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Review
. 2021 Nov;62(11):1153-1165.
doi: 10.1007/s00108-021-01170-2. Epub 2021 Oct 4.

[Renal insufficiency in the context of cardio-pulmonary-renal pathophysiology]

[Article in German]
Vedat Schwenger  1 , Insa E Emrich  2 , Felix Mahfoud  2 , Jörg Latus  3 , Andrew Remppis  4
Affiliations
Review

[Renal insufficiency in the context of cardio-pulmonary-renal pathophysiology]

[Article in German]
Vedat Schwenger et al. Internist (Berl). 2021 Nov.

Abstract
in English, German

Heart failure and renal insufficiency as well as pulmonary hypertension are pathophysiologically closely associated as a cardio-renal or cardio-pulmonary-renal syndrome. Due to the frequent hospitalization of patients affected by this syndrome, it is of high medical and also health economic relevance. Besides the inhibition of the renin-angiotensin-aldosterone system (RAAS), multimodal treatment options are available with mineralocorticoid receptor antagonists, angiotensin receptor-neprilysin inhibitors and sodium-glucose transporter 2 (SGLT-2) inhibitors. Profound knowledge of the pathophysiology and the therapeutic options is as necessary for an optimized medical care as patient-oriented, transdisciplinary and cross-sectoral care.

Herzinsuffizienz und Niereninsuffizienz sowie pulmonale Hypertonie sind als kardiorenales oder kardiopulmorenales Syndrom pathophysiologisch eng miteinander verzahnt. Aufgrund der häufigen Hospitalisierung der hiervon betroffenen Patienten kommt diesem Syndrom eine hohe medizinische, aber auch gesundheitsökonomische Relevanz zu. Neben der Blockade des Renin-Angiotensin-Aldosteron-Systems stehen mit den Mineralokortikoidrezeptorantagonisten, Angiotensinrezeptor-Neprilysin-Inhibitoren sowie Natrium-Glukose-Kotransporter-2(SGLT-2)-Inhibitoren multimodale Therapiemöglichkeiten zur Verfügung. Die Kenntnis der pathophysiologischen Grundlagen und der therapeutischen Optionen ist für eine optimierte medizinische Betreuung genauso notwendig wie eine patientenorientierte, transdisziplinäre und sektorenübergreifende Versorgung.

Keywords: Cardio-renal syndrome; Heart failure with preserved ejection fraction; Heart failure with reduced ejection fraction; Pulmonary hypertension; Renal failure.

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