Stefan Anker教授：德国柏林洪堡大学附属Charité医院。在心力衰竭和恶病质方面深有研究。是欧洲心力衰竭协会委员会成员以及数个重要的同行评议的杂志委员会成员。
　　International Circulation: What are some of the initial indicators of cardiorenal syndrome (CRS)? What biomarkers are we looking at?
　　Dr Anker: Typically， you would measure markers for both cardiac and kidney function. For the heart， an echocardiography showing left ventricular dysfunction with low left ventricular ejection fraction could be one biomarker for cardiac dysfunction. Alternatively， blood-based markers， such as the natriuretic peptides would work: NT-proBNP， BNP or Mid-regional proANP would be candidates. On the other hand， assessing factors of kidney dysfunction would be important. A simple factor in common use is ordinary creatinine levels for an ambulatory， stable patient， but if there are concerns about kidney function and there are changes over time， you would want an estimated GFR. If the patient is very ill， measuring creatinine clearance with a proper urine collection is most desirable.
　　《国际循环》：心肾综合征初期的生物标志物有哪些？
　　Anker教授：通常来讲，我们会测定心脏和肾脏的生物标志物。从单纯的生物标志物角度来说，心脏超声显示左室功能障碍同时射血分数下降是心脏功能障碍的标志物之一。此外，血清学标志物（例如利钠尿肽）也有作用。氨基端前脑钠肽、脑钠肽和前心钠肽是候选的生物标志物。另外，观察肾功能障碍的指标也有帮助。目前常用的一个简单的指标是测定能够活动的、病情稳定患者的肾功能。但如果对肾功能有所顾虑且肾功能不断变化，可测定估算肾小球滤过率（GFR）。如果患者病情严重，在正确采集尿液标本的情况下测定肌酐清除率是最理想的。
 

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