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DOI: 10.1055/a-2215-1606
Therapie der Herzinsuffizienz bei chronischer Nierenerkrankung
Individuelles Management des kardiorenalen Syndroms im Behandlungsteam
ZUSAMMENFASSUNG
Bei Patienten mit kombinierter Herzinsuffizienz und mittel- bis höhergradiger Niereninsuffizienz (CKD: „chronic kidney disease“) ist kein einfacher Transfer der Standardtherapie der Herzinsuffizienz möglich. Es müssen die besonderen Umstände der hohen Komorbidität, der veränderten Pharmakokinetik und -dynamik sowie die Zulassungen der Medikation bedacht werden. Nichtsdestotrotz wird Herzinsuffizienz bei CKD-Patienten grundsätzlich sehr ähnlich wie bei Nierengesunden behandelt. Ein enger fachlicher Austausch zwischen den beteiligten Disziplinen ist geeignet, die bereits genannten Klippen zu umschiffen. Dies trifft besonders für Dialysepatienten mit (schwerer) Herzinsuffizienz zu, deren Therapie eine Individualentscheidung im Behandlungsteam sein sollte.
Publikationsverlauf
Artikel online veröffentlicht:
19. April 2024
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Literatur
- 1 Ronco C, House AA, Haapio M. Cardiorenal and renocardiac syndromes: the need for a comprehensive classification and consensus. Nat Clin Pract Nephrol 2008; 04: 310-311
- 2 Kenneally LF, Lorenzo M, Romero-González G. et al Kidney function changes in acute heart failure: a practical approach to interpretation and management. Clin Kidney J 2023; 16: 1587-1599
- 3 McCallum W, Sarnak MJ. Cardiorenal syndrome in the hospital. Clin J Am Soc Nephrol 2023; 18: 933-945
- 4 Bozkurt B, Coats AJ, Tsutsui H. et al Universal definition and classification of heart failure: a report of the Heart Failure Society of America, Heart Failure Association of the European Society of Cardiology, Japanese Heart Failure Society and Writing Committee of the Universal Definition of Heart Failure J Card Fail 2021; 1: S1071-9164(21)00050–6. DOI: 10.1016/j.cardfail.2021.01.022.
- 5 McDonagh TA, Metra M, Adamo M. et al ESC Scientific Document Group. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: Developed by the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). With the special contribution of the Heart Failure Association (HFA) of the ESC. Eur J Heart Fail 2022; 24: 4-131
- 6 Schneider MP, Schmid M, Nadal J. et al GCKD study investigators. Copeptin, natriuretic peptides, and cardiovascular outcomes in patients with CKD: The German Chronic Kidney Disease (GCKD) Study. Kidney Med 2023; 05: 100725
- 7 Gregg LP, Adams-Huet B, Li X. et al Effect modification of chronic kidney disease on the association of circulating and imaging cardiac biomarkers with outcomes. J Am Heart Assoc 2017; 06: e005235
- 8 Kidney Disease: Improving Global Outcomes (KDIGO) KDIGO 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney Int Suppl 2013; 03: 1-150
- 9 Mebazaa A, Davison B, Chioncel O. et al Safety, tolerability and efficacy of up-titration of guideline-directed medical therapies for acute heart failure (STRONG-HF): a multinational, open-label, randomised, trial. Lancet 2022; 400: 1938-1952
- 10 Mullens W, Martens P, Testani JM. et al Renal effects of guideline-directed medical therapies in heart failure: a consensus document from the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail 2022; 24: 603-619
- 11 Fachinfo-Service® – Fachinformationsverzeichnis Deutschland. Arzneimittelinformationen für Deutschland. Im Internet. https://www.fachinfo.de Stand: 24.11.2023
- 12 Metra M, Tomasoni D, Adamo M. et al Worsening of chronic heart failure: definition, epidemiology, management and prevention. A clinical consensus statement by the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail 2023; 25: 776-791
- 13 Mullens W, Damman K, Testani JM. et al Evaluation of kidney function throughout the heart failure trajectory – a position statement from the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail 2020; 22: 584-603
- 14 Kraus BJ, Weir MR, Bakris GL. et al Characterization and implications of the initial estimated glomerular filtration rate ‘dip’ upon sodium-glucose cotransporter-2 inhibition with empagliflozin in the EMPA-REG OUTCOME trial. Kidney Int 2021; 99: 750-762
- 15 Adamson C, Docherty KF, Heerspink HJL. et al Initial decline (Dip) in estimated glomerular filtration rate after initiation of dapagliflozin in patients with heart failure and reduced ejection fraction: insights from DAPA-HF. Circulation 2022; 146: 438-449
- 16 Mewton N, Girerd N, Boffa JJ. et al Practical management of worsening renal function in outpatients with heart failure and reduced ejection fraction: Statement from a panel of multidisciplinary experts and the Heart Failure Working Group of the French Society of Cardiology. Arch Cardiovasc Dis 2020; 113: 660-670
- 17 McDonagh TA, Metra M, Adamo M. et al ESC Scientific Document Group. 2023 Focused update of the 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J 2023; 44: 3627-3639
- 18 Anker SD, Butler J, Filippatos G. et al Empagliflozin in heart failure with a preserved ejection fraction. N Engl J Med 2021; 385: 1451-1461
- 19 Solomon SD, McMurray JJV, Claggett B. et al Dapagliflozin in heart failure with mildly reduced or preserved ejection fraction. N Engl J Med 2022; 387: 1089-1098
- 20 Yu AS, Pak KJ, Zhou H. et al All-cause and cardiovascular-related mortality in CKD patients with and without heart failure: a population-based cohort study in Kaiser Permanente Southern California. Kidney Med 2023; 05: 100624
- 21 Anker SD, Usman MS, Anker MS. et al Patient phenotype profiling in heart failure with preserved ejection fraction to guide therapeutic decision making. A scientific statement of the Heart Failure Association, the European Heart Rhythm Association of the European Society of Cardiology, and the European Society of Hypertension. Eur J Heart Fail 2023; 25: 936-955
- 22 McGuire DK, Busui RP, Deanfield J. et al Effects of oral semaglutide on cardiovascular outcomes in individuals with type 2 diabetes and established atherosclerotic cardiovascular disease and/or chronic kidney disease: Design and baseline characteristics of SOUL, a randomized trial. Diabetes Obes Metab 2023; 25: 1932-1941
- 23 Biggar P, Mitzner S.. Therapie der renalen Anämie – Primär adäquate Eisenversorgung für Hämoglobinzielwerte von 10,0–12,0 g/dl. Kompendium Nephrologie 2023: 6-14
- 24 Blankestijn PJ, Vernooij RWM, Hockham C. et al Effect of hemodiafiltration or hemodialysis on mortality in kidney failure. N Engl J Med 2023; 389: 700-709
- 25 Haddiya I, Valoti S. Current knowledge of beta-blockers in chronic hemodialysis patients. Int J Nephrol Renovasc Dis 2023; 16: 223-230
- 26 Rossignol P, Silva-Cardoso J, Kosiborod MN. et al Pragmatic diagnostic and therapeutic algorithms to optimize new potassium binder use in cardiorenal disease. Pharmacol Res 2022; 182: 106277
- 27 Reeves PB, Mc Causland FR. Mechanisms, clinical implications, and treatment of intradialytic hypotension. Clin J Am Soc Nephrol 2018; 13: 1297-1303
- 28 Spatola L, Rivera RF, Migliore F. et al Cardiovascular implantable electronic devices in hemodialysis patients: an updated review. J Cardiovasc Med (Hagerstown) 2021; 22: 867-873