avkАрхивъ внутренней медициныThe Russian Archives of Internal Medicine2226-67042411-6564“SINAPS” LLC10.20514/2226-6704-2019-9-1-5-22avk-879Research ArticleОБЗОРНЫЕ СТАТЬИREVIEW ARTICLESКАРДИОРЕНАЛЬНЫЙ СИНДРОМ У БОЛЬНЫХ С СЕРДЕЧНОЙ НЕДОСТАТОЧНОСТЬЮ КАК ЭТАП КАРДИОРЕНАЛЬНОГО КОНТИНУУМА (ЧАСТЬ I): ОПРЕДЕЛЕНИЕ, КЛАССИФИКАЦИЯ, ПАТОГЕНЕЗ, ДИАГНОСТИКА, ЭПИДЕМИОЛОГИЯ (ОБЗОР ЛИТЕРАТУРЫ)CARDIORENAL SYNDROME IN PATIENTS WITH CHRONIC HEART FAILURE AS A STAGE OF THE CARDIORENAL CONTINUUM (PART I): DEFINITION, CLASSIFICATION, PATHOGENESIS, DIAGNOSIS, EPIDEMIOLOGYРезникЕ. В.ReznikE. V.

Кафедра госпитальной терапии № 2 лечебного факультета 

Москва

Internal Disease № 2 Department 

Moscow

elenaresnik@gmail.comНикитинИ. Г.NikitinI. G.

Кафедра госпитальной терапии № 2 лечебного факультета 

Москва

Internal Disease № 2 Department

Moscow

ФГБОУ ВО РНИМУ им. Н.И. Пирогова МЗ РФРоссияRussian National Research Medical University n.a. N.I. PirogovRussian Federation20191202201991522Copyright © Резник Е.В., Никитин И.Г., 20192019Резник Е.В., Никитин И.Г.Reznik E.V., Nikitin I.G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.medarhive.ru/jour/article/view/879

Сочетание сердечной недостаточности и почечной недостаточности названо кардиоренальным синдромом. Он является закономерным этапом кардиоренального континуума и, возможно, представляет собой лишь малое звено кардиоренально-церебрально-метаболической оси. Несмотря на то, что словосочетание «кардиоренальный синдром» и 5 его типов прочно вошли в медицинский лексикон, многие аспекты этой проблемы до сих пор не ясны. Кардиоренальный синдром может быть диагностирован у 32-90,3% больных с сердечной недостаточностью. В большинстве случаев развивается кардиоренальный синдром 1 или 2 типа: у больных с хронической сердечной недостаточностью кардиоренальный синдром представлен развитием хронической болезни почек, у больных с острой сердечной недостаточностью — острого почечного повреждения. Нарушение функции почек оказывает неблагоприятное прогностическое значение: приводит к повышению смертности больных с сердечной недостаточностью. Необходимо своевременно диагностировать наличие кардиоренального синдрома и учитывать его наличие при ведении больных с сердечной недостаточностью. Требуется дальнейшее изучение способов профилактики развития и предотвращения прогрессирования поражения почек у больных с сердечной недостаточностью, на которое должны быть направлены усилия мультидисциплинарной команды. В первой части обзора рассматриваются понятие, классификация, имеющиеся в настоящее время данные о механизмах развития, эпидемиологии и прогностическом значении кардиоренального синдрома у больных с сердечной недостаточностью.

The combination of heart failure and renal failure is called cardiorenal syndrome. It is a stage of the cardiorenal continuum and, possibly, a small link of the cardiorenal-cerebral-metabolic axis. Despite the fact that the phrase “cardiorenal syndrome” and its five types have become a part of the medical lexicon, many aspects of this problem are still not clear. Cardiorenal syndrome can be diagnosed in 32-90.3% of patients with heart failure. Cardiorenal syndrome type 1 or 2 develops in most cases of heart failure: cardiorenal syndrome presents with the development ofchronic kidney disease in patients with chronic heart failure and acute kidney injury in patients with acute heart failure. Impaired renal function has an unfavorable prognostic value. It leads to an increase in the mortality of patients with heart failure. It is necessary to timely diagnose the presence of cardiorenal syndrome and take into account its presence when managing patients with heart failure. Further researches are needed on ways toprevent the development and prevent the progression of kidney damage in patients with heart failure, to which the efforts of the multidisciplinary team should be directed. The first part of this review examines the currently definition, classification, pathogenesis, epidemiology and prognosis of cardiorenal syndrome in patients with heart failure.

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The authors declare that there are no conflicts of interest present.