心力衰竭和慢性病的交叉点:共同管理的挑战
Amaan Alvi1, Hithyshi Singamala2, Sai Surya Vamsi Gadde3
1Internal Medicine, King George's Medical University, Lucknow, IND.
Cureus
|February 9, 2026
概括
心力衰竭 (HF) 和慢性病 (CKD) 经常并存,使诊断和治疗复杂化. 本综述探讨了管理这些重叠条件的挑战和证据缺口,特别是在先进的CKD中.
科学领域:
- 心脏病学和脏病学.
- 心脏病医疗 - 心脏病医疗
- 翻译研究是翻译研究.
背景情况:
- 心力衰竭 (HF) 和慢性病 (CKD) 经常同时存在,双向关系加剧器官损伤.
- 这种重叠显著增加了发病率,死亡率和医疗保健成本.
- 晚期CKD患者在HF试验中代表性不足,导致严重的证据差距.
研究的目的:
- 审查连接HF和CKD的病理生理机制.
- 突出患者的诊断和治疗挑战与同时存在的HF和CKD.
- 综合新出现的证据,并概述优化管理的未来方向.
主要方法:
- 对病理生理学相互作用,诊断挑战和治疗策略的文献综述.
- 关于指导方针导向医学疗法的当前证据和最近进展的综合.
- 探索新的方法,包括多学科护理,精准医学和数字健康.
主要成果:
- 病理生理学联系包括血液动力学拥堵,RAAS/SNS激活,氧化应激,炎症和尿素毒素.
- 诊断因重叠的症状,不可靠的生物标志物 (BNP,NT-proBNP) 和成像限制而复杂化.
- 由于安全性问题 (高卡利米亚,功能下降) 和改变的药理动力学,治疗受到阻碍,对晚期CKD的数据有限.
结论:
- 最近的进步,如finerenone和SGLT-2抑制剂显示出希望,但需要在高级CKD和透析人群中进一步验证.
- 多学科护理,精准医学和数字创新对于改善结果至关重要.
- 优化高频和CKD的联合管理需要解决当前的挑战,并拥抱未来的研究方向.
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