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		<h1 class="catchCopy">心不全診療において必須である体液管理を極める！</h1>
		

		<h2 class="series">Management of Heart Failure&nbsp;&nbsp;</h2>
		
		<h1 class="title">心腎連関を深め 体液管理を極める<span class="version"></span></h1>
		

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					編集：猪又孝元（北里大学講師）
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					監修：松﨑益德（医療法人 聖比留会 会長）
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					責任編集：伊藤　浩（岡山大学教授）
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					<span class="transparent">責任編集</span>　筒井裕之（北海道大学教授）
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				<ul class="property"><li class="disc">A5判・196頁・2色刷</li><li class="disc">ISBN&nbsp;978-4-8306-1962-5</li><li class="disc">2016年3月1日発行</li></ul>

				
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		<div class="headers"><h3 class="current content">内容</h3><h3 class="preface">序文</h3><h3 class="indexes">主要目次</h3></div><section class="current content">循環器医が本当に知りたい疑問を腎専門医に届け，知識を得る，あるいは共有する機会はほぼ皆無であった．事実，「循環器医のために」，主に「腎臓医により教示される」実践本はこれまでに見当たらない．循環器医が主に心不全診療で行う体液管理に際し，腎臓をどう理解すべきかを腎専門医に“具体的に”語っていただく，またその一方で，そもそも謎に満ちた腎臓という臓器に，血行動態という見慣れない修飾要因が加わることで，さらに複雑に変化する腎臓を理解し直すという別境地へ多くの腎専門医を巻き込みたい，そんな野望も秘めた一冊である．</section><section class="preface">序文<br><br>　心腎連関の重要性が叫ばれて久しい．慢性腎臓病における心血管病リスクから始まったこの概念も，急速に浸透していく過程で，現場の興味は次第に心不全での体液管理における腎の解釈へと移っている．「目に見えない治療」から「目に見える治療」へのシフトである．特に，救急・集中治療領域を含む循環器診療ベッドサイドでは腎への疑問が増える一方，明確な指針に乏しい現状で，担当医が右往左往する姿が日常的に，しかも，長い間繰り返されてきた．<br>　しかしながら，循環器医が本当に知りたい疑問を腎専門医に届け，知識を教示いただく，あるいは，共有する機会はほぼ皆無であった．事実，「循環器医のために」，主に「腎臓医により教示される」実践本はこれまでに見当たらない．ぜひとも，循環器医が主に心不全診療で行う体液管理に際し，「腎臓をどう理解すべきかを腎専門医に“具体的に”語っていただきたい」，その思いで企画したのが本書である． 一方で，「そもそも謎に満ちた腎臓という臓器に，血行動態という見慣れない修飾要因が加わることで， さらに複雑に変化する腎臓を理解し直す」という別境地へ多くの腎専門医を巻き込みたい─そんな野望も秘めている．トップランナーからのアドバイスを通じ， 多くの挑戦的なテーマに少しでも解決の道が広がるよう，新たな世界を臨床現場に導けることを切に願ってやまない．<br><br>2016年3月<br>北里大学　猪又孝元</section><section class="indexes">I 心不全に影響する体液の理解─循環器医は体液をどうしたいのか？─<br>　1 体液の「量」と心不全<br>　2 体液の「圧」と心不全<br>　3 体液の「組成」と心不全<br>II 腎臓の体液管理メカニズム─心不全管理にどう関わるか─<br>　1 腎臓の水電解質バランス機構<br>　2 腎が体液調節を司る際の修飾因子─心不全時に着目して─<br>　　a．腎低灌流<br>　　b．腎うっ血<br>　　c．神経体液性因子<br>　　d．comorbidity<br>　　e．併用薬物<br>III 病態─CRS分類に基づく心腎連関の理解：臨床シナリオから考える─<br>　1 CRS type 1（acute cardiac dysfunction leading to acute kidney injury）<br>　2 CRS type 2（chronic heart failure leading to renal dysfunction）<br>　3 CRS type 3（acute kidney injury leading to acute cardiac dysfunction）<br>　4 CRS type 4（chronic renal failure leading to cardiac dysfunction）<br>IV 体液管理に必要な腎機能・腎障害を何ではかるか─具体的なメルクマールとは─<br>　1 心不全急性期管理での腎指標<br>　2 心不全慢性期管理での腎指標<br>　3 尿細管・集合管の機能<br>　4 腎血管・腎灌流<br>V 腎保護を理解する─循環器医はどう腎臓を見守るべきか─<br>　1 そもそも腎保護とは何か<br>　2 どこまで腎障害が許容できるか，待てば腎は再生するか<br>　3 腎保護と心保護の優先権，管理におけるバランスシート<br>　　a．腎臓専門医の立場から<br>　　b．心臓専門医の立場から<br>VI 心腎連関を意識した心不全治療ツールの活用─どう腎臓を意識するか─<br>　1 心不全基本治療薬<br>　　a．レニン・アンジオテンシン・アルドステロン系阻害薬<br>　　b．β遮断薬<br>　　c．ナトリウム利尿薬<br>　2 カルペリチド<br>　3 ドパミン<br>　4 トルバプタン<br>　5 透析・限外濾過<br>索引</section></article>
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