通讯作者: 李杰, lijie090715@126.com

DOI：10.12201/bmr.202504.00077

Research Advances in Heart Failure with Preserved Ejection Fraction Complicated by Chronic Kidney Disease

• 摘要：射血分数保留的心力衰竭（heart failure with preserved ejection fraction,HFpEF）与慢性肾脏疾病（chronic kidney disease,CKD）是两类具有共同危险因素和病理生理机制的慢性疾病，二者相互影响，显著增加心血管及肾脏不良结局风险。钠水潴留、神经内分泌激活、慢性炎症、贫血、氧化应激及盐皮质激素受体过度激活等机制共同驱动心肾恶性循环，导致心肌纤维化、心室僵硬度增加及肾脏损伤。近年来，针对HFpEF合并CKD的治疗策略取得重要进展，除了传统的利尿剂以外，SGLT2抑制剂、非甾体类盐皮质激素受体拮抗剂、GLP-1受体激动剂等药物展现出新的治疗前景。本文综述了 HFpEF 合并 CKD 的流行病学、病理生理机制、治疗的最新研究进展，旨在提高临床对这一复杂共病状态的认识与管理水平。

  关键词： 心力衰竭；射血分数保留的心力衰竭；慢性肾脏疾病；心肾综合征；SGLT2抑制剂；综述; ; ; ; ; 

   

  Abstract: Heart failure with preserved ejection fraction (HFpEF) and chronic kidney disease (CKD) are two chronic diseases with common risk factors and pathophysiological mechanisms. They interact with each other and significantly increase the risk of adverse cardiovascular and renal outcomes. Mechanisms such as sodium and water retention, neuroendocrine activation, chronic inflammation, anemia, oxidative stress, and excessive activation of the mineralocorticoid receptor jointly drive the vicious cycle of heart and kidney, leading to myocardial fibrosis, increased ventricular stiffness, and renal damage. In recent years, important progress has been made in the treatment strategies for HFpEF combined with CKD. In addition to traditional diuretics, drugs such as SGLT2 inhibitors, non-steroidal mineralocorticoid receptor antagonists, and GLP-1 receptor agonists have shown new therapeutic prospects. This article reviews the epidemiology, pathophysiological mechanisms, and the latest research progress in the treatment of HFpEF combined with CKD, aiming to enhance clinical understanding and management of this complex comorbidity.

  Key words: Heart failure; Heart failure with preserved ejection fraction; Chronic kidney disease; Cardiorenal syndrome; SGLT2 inhibitors; Review

  提交时间：2025-04-30

  版权声明：作者本人独立拥有该论文的版权，预印本系统仅拥有论文的永久保存权利。任何人未经允许不得重复使用。
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• 序号	提交日期	编号	操作
  1	2025-02-11	bmr.202504.00077V1	下载

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