КАРДИОРЕНАЛЬНЫЙ СИНДРОМ У БОЛЬНЫХ С СЕРДЕЧНОЙ НЕДОСТАТОЧНОСТЬЮ КАК ЭТАП КАРДИОРЕНАЛЬНОГО КОНТИНУУМА (ЧАСТЬ I): ОПРЕДЕЛЕНИЕ, КЛАССИФИКАЦИЯ, ПАТОГЕНЕЗ, ДИАГНОСТИКА, ЭПИДЕМИОЛОГИЯ (ОБЗОР ЛИТЕРАТУРЫ)

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.

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