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 check-ups. Until recently, bubble urine and abnormal urination occurred, so he hurried to the nephrology department for examination. It was because I didn’t take the heart failure medicine on time that the heart function deteriorated again, which led to kidney failure. Afterwards, 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 poor. Once gone, never to return, he embarked on the fate of kidney dialysis.
To prevent heart failure patients with cardiorenal syndrome, patients should take regular medication and follow up with follow-up visits on a regular basis
Dr. Zhang Minyu from the Department of Nephrology at E-Da Hospital pointed out that heart failure will lead to long-term insufficient blood output, which will gradually affect kidney function. If heart failure patients are not actively treated, chronic renal failure may occur over time, and even progress to uremia, which is serious Patients can only rely on dialysis treatment or kidney transplantation 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 excess water in the body, and the heart is overloaded for a long time, which will aggravate 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 the deterioration of both heart and kidney!” “Patients who have entered dialysis should also actively treat heart failure to avoid deterioration into end-stage heart failure.” Appropriate drug treatment will be selected according to the patient’s condition, and the current standard medication for heart failure can be divided into the following four categories:
1. Renin-angiotensin-aldosterone system (RAAS) blockers:Reduce 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. Beta sympathetic blocker (β-Blocker):It can inhibit the overactivated sympathetic nervous system, slow down the heartbeat, lower blood pressure, and then reduce myocardial oxygen consumption;
3. Mineracorticoid receptor antagonist (MRA):It has the effect of retaining blood potassium and mild diuresis, can reduce cardiac fibrosis, and resist the harm of hormones to cardiovascular, but it cannot be used to treat dialysis patients;
4. Sodium-glucose common transporter-2 inhibitor (SGLT2i):Reduce the reabsorption of sodium ions, promote urine excretion to reduce the burden on the heart, but it cannot be used to treat dialysis patients.
Prevention is essential in life, maintain 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 quit 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 assistance of Taiwan Novartis (TW2301168365)
