病和心力衰竭:最近的进展和当前的挑战:从病中得出的结论:改善全球结果 (KDIGO) 争议 会议会议
Carolyn S P Lam1, Biykem Bozkurt2, David Z I Cherney3
1National Heart Centre Singapore and Duke-National University of Singapore, Singapore.
JACC. Heart failure
|March 7, 2026
概括
同时存在的心力衰竭 (HF) 和慢性病 (CKD) 存在管理挑战. 考虑共同风险和量身定制的治疗方法的综合方法对于改善患者的治疗结果至关重要.
科学领域:
- 心脏病学 心脏病学
- 腎臟病學 (nephrology) 是一種醫學專業.
- 翻译医学是一种翻译医学.
背景情况:
- 心力衰竭 (HF) 和慢性病 (CKD) 经常同时存在,增加住院,疾病进展和死亡的风险.
- 目前对结合性HF和CKD的诊断和管理策略面临着重大挑战,尽管在个体疾病治疗方面取得了进展.
研究的目的:
- 为了解决近期的进展和当前的挑战,在管理心力衰竭和慢性脏疾病同时存在的患者.
- 讨论HF和CKD之间的复杂,双向关系,包括共享的病理生理学和生物标志物解释.
主要方法:
- 病:改善全球结果 (KDIGO) 争议 病和心力衰竭会议于2024年3月召开专家会议.
- 讨论的重点是共同的风险因素,重叠的病理生理学,生物标志物的解释 (尿素,血清肌) 和治疗策略.
主要成果:
- -葡萄糖共传输体-2 抑制剂,氨酸-安吉奥素-阿尔多斯特系统抑制剂,费内伦和类似葡萄糖的-1 受体激动剂显示出对HF和CKD患者的潜在益处,尽管在晚期CKD的证据有限.
- 在HF治疗开始期间,小的,血液动力学驱动的功能下降通常与不良结果无关,并且不需要停止治疗.
- 强调需要针对CKD的HF诊断值,以及在HF中改进急性损伤的定义.
结论:
- 对HF和CKD的综合管理方法,强调个性化,临床背景和共同目标,对于改善患者护理至关重要.
- 未来的临床试验应纳入脏特异性终点,症状负担和生活质量测量,以更好地评估这种患者群体的干预措施.
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