CHAPTER


DOI :10.26650/B/CH12CH47.2023.014.22   IUP :10.26650/B/CH12CH47.2023.014.22    Full Text (PDF)

Yaşlılarda Kardi̇yorenal Sendrom

Mustafa Balal

Akut yada kronik kalp veya böbrek hastalıkları diğer organda akut yada kronik haralanmalara yol açar, bu durum kardiyo-renal sendrom olarak adlandırılır. Şüphesiz ki organlar arasında biri iletişim vardır yani organlar birbirleri ile haberleşmektedir. Bu haberleşme başlıca sitokinler, interlökinler, hormonlar, nöro-humoral mekanizmalar ve diğer mediyatörlerle olmaktadır. İletişim kalp-böbrek, solunum sistemi-böbrek, karaciğer-böbrek arasında yoğun şekilde vardır. Böbrekler birçok organla uyum içinde çalışmaktadır. Kalp hastalıkları böbreklerde hasarlanma/disfonsiyona yol açarken böbrek hastalıkları da kalp te hasarlanma/ disfonksiyona yol açar. Aslında hem kalp hem de böbrekler özelleşmiş damar yapısı şeklinde olan organlardır. Bu nedenle her iki organda hasarlanma yapacak faktörler çok benzerdir. Literatürde böbrek hastalığı kalp hastalığının eşdeğeri olarak kabul edilmektedir. Yaşlanmayla birlikte hem kalp hem de böbrekte yapısal ve fonksiyonel değişiklikler olmaktadır. Her iki organda yaşlanma ile gelişen fonksiyon kaybı/yapısal değişiklikler diğer hastalıklarda da olduğu gibi kardiyorenal sendrom tanısı prognozu ve tedavisi konusunda zorluk oluşturmaktadır. Yaşlanmayla birlikte ilaçların biyoyararlanımı, ıtrahı, etki ve yan etki profilleri değişmektedir. Bu nedenle yaşlılarda ilaç tedavisi ayrı bir dikkat gerektirmektedir.



References

  • 1. The Aging Kidney. Rule AD, GlassockRJ, UpToDate 2023 google scholar
  • 2. Glasscok RJ Rule AD. The implications of anatomical and functional changes of the aging kidney: with emphasis on the glomeruli. Kidney Int 201282:270 google scholar
  • 3. Mancilla E, Avila-Casado C, Uribe-Uribe N et al. Time zero renal biopsyin living kidney transplantation: a valuable oppurtunity to corralate predonation clinical data with histological abnormalities. Transplamtation 2008;86:1684. google scholar
  • 4. Kappel B, Olsen S. Cortical interstitial tissue and sclerosed glomeruli im normal human kidney, related to age and sex. A quantitative study. Virchows Arch A Pathol Anat Histol 1980;387:271. google scholar
  • 5. Hommos MS, Zeng C, Liu Z, et al. Global glomerulosclerosis with nephrotic syndrome; the clinical im-portance of age adjusment. Kidney Int 2018;93:1175. google scholar
  • 6. Srivastava A, Palsson R, Kaze AD, et al. The prognostic Value of Histopathologic Lesions in Native Kidney Biopsy Specimens: Result from the Boston Kidney Biopsy Cohort Study. J Am Soc Nephrol 2018;29:2213. google scholar
  • 7. Denic A, Ricaurte L, Lopez CL, et al. Glomerular Volume and Glomurulosclerosis at Different Depths within the Human Kidney. J Am Soc Nephrol 2019;30:1471. google scholar
  • 8. Nyengaard JR, Bendtsen TF. Glomerular number and size in relation to age, kidney weight and body surface in normal man. Anat Rec1992;232:194, google scholar
  • 9. Hoy WE, Douglas-Denton RN, Hughson MD, et al. A stereological study of kidneys at autopsy. Kidney Int Suppl 2003:S31. google scholar
  • 10. Heylen L, Thienpont B, BUusschaert P, et al. Age-related changes in DNA methylation affect renal histo-logy and post-transplant fibrosis. Kidney Int 2019;96:1195, google scholar
  • 11. Rule AD, Semret MH, Amer H, et al. Association of kidney function and metabolic risk factors with density of glomeruli on renal biopsy samples from living donors. Myo Clin Poc 2011;86:282. google scholar
  • 12. Elsherbiny HE, Alexander MP, Kremers WK et al. Nephron hypertrophy and glomerulosclerosis and their association with kidney function and risk factors among living donors. Clin J Am Soc Nephrol 2014;9:1892. google scholar
  • 13. Roseman DA, Hwang SJ, Oyama-Manabe N et al. Clinical associations of total kidney volume: the Fra-mingham Heart Study. Nephrol Dial Transplant 2017;32:1344. google scholar
  • 14. Eknoyan G. A clinical view of simple and complex renal cysts. J Am Soc Nephrol 2009;20:1874. google scholar
  • 15. Rule AD, Sasiwimonphan K, Lieske JC et al. Characteritics of renal cystic and solid lesions based on contrast-enhanced tomography of potential kidney donors. A J Kidney Dis 2012;59:611. google scholar
  • 16. Baert L,Steg A. Is the diverticulum of the distal and collecting tubules a preliminary stage of the simple cyst in adult? J Urol 1977;118:707. google scholar
  • 17. Ravine D,Gibson RN, Walker RG et al. Evaluation of ultrasonographic diagnostic criteria for autosomal dominant polycystic kidney disease 1. Lancet1994;343:824. google scholar
  • 18. Lew SW, Bosch JP. Effect of diet on creatinine clearance and excretion in young and elderly healthy sub-jects and in patients with renal disease. J Am Soc Nephrol 1991;2:856. google scholar
  • 19. Daugirdas JT, Meyer K, Greene T, et al. Scaling of measured glomerular filtration rate in kidney donor candidates by anthropometric esimates of body surface area, body water, metabolic rate, or liver size. Clin J AmSoc Nephrol 2009;4:1575. google scholar
  • 20. Pottel H, Hoste L, Yayo E Delanaye P. Glomerular Filtration Rate in Healthy Living Potential Kidney Donors: A Meta Analysis Supporting the Construction of the Full Age Spectrum Equation. Nephron 2017;135:105. google scholar
  • 21. Rule AD, Larson TS. Do we need another equation to estimate GFR from serum creatinine in renal allograft recipients? Nephrol Dial Transplant 2008;23:2427. google scholar
  • 22. Pottel H, Hoste L, Delanaye P et al. Demystifiying ethnic/sex differences in kidney function: is the dif-ference in (estimating) glomerular filtration rate or in serum creatinine concentration? Clin Chim Acta 2012;413:1612. google scholar
  • 23. White N. The relationship of the degree of coronary atherosclerosis with age in men. Circulation 1950; 1:645. google scholar
  • 24. Wehrum T, Lodemann T, Hagenlocher P, et al. Age-related changes of right atrial morphology and inflow pattern assessed using 4D flow cardiovascular magnetic resonance: results of a population-based study. J Cardiovasc Magn Reson 2018; 20:38. google scholar
  • 25. Van de Veire NR, De Backer J, Ascoop AK, et al. Echocardiographically estimated left ventricular end-di-astolic and right ventricular systolic pressure in normotensive healthy individuals. Int J Cardiovasc Imaging 2006; 22:633. google scholar
  • 26. Gates PE, Tanaka H, Graves J, Seals DR. Left ventricular structure and diastolic function with human ageing. Relation to habitual exercise and arterial stiffness. Eur Heart J 2003; 24:2213. google scholar
  • 27. Kitzman DW, Scholz DG, Hagen PT, et al. Age-related changes in normal human hearts during the first 10 decades of life. Part II (Maturity): A quantitative anatomic study of 765 specimens from subjects 20 to 99 years old. Mayo Clin Proc 1988; 63:137. google scholar
  • 28. Bergmann O, Bhardwaj RD, Bernard S, et al. Evidence for cardiomyocyte renewal in humans. Science 2009; 324:98. google scholar
  • 29. Olivetti G, Melissari M, Capasso JM, Anversa P. Cardiomyopathy of the aging human heart. Myocyte loss and reactive cellular hypertrophy. Circ Res 1991; 68:1560. google scholar
  • 30. Zhang XP, Vatner SF, Shen YT, et al. Increased apoptosis and myocyte enlargement with decreased car-diac mass; distinctive features of the aging male, but not female, monkey heart. J Mol Cell Cardiol 2007; 43:487. google scholar
  • 31. Jones SA, Boyett MR, Lancaster MK. Declining into failure: the age-dependent loss of the L-type calcium channel within the sinoatrial node. Circulation 2007; 115:1183. google scholar
  • 32. Stratton JR, Cerqueira MD, Schwartz RS, et al. Differences in cardiovascular responses to isoproterenol in relation to age and exercise training in healthy men. Circulation 1992; 86:504. google scholar
  • 33. Ozemek C, Whaley MH, Finch WH, Kaminsky LA. High Cardiorespiratory Fitness Levels Slow the Dec-line in Peak Heart Rate with Age. Med Sci Sports Exerc 2016; 48:73. google scholar
  • 34. Fleg JL, Kennedy HL. Long-term prognostic significance of ambulatory electrocardiographic findings in apparently healthy subjects greater than or equal to 60 years of age. Am J Cardiol 1992; 70:748. google scholar
  • 35. Fleg JL, O’Connor F, Gerstenblith G, et al. Impact of age on the cardiovascular response to dynamic upright exercise in healthy men and women. J Appl Physiol (1985) 1995; 78:890. google scholar
  • 36. Hamada M, Shigematsu Y, Takezaki M, et al. Plasma levels of atrial and brain natriuretic peptides in ap-parently healthy subjects: Effects of sex, age, and hemoglobin concentration. Int J Cardiol 2017; 228:599. google scholar
  • 37. Swain SM, Whaley FS, Ewer MS. Congestive heart failure in patients treated with doxorubicin: a retros-pective analysis of three trials. Cancer 2003; 97:2869. google scholar
  • 38. Avolio AP, Kuznetsova T, Heyndrickx GR, et al. Arterial Flow, Pulse Pressure and Pulse Wave Velocity in Men and Women at Various Ages. Adv Exp Med Biol 2018; 1065:153. google scholar
  • 39. Oue A, Asashima C, Oizumi R, et al. Age-related attenuation of conduit artery blood flow response to passive heating differs between the arm and leg. Eur J Appl Physiol 2018; 118:2307. google scholar
  • 40. Rangaswami J Bahalla V, Bşair JEA et al. Cardiorenal syndrome classificationpathophsiology, diag-nosis and treatment strategies: a scientific statement from the American Heart Association. Circulation 2019;319:840. google scholar
  • 41. Nohria A, Hasselblad V, Srebbins A et al. Cardiorenal inreactions: insights from the ESCAPE trial. J Am Coll Cardiol 2008;51:1268. google scholar
  • 42. Rule AD, Amer H, Cornell LD et al. Tha association between age nehrosclerosis on renal biopsy among healthy adults. Ann Intern Med. 2010;152:561. google scholar
  • 43. Legrand M, Rossignol P. Cardiovascular consequences acut kidney injury. N Engl J Med 2020;382:2238. google scholar
  • 44. Bikle DD. Vitamin D metabolism, mechanism of action and clinicalapplications. Chem Biol 2014;21:319. google scholar
  • 45. Marcos R, Lazaar I, KucharikM et al. The healthy, aging, and diseased kidney: relationship with cardio-vascular disease. JAGS 2020;69:539. google scholar
  • 46. Cardiorenal syndrome: Prognosis and treatment. Kiernan MS, Udelson JE, Sarnak M, UpToDate 2023 google scholar
  • 47. Testani JM, Chen J, McCauley BD, et al. Potential effects of aggressive decongestion during the treatment of decompensated heart failure on renal function and survival. Circulation 2010; 122:265. google scholar
  • 48. Kiernan MS, Wentworth D, Francis G, et al. Predicting adverse events during angiotensin receptor blocker treatment in heart failure: results from the HEAAL trial. Eur J Heart Fail 2012; 14:1401. google scholar
  • 49. Li X, Zhang Q, Zhu L, et al. Effects of SGLT2 inhibitors on cardiovascular, renal, and major safety outco-mes in heart failure: A meta-analysis of randomized controlled trials. Int J Cardiol 2021; 332:119. google scholar
  • 50. Costanzo MR, Johannes RS, Pine M, et al. The safety of intravenous diuretics alone versus diuretics plus parenteral vasoactive therapies in hospitalized patients with acutely decompensated heart failure: a pro-pensity score and instrumental variable analysis using the Acutely Decompensated Heart Failure National Registry (ADHERE) database. Am Heart J 2007; 154:267. google scholar
  • 51. Ungar A, Fumagalli S, Marini M, et al. Renal, but not systemic, hemodynamic effects of dopamine are influenced by the severity of congestive heart failure. Crit Care Med 2004; 32:1125. google scholar
  • 52. Varriale P, Mossavi A. The benefit of low-dose dopamine during vigorous diuresis for congestive heart failure associated with renal insufficiency: does it protect renal function? Clin Cardiol 1997; 20:627. google scholar
  • 53. Konstam MA, Gheorghiade M, Burnett JC Jr, et al. Effects of oral tolvaptan in patients hospitalized for worsening heart failure: the EVEREST Outcome Trial. JAMA 2007; 297:1319. google scholar
  • 54. Scibona P, Belloso WH. Pharmacogeriatrics and the kidney; Clinical Nephrogeriatrics edit; Musso CG, Ma-cıas-Nunez JF, Jauregui JR, Covic A. 2019: ISBN 978-3-030-18710-1 ISBN 978-3-030-18711-8 (eBook). google scholar
  • 55. Wei L, Ye X, Pei X, Wu J, Zhao W. Reference intervals for serum cystatin C and factors influencing cystatin C levels other than renal function in theelderly. PLoS One. 2014;9(1):e86066. google scholar
  • 56. Törner A, Odar-Cederlöf I, Kallner A, et al. Renal function in community-dwelling frail elderly. Compari-son between measured and predicted glomerular filtration rate in the elderly and proposal for a new cystatin C-based prediction equation. Aging Clin Exp Res. 2008;20(3):216-25. google scholar
  • 57. Keller F. Kidney function and age. Nephrol Dial Transplant. 1987;2(5):382. google scholar
  • 58. Musso CG. Acute renal failure in the elderly: pearls for its assessment and treatment. Electron J Biomed. 2005;1:1-93. google scholar
  • 59. Renkke H, Denker B. Renal pathophysiology. Philadelphia: Lippincott Williams & Wilkins; 2007. google scholar
  • 60. Onuigbo MA, Onuigbo NT. The Syndrome of Rapid Onset End-Stage Renal Disease (SOROESRD) - a new Mayo Clinic Dialysis services experience, January 2010-February 2011. In: Di Iorio B, Heidland A, Onuigbo M, Ronco C, editors. Hemodialysis: when, how, why, vol. 2012. New York: NOVA Publishers; 2012. p. 443-85. google scholar
  • 61. Onuigbo M, Onuigbo N, Musso CG. Syndrome of rapid-onset end-stage renal disease in incident Mayo Clinic chronic hemodialysis patients. Indian J Nephro 2014;24:75-81. google scholar
  • 62. Schaeffner ES, Ebert N, Delanaye P, Frei U, Gaedeke J, Jakob O, Kuhlmann MK, Schuchardt M, Tölle M, Ziebig R, van der Giet M, Martus P. Two novel equations to estimate kidney function in persons aged 70 years or older. Ann Intern Med. 2012;157(7):471-8. google scholar
  • 63. Alshaer IM, Kilbride HS, Stevens PE, Eaglestone G, Knight S, Carter JL, Delaney MP, Farmer CK, Irving J, O’Riordan SE, Dalton RN, Lamb EJ. External validation of the Berlin equations for estimation of GFR in the elderly. Am J Kidney Dis. 2014;63(5):862-5. google scholar
  • 64. Musso CG. Geriatric nephrology and the “nephrogeriatric giants”. Int Urol Nephrol. 2002;34:255. google scholar
  • 65. Musso CG, Oreopoulos D. Geriatric nephrology. In: Pathy J, Sinclair A, Morley J, editors. Principles and practice of geriatric medicine. West Sussex: Wiley; 2012. google scholar
  • 66. Musso CG, Rd M, Algranati L, Farias Edos R. Renal potassium excretion: comparison between chronic renal disease patients and old people. Int Urol Nephrol. 2005;37(1):167-70. google scholar
  • 67. Musso C, Liakopoulos DMR, Imperiali N, Algranati L. Transtubular potassium concentration gra-dient: comparison between healthy old people and chronic renal failure patients. Int Urol Nephrol. 2006;38(2):387-90. google scholar
  • 68. Musso CG, Macias Nunez JF, Oreopoulos DG. Physiological similarities and differences between renal aging and chronic renal disease. J Nephrol. 2007;20(5):586-7. google scholar
  • 69. Scibona P, Angriman F, Vazquez C, Ferreyro BL, Perelsztein AG, Simonovich VA, Jauregui JR, Musso CG, Belloso WH. Individualisation of drug therapy in older people. Rev Clin Gerontol. 2014;24:145-57. google scholar
  • 70. Lacy C, Armstrong L, Goldman M, Lance L. Drug information handbook. Philadelphia: LexiComp; 2004. p. 646. google scholar


SHARE




Istanbul University Press aims to contribute to the dissemination of ever growing scientific knowledge through publication of high quality scientific journals and books in accordance with the international publishing standards and ethics. Istanbul University Press follows an open access, non-commercial, scholarly publishing.