Title: Cardiorenal Syndrome
题目：心肾综合征
Author 作者: Semhar Tewelde

Cardiorenal syndrome (CRS) type 1 is the development of acute kidney injury (AKI) in the patient with acute cardiac illness, most commonly acute decompensated heart failure (ADHF)
心肾综合征（CRS）1型患急性心脏疾病病人出现了急性肾损伤（AKI），最常见的是急性失代偿性心脏衰竭（ADHF）
Multiple pathophysiological mechanisms result in CRS characterized by a rise in serum creatinine, oliguria, diuretic resistance, and worsening ADHF
多种病理生理机制导致CRS，主要表现为血清肌酐上升，少尿，利尿剂抵抗，及失代偿性心力衰竭恶化
There are a host of predisposing factors that create baseline risk for CRS (DM, HTN, OSA)
诱发导致产生CRS的基础危险因素有很多（糖尿病，高血压，阻塞性睡眠呼吸暂停综合征）
The final common pathway often results in bidirectional organ injury, drug resistance, and death 
最后共同通路常常导致双向脏器损伤，药物抵抗和死亡
The combination of worsening renal function, volume overload, and diuretic refractoriness makes the management of CRS challenging
由于肾功能恶化，容量超负荷，利尿剂无效的同时存在，使CRS的处理更具有挑战性
Current therapies although often ineffective include aggressive diuresis and positive inotropes
虽然效果不理想，目前的治疗方法包括积极的利尿和正性肌力药物的使用

References 参考文献：
Ronco C, et al. Cardiorenal Syndrome Type I: Pathophysiological Crosstalk Leading to Combined Heart and Kidney Dysfunction in the Setting of Acutely Decompensated Heart Failure. JACC Vol. 60, No. 12, 2012