A retired man over 60 years old had heart failure in the past, but he did not develop the habit of regular medication and regular heart examinations. Until recently, bubble urine and abnormal urination occurred, so he hurried to the nephrology department for examination. ■ Because I did not take the heart failure medication on time, the heart function deteriorated again, which led to kidney failure. After that, under the joint treatment of the heart and kidney team, the heart function has improved, and the left ventricular ejection fraction has increased from less than 30% to more than 40% (the normal value is 52 -74%), but his kidney function is still bad. After he left, without returning, he began the fate of kidney dialysis.
To prevent heart failure patients with cardiorenal syndrome, patients should take regular medication and follow up with regular follow-up visits.
Dr Zhang Minyu from the Nephrology Department of E-Da Hospital noted that heart failure will lead to insufficient blood output in the long term, which will gradually affect kidney function. If heart failure patients are not actively treated , chronic renal failure can occur over time, and even progress to uremia, which is serious. Patients can rely on dialysis treatment or a kidney transplant to replace the work of the kidneys to maintain body functions; on the other hand, due to the deterioration of kidney function, they cannot excrete too much water in the body, and the heart is overloaded for a long time, which will worsen the degree of heart failure, cardiorenal syndrome.
Dr. Zhang Minyu emphasized, “Patients with heart failure should take medication regularly and follow up regularly to avoid deterioration of the heart and kidneys!” “Patients who have entered dialysis should also actively treat heart failure to avoid deterioration of the heart in the final stage. failure.” Appropriate drug treatment will be chosen according to the patient’s condition, and the current standard medicine for heart failure can be divided into the following four categories:
1. Renin-angiotensin-aldosterone system (RAAS) inhibitors:Reducing the burden on the heart by dilating blood vessels and lowering blood pressure, including angiotensin converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARB);
2. Sympathetic beta blocker (β-Blocker):It can suppress the overactive sympathetic nervous system, slow the heartbeat, lower blood pressure, and then reduce myocardial oxygen consumption;
3. Mineralocorticoid receptor antagonist (MRA):It has the effect of keeping blood potassium and mild diuresis, can reduce cardiac fibrosis, and resist the damage of hormones to cardiovascular, but it cannot be used to treat dialysis patients;
4. Common sodium-glucose transporter-2 inhibitor (SGLT2i):Reduce the reabsorption of sodium ions, promote urine excretion to reduce the burden on the heart, but can not be used to treat dialysis patients.
Prevention is essential in life, maintaining good habits to reduce the worsening of heart failure
In addition to drug treatment, Dr. Zhang Minyu also reminded patients with heart failure to pay more attention to blood pressure control, maintain good eating habits with less salt, less sugar, and less oil, and stop bad habits such as smoking, drinking, and staying up late for a long time Risk of worsening failure.
This health education article was published with the support of Taiwan Novartis (TW2301168365)
