Kardiyorenal Sendromda Güncel Yaklaşımlar

Son yıllarda kalp ve böbrek hastalıklarının yükü dünyada artmaktadır. Çalışmalar her iki hastalığın birlikte mevcut olmasının morbidite, mortalite ve sağlık bakım harcamalarında artışa katkıda bulunduğunu göstermektedir. Bugün sağlık sistemlerinin karşılaştığı başlıca zorluklardan biri, kardiyorenal sendromu önlemek ve kardiyorenal sendrom gelişen bireylere kaliteli sağlık hizmetleri sunmaktır. Kardiyorenal sendrom kalp ve böbrek fonksiyon bozukluklarının birlikte mevcut olduğu farklı klinik durumları ifade eden genel bir terimdir. Kardiyorenal sendromun insidansı artmasına karşın, patofizyolojisi ve etkin yönetimi ile ilgili kanıtlar sınırlıdır. Kardiyorenal sendrom gelişen hastalarda nörohümoral, hemodinamik ve daha az bilinen başka faktörlerin etkileşimine bağlı olarak ciddi sorunlar ortaya çıkabilmektedir. Bu nedenle kardiyorenal sendromun yönetiminde multidisipliner, çok yönlü ve hasta merkezli bir yaklaşım gereklidir. Bu derlemede kardiyorenal sendromun tanımı, sınıflaması, epidemiyolojisi, patofizyolojisi, önleme ve yönetim stratejileri ile ilgili en son gelişmeler ele alındı.

[Current Approaches in Cardio-Renal Syndrome]

In recent years, burden of cardiac and kidney diseases throughout the world is increasing. Studies show that the coexistence of both diseases contributes to increased mortality, morbidity, and healthcare costs. One of the major challenges facing health systems today is to prevent cardio-renal syndrome and provide quality health services to individuals with cardio-renal syndrome. The cardio-renal syndrome is a general term to describe different clinical conditions in which heart and kidney dysfunctions coexist. Although the incidence of cardio-renal syndrome is increasing, the evidences are limited about its pathophysiology and effective management. Severe problems may occur due to the interaction of neurohumoral, hemodynamic, and other less known factors in patients with cardio-renal syndrome. Therefore, the management of cardio-renal syndrome requires a multidisciplinary, mutifaceted and patient-centred approach. The most recent developments on the definition, classification, epidemiology, pathophysiology, and prevention and management strategies of cardio-renal syndrome are discussed in this review.

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