Update kardiorenales Syndrom

Zusammenfassung

Das kardiorenale Syndrom bezeichnet die Interaktion zwischen Herz- und Nierenerkrankungen. Akute oder chronische Funktionseinschränkungen des einen Organs können dabei zu akuten oder chronischen Funktionseinschränkungen des jeweils anderen führen. Die Prävalenz nimmt seit Jahren stetig zu. Betroffene Patienten gehören zur kardiovaskulären Hochrisikogruppe, deren adäquate leitliniengerechte Therapie unerlässlich ist. Im Folgenden möchten wir einen Überblick über neueste Studienergebnisse geben und auf wichtige Komorbiditäten und deren Behandlung hinweisen.

Abstract

The cardiorenal syndrome comprises interactions between heart and kidney disorders. This interaction is bidirectional: acute or chronic dysfunction in one organ may induce an acute or chronic dysfunction in the other one. Due to aging population and better survival after acute myocardial infarction, the prevalence of the cardiorenal syndrome is steadily rising. As the cardiorenal syndrome comes along with high morbidity and mortality, adequate guideline-based therapy is essential to improve patientsʼ outcome and their quality of life. In the following, we would like to give an overview about novel clinical trial results concerning the cardiorenal syndrome and important comorbidities.

Was ist wichtig?

• Das kardiorenale Syndrom beschreibt einen Symptomenkomplex als Folgestörung gemeinsam auftretender Herz- und Nierenerkrankungen, die einzeln, aber vor allem in Kombination, mit einer schlechten Prognose assoziiert sind.

• Eine leitliniengerechte Herzinsuffizienztherapie mit konsequenter RAAS-Blockade und individualisierter diuretischer Therapie kann die Prognose und Symptomatik der Patienten verbessern.

• Die Pharmakotherapie kann durch die bestehende Nierenfunktionseinschränkung und das Auftreten von Hyperkaliämien limitiert sein.

• Studien zum Einsatz von neuen Substanzen (SGLT-II-Inhibitoren, Kaliumbinder, ARNI) bei Patienten mit kardiorenalem Syndrom werden dringend benötigt und schließen aktuell zum Teil bereits entsprechende Patienten ein.

Schlüsselwörter

Herzinsuffizienz - Nierenfunktionseinschränkung - kardiorenales Syndrom - evidenzbasierte medikamentöse Therapie

Key words

heart failure - kidney disease - cardiorenal syndrome - guideline-based therapy

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