Yaşlılarda Kardi̇yorenal Sendrom
Mustafa BalalAkut 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.
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