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Medicinski časopis
2012, vol. 46, br. 1, str. 30-34
jezik rada: srpski
vrsta rada: pregledni članak
doi:10.5937/mckg46-1986


Kardio-renalni sindrom tip 2 - etiopatogeneza, dijagnostika i lečenje
aKlinika za urologiju i nefrologiju, Centar za nefrologiju i dijalizu, Klinički centar, Kragujevac
bCentar za kliničku i eksperimentalnu farmakologiju, Klinički centar, Kragujevac
cKlinika za internu medicinu, Klinički centar, Kragujevac

e-adresa: aca96@eunet.rs

Projekat

Analiza strukture troškova i uticaja na zdravstveni budžet Republike Srbije epidemiološki najmasovnijih i/ili najskupljih oboljenja i procena odnosa troškovi / efektivnost / korisnost medicinskih intervencija (MPNTR - 175014)

Sažetak

Zastojna srčana slabost za posledicu ima smanjen srčani rad, smanjenu zapreminu arterijske krvi koja obezbeđuje perfuziju organa, hipoperfuziju tkiva i aktivaciju neurohormonalnih sistema. Rad je imao za cilj da analizira faktore rizika, patogenetske mehanizme razvoja kardiorenalnog sindroma i da ukaže na klinički značaj ranog otkrivanja i pravovremenog lečenja kardiorenalnog sindroma kod bolesnika sa akutnim popuštanjem hronične zastojne srčane slabosti. Analizirani su stručni radovi i kliničke studije koje se bave etiopatogenezom, dijagnostikovanjem i lečenjem kardiorenalnog sindroma. Zbog prepunjenosti kapilara pluća bolesnik oseća gušenje, javljaju se pleuralni izliv, ascites, periferni i generalizovani otoci. Smanjena efektivna zapremina arterijske krvi smanjuje perfuziju bubrega, usled čega dolazi do razvoja akutnog oštećenja bubrega. Pojačana aktivnost neurohormonalnih sistema, rezistencija na diuretike, zadržavanje natrijuma i vode u organizmu povećavaju opterećenje volumenom i pogoršavaju srčanu slabost. Kontrolisano odstranjivanje tečnosti vantelesnom ultrafiltracijom popravlja kliničko stanje bolesnika kod kojih postoji preopterećenje volumenom i prepunjenost kapilara pluća. Održavanje ravnoteže između zapremine ekstracelularne tečnosti koja se odstranjuje i zapremine arterijske krvi koja obezbeđuje perfuziju bubrega, ima ključnu ulogu u sprečavanju razvoja akutnog oštećenja bubrega i značajno doprinosi smanjenju morbiditeta i mortaliteta, i poboljšanju kvaliteta života ovih bolesnika.

Ključne reči

zastojna srčana slabost; akutno oštećenje bubrega; ultrafiltracija; rezistencija na diuretike

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