avkАрхивъ внутренней медициныThe Russian Archives of Internal Medicine2226-67042411-6564“SINAPS” LLC10.20514/2226-6704-2019-9-2-93-106avk-900Research ArticleОБЗОРНЫЕ СТАТЬИREVIEW ARTICLESКардиоренальный синдром у больных с сердечной недостаточностью как этап кардиоренального континуума (часть 2): прогностическое значение, профилактика и лечениеCardiorenal syndrome in patients with heart failure as a stage of the cardiorenal continuum (part 2): prognosis, prevention and treatmentРезникЕ. В.ReznikE. V.

Кафедра госпитальной терапии № 2, Лечебный факультет.

Москва

Internal Disease № 2 Department.

Moscow

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

Кафедра госпитальной терапии № 2, Лечебный факультет.

Москва

Internal Disease № 2 Department.

Moscow

ФГБОУ ВО РНИМУ им. Н.И. Пирогова МЗ РФРоссияRussian National Research Medical University n.a. N.I. PirogovRussian Federation2019300320199293106Copyright © 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/900

Кардиоренальный синдром у больных с сердечной недостаточностью — закономерное звено в цепи кардиоренального континуума. С пациентами с кардиоренальным синдромом могут столкнуться врачи различных специальностей: терапевты, кардиологи, нефрологи, реаниматологи, анестезиологи, кардиохирурги и др. В первой части обзора были рассмотрены понятие, классификация, патогенез, критерии диагностики и эпидемиологические данные, касающиеся кардиоренального синдрома у больных с сердечной недостаточностью. Во второй части рассмотрены прогностическое значение, подходы к профилактике и лечению кардиоренального синдрома у больных с сердечной недостаточностью. Они включают в себя лечение сердечно-сосудистой патологии и сердечной недостаточности в соответствии с современными рекомендациями и предотвращение эпизодов острой и декомпенсации хронической сердечной недостаточности; диету; отказ от курения, алкоголя, нефротоксичных веществ; контроль массы тела, артериального давления, гликемии; применение ингибиторов анги-отензинпревращающего фермента, антагонистов рецепторов ангиотензина или ангиотензиновых рецепторов и неприлизина ингибиторов (АРНИ), статинов; снижение внутрибрюшного давления и другие. Необходима разработка и внедрение новых подходов к нефропротекции у больных с кардиоренальным синдромом, что возможно при совместной работе мультидисциплинарной команды.

Cardiorenal syndrome in patients with heart failure is a regular link in the chain of cardiorenal continuum. Physicians of various specialties may encounter patients with cardiorenal syndrome: general practitioners, cardiologists, nephrologists, resuscitators, anesthetists, cardiac surgeons, etc. The currently definition, classification, pathogenesis, diagnosis and epidemiology of cardiorenal syndrome in patients with heart failure were presented in first part of our review. In the second part, prognosis, approaches to the prevention and treatment of cardiorenal syndrome in patients with heart failure are discussed. They include the treatment of cardiovascular pathology and heart failure in accordance with current guidelines for the prevention of episodes of acute and decompensated chronic heart failure; diet; smoking cessation, alcohol, nephrotoxic substances; body weight, blood pressure and glycemia control; angiotensin converting enzyme inhibitors, angiotensin receptor antagonists or angiotensin receptors and neprilisin inhibitors (ARNI), statins; reducing of the abdominal pressure and others. It is necessary to develop and introduce new approaches to nephroprotection in patients with cardiorenal syndrome, which is possible with the joint work of a multidisciplinary team.

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