オオノ　ミチヤ   OHNO MICHIYA   大野　道也    所属   朝日大学  歯学部 総合医科学講座 内科学（朝日大学病院）    職種   教授
言語種別	英語
発行・発表の年月	2018/09
形態種別	記事・総説・解説・論説等（学術雑誌）
査読	査読あり
標題	Renal congestion related to worsening renal function in patients with acute decompensated heart failure: Diuretic strategy for acute cardiorenal syndrome　(Review Article)
執筆形態	共著
掲載誌名	Arch Clin Nephrol
掲載区分	国外
巻・号・頁	4(2),pp.12-17
著者・共著者	Michiya Ohno, Yuki Misao, Hiroshige Ohashi
概要	Deterioration of renal function in patients with acute decompensated heart failure (ADHF) infl uences the prognosis, suggesting that ADHF should be managed as an acute cardiorenal syndrome. Close collaboration between cardiologists and nephrologists is frequently crucial for management of this condition. It is noteworthy that renal congestion promotes worsening renal function (WRF). High-dose loop diuretics can cause WRF, but are often necessary for treatment of congestion, which is the main symptom of ADHF. However, it is controversial whether WRF associated with diuretic therapy actually has a poor prognosis. In this review, we focus on the mechanism of renal congestion related to WRF in patients with ADHF and on the current status of WRF. We also review the use of loop diuretics to treat ADHF and chronic heart failure, as well as the current role of selective vasopressin-2 receptor antagonist therapy.