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Heart Failure, Chronic Kidney Disease, and Biomarkers – An Integrated Viewpoint –

机译:心力衰竭,慢性肾病和生物标志物 - 综合观点 -

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Chronic kidney disease (CKD) is frequently associated with a progressive decrease in the glomerular filtration rate, which leads to endstage renal disease (ESRD). Heart failure (HF) is a complex syndrome rather than a primary diagnosis, and considered as the endpoint of all cardiovascular disorders. It is the leading cause of death among the cardiovascular diseases in patients with CKD and ESRD. There is some interaction between the heart and kidney (the so-called "cardiorenal syndrome"), and HF patients with the complication of CKD or ESRD show a worse prognosis. Thus, early diagnosis and aggressive management of HF are needed in patients with CKD and ESRD. A number of biomarkers appear to have growing clinical importance and are reported for detection and stratification of HF. Although HF and CKD have a close interrelationship, the utility of the biomarkers has not been adequately studied with regard to the relationship with renal dysfunction. This paper reviews of the current evidence about laboratory biomarkers in patients with HF or CKD, emphasizing the emerging cardiac biomarkers (ie, BNPs and cardiac troponins), and the biomarkers of renal injury (ie, cystatin C and neutrophil gelatinase-associated lipocalin). Furthermore, it discusses the potential role of these markers in terms of heart?-?kidney interactions and their utility in the diagnostic and therapeutic strategies for cardiorenal syndrome.??( Circ J ?2010; 74: 1274?-?1282)
机译:慢性肾脏疾病(CKD)经常与肾小球过滤速率的逐步降低相关,这导致肠炎肾病(ESRD)。心力衰竭(HF)是复杂的综合症而不是初级诊断,并被认为是所有心血管障碍的终点。这是CKD和ESRD患者心血管疾病中死亡的主要原因。心脏和肾脏之间存在一些相互作用(所谓的“心肺综合征”)和CKD或ESRD并发症的HF患者表现出更糟糕的预后。因此,CKD和ESRD患者需要对HF的早期诊断和侵蚀性管理。许多生物标志物似乎越来越高的临床重要性,据报道了HF的检测和分层。虽然HF和CKD具有密切相互关系,但在与肾功能紊乱的关系方面没有充分研究生物标志物的效用。本文对HF或CKD患者的实验生物标志物的目前的证据,强调了新兴的心脏生物标志物(即BNP和心肌肌钙蛋白),以及肾损伤的生物标志物(即胱抑素C和中性粒细胞明胶酶相关的脂蛋白)。此外,它讨论了这些标志物在心脏病方面的潜在作用? - ?肾脏相互作用及其在心血管综合征诊断和治疗策略中的效用。??(电汇J- 2010; 74:1274? - ?1282)

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