개와 고양이의 심장-신장 증후군

시작하기 전에 iii
서문 vii
역자 서문 ix

01 인의에서 심장-신장 증후군...............................1
서론 2
CRS의 유형.....................................................................................2
Cardiorenal syndrome type 1 (CRS1)...............................................2
CRS1의 정의와 역학.........................................................................2
CRS1의 병태생리............................................................................3
CRS1의 진단..................................................................................3
CRS1의 치료..................................................................................5
Cardiorenal syndrome type 2 (CRS2)...............................................7
CRS2의 정의와 역학.........................................................................7
CRS2의 병태생리............................................................................7
CRS2의 진단..................................................................................8
CRS2의 치료..................................................................................8
Cardiorenal syndrome type 3 (CRS3)...............................................9
CRS3의 정의와 역학.........................................................................9
CRS3의 병태생리............................................................................9
CRS3의 진단..................................................................................9
CRS3의 치료................................................................................10
Cardiorenal syndrome type 4 (CRS4).............................................11
CRS4의 정의와 역학.......................................................................11
CRS4의 병태생리..........................................................................11
CRS4의 치료................................................................................12
Cardiorenal syndrome type 5 (CRS5).............................................12
CRS5의 정의와 역학.......................................................................12
CRS5의 병태생리..........................................................................13
CRS5의 진단................................................................................13
CRS5의 치료................................................................................13

02 개와 고양이의 심혈관계-신장 축의 개요.....15
서론 16
병태생리.......................................................................................17
분류 19
급성 심장 질환에 의해 발생한 심혈관계-신장 질환(CvRDAH)....................20
병태생리.....................................................................................20
진단 검사....................................................................................21
치료 23
만성 심장 질환에 의해 발생한 심혈관계-신장 질환(CvRDCH).....................23
병태생리.....................................................................................23
진단 검사....................................................................................25
치료 27
급성 신장 질환에 의해 발생한 심혈관계-신장 질환(CvRDAK).....................28
병태생리.....................................................................................28
진단 검사....................................................................................29
치료 30
만성 신장 질환에 의해 발생한 심혈관계-신장 질환(CvRDCK).....................31
병태생리.....................................................................................32
진단 검사....................................................................................32
치료 33
심장과 신장 질환에 영향을 주는 전신 질환에 의해 발생한 심혈관계-신장 질환 (CvRDHK)...............34
병태생리.....................................................................................34
진단 검사....................................................................................34
치료 34

03 심혈관계 질환에 속발한 신장 질환..............37
급성 신장 손상을 유발하는 급성 심혈관계 질환 38
서론 38
발병원인.......................................................................................38
발병기전.......................................................................................39
급성 심부전의 발병기전.....................................................................39
혈역학적 반응...............................................................................40
신장 기능의 악화.............................................................................44
혈역학적 기전...............................................................................45
신경 호르몬 기전...........................................................................45
염증발생 기전...............................................................................46
세뇨관 자체의 손상........................................................................46
진단 46
Urea와 creatinine.........................................................................46
새로운 바이오마커............................................................................47
치료 47
만성 신장 손상을 유발하는 만성 심혈관계 질환 49
서론 49
병인론..........................................................................................49
이첨판 폐쇄부전..............................................................................49
확장성 심근증.................................................................................50
고양이의 비대성 심근증.....................................................................50
병태생리.......................................................................................51
진단 53
영상진단........................................................................................53
방사선........................................................................................53
심장 초음파.................................................................................55
혈압 측정.......................................................................................56
실험실 검사....................................................................................56
신장 질환의 바이오마커...................................................................56
심장 질환의 바이오마커...................................................................59
혈액학........................................................................................59
치료.............................................................................................60

04 신장 질환에 속발하는 심혈관 질환..............63
심장 기능의 손상을 유발하는 급성 신장 질환..................................64
서론.............................................................................................64
병인학..........................................................................................65
병태생리학....................................................................................65
급성 신부전이 심장에 직접적으로 미치는 영향........................................65
면역계 장애.................................................................................65
염증반응과 산화적 스트레스.............................................................65
세포 자연사(apoptosis)..................................................................66
신경호르몬 활성............................................................................67
급성 신부전이 심장에 간접적으로 미치는 영향........................................67
체액 과부하.................................................................................67
전해질 불균형...............................................................................67
산증..........................................................................................69
요독소........................................................................................70
진단.............................................................................................70
영상 진단.......................................................................................70
방사선........................................................................................70
초음파........................................................................................71
실험실 진단....................................................................................71
치료.............................................................................................72
단계에 따른 분류.............................................................................72
급성 신장 손상의 고위험군...............................................................72
1단계 그룹(stage 1; risk)...............................................................72
2단계 그룹(stage 2; injury)............................................................73
3단계 그룹(stage 3; failure)...........................................................73
보존적 치료....................................................................................73
수액 요법....................................................................................73
고칼륨혈증..................................................................................75
저칼륨혈증..................................................................................77
산증..........................................................................................77
고칼슘혈증..................................................................................77
저칼슘혈증..................................................................................78
고인혈증.....................................................................................78
이뇨의 회복.................................................................................78
호흡기 증상 관리...........................................................................79
고혈압 관리.................................................................................79
소화기 증상 관리...........................................................................79
신장 대체술(renal replacement therapy).........................................79
심장 기능의 손상을 유발하는 만성 신장 질환..................................81
서론.............................................................................................81
병인학..........................................................................................83
병태생리학....................................................................................84
전신 고혈압....................................................................................84
요독증...........................................................................................85
전해질 이상....................................................................................85
혈장 용적 이상................................................................................85
약물 중독.......................................................................................86
빈혈..............................................................................................86
Canine leishmaniasis....................................................................87
진단.............................................................................................87
혈압 측정.......................................................................................87
심전도...........................................................................................88
영상 진단.......................................................................................88
실험실 검사....................................................................................90
치료.............................................................................................91

05 심장과 신장에 영향을 주는 전신 질환에 의한 심혈관계-신장 질환.................................93
서론.............................................................................................94
진단.............................................................................................95
심장의 손상 정도의 평가....................................................................95
신장 손상의 평가...........................................................................100
중증 환자: 패혈증, 쇼크와 감염성 질환...........................................102
내분비질환..................................................................................103
당뇨병.........................................................................................103
갑상선기능항진증...........................................................................103
갑상선기능저하증...........................................................................104

06 심혈관계-신장 축 질환이 있는 환자의 마취 관리...................................................................105
서론...........................................................................................106
신장에 영향을 미치는 심혈관 질환 환자..........................................107
급성 심혈관 질환...........................................................................108
만성 심혈관계 질환.........................................................................112
확장성 심근증과 판막 폐쇄부전........................................................112
비대성 심근증과 판막 협착증..........................................................114
심혈관계에 영향을 미치는 신장 질환 환자.......................................116
급성 신장 손상 환자의 마취..............................................................118
만성 신부전 환자의 마취..................................................................120
참고문헌..............................................................................121