TWO ARE NOT BETTER: CANINE CHRONIC KIDNEY DISEASE AND HEART DISEASE

摘要

Chronic kidney disease (CKD) and heart disease are both common in dogs, often with an increased incidence in the aging population. Both are typically irreversible and progressive with highly variable survival rates. The interactions between the heartand kidneys are referred to as the "cardiorenal syndrome" in humans. The pathophysiology is complex and involves reduced cardiac output, renal hypoperfusion, activation of the renin angiotensin aldosterone system (RAAS) and sympathetic nervous system. Indogs, treatment is often complicated by systemic hypertension, electrolyte abnormalities, anemia, concurrent diseases (diabetes mellitus, hyperadrenocorticism, arthritis/orthopedic) and polypharmacy situations. Poor perfusion to the kidneys activates the RAAS system resulting in sodium and water retention and increased circulating blood volume contributing to overload of the cardiovascular system. What is good for one system is counterproductive for the other. Is it possible to strike a balance? How dowe manage heart failure in dogs with kidney disease?