen Faktoren und der damit zusammenhängenden therapeutischen Strategien vor dem Hintergrund der unterschiedlichen Formen des kardiorenalen Syndroms weiter untersucht werden.
Abstract
During recent years it has become evident that renal failure can promote heart failure and vice versa. Thus, the term cardiorenal syndrome was coined involving hemodynamic factors, neurohumoral mechanisms, inflammatory processes and endothelial dysfunction as pathophysiological pathways. Therapeutic goals include correction of the volume status and hemodynamic parameters, blockade of the renin-angiotensin-aldosterone system (RAAS) as well as control of concomitant comorbidities. Future studies should aim at the importance of the various pathophysiological factors together with the corresponding therapeutic strategies and precise epidemiological information in these patients.
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Schamberger, B., Lutz, J., Bruck, H. et al. Kardiorenales Syndrom. Nephrologe 8, 298–307 (2013). https://doi.org/10.1007/s11560-012-0736-6
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DOI: https://doi.org/10.1007/s11560-012-0736-6