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Niereninsuffizienz im Kontext der kardiopulmorenalen Pathophysiologie

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

  • Schwerpunkt: Kardio-pulmo-renale Medizin
  • Published:
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Zusammenfassung

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.

Abstract

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.

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Authors and Affiliations

  1. Klinik für Nieren‑, Hochdruck- und Autoimmunerkrankungen, Klinikum der Landeshauptstadt Stuttgart gKAöR, Katharinenhospital, Kriegsbergstr. 60, 70174, Stuttgart, Deutschland

    Vedat Schwenger & Jörg Latus

  2. Klinik für Innere Medizin III – Klinik für Kardiologie, Angiologie und Internistische Intensivmedizin, Universitätsklinikum des Saarlandes, Homburg, Deutschland

    Insa E. Emrich & Felix Mahfoud

  3. Klinik für Kardiologie, Herz- und Gefäßzentrum Bad Bevensen, Bad Bevensen, Deutschland

    Andrew Remppis

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Correspondence to Vedat Schwenger.

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Interessenkonflikt

V. Schwenger, I.E. Emrich, F. Mahfoud, J. Latus und A. Remppis geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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B. Andrew Remppis, Bad Bevensen

Vedat Schwenger, Stuttgart

Claus F. Vogelmeier, Marburg

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Schwenger, V., Emrich, I.E., Mahfoud, F. et al. Niereninsuffizienz im Kontext der kardiopulmorenalen Pathophysiologie. Internist 62, 1153–1165 (2021). https://doi.org/10.1007/s00108-021-01170-2

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