Anemia e síndrome cardiorenal na insuficiência cardíaca: artigo de revisão
Palavras-chave:
Anemia, insuficiência cardíaca, insuficiência renal crónica, insuficiência cardiorenal, eritropoietina, ferro, ácido fólicoResumo
A presença de anemia e de síndrome cardio-renal nos doentes
com insuficiência cardíaca crónica é frequente e pode associar-se
a deterioração clínica e aumento da mortalidade.
A anemia que surge nos doentes com insuficiência cardíaca
crónica é de etiologia multifactorial e poderá ser um marcador e
um factor agravante da doença renal crónica (DRC). A associação
da insuficiência cardíaca congestiva com a DRC denomina-se
síndrome cardiorenal e indica pior prognóstico. Reveste grande
utilidade fazer o doseamento da creatinina e o cálculo da depuração renal da creatinina nos doentes com ICC de forma a
identificar precocemente esta patologia.
Dever-se-á também dosear o ferro, a ferritina e a capacidade
total de fixação do ferro. Perante a deficiência de ferro, a administração de eritropoietina e ferro deve ser considerada.
A correcção da anemia está associada a melhor prognóstico,
podendo o nível de 12g/dL de hemoglobina (36% hematócrito)
ser o valor desejável.
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Referências
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