Cardio-renal syndrome is a challenging clinical entity to manage, and is often associated with increased morbidity and mortality. We hypothesized that adaptive servo-ventilation (ASV), non-invasive positive pressure ventilation that ameliorates systemic/pulmonary congestion, may improve renal function in patients with symptomatic heart failure complicated by the cardio-renal syndrome. Patients with symptomatic congestive heart failure who underwent ASV therapy for over 1 month were included in this retrospective study. The trajectory of the estimated glomerular filtration ratio (eGFR) between the pre-1 month period and the post-one-month period (on ASV) were compared. A total of 81 patients (median 65 years old, 65 men) were included. eGFR decreased during the pre-1 month period from 52.7 (41.7, 64.6) down to 49.9 (37.3, 63.5) mL/minute/1.73 m² (P < 0.001) whereas we observed an increase following one-month of ASV therapy up to 53.4 (38.6, 68.6) mL/minute/1.73 m² (P = 0.022). A reduction in furosemide equivalent dose following the initiation of ASV therapy was independently associated with increases in eGFR with an adjusted odds ratio of 13.72 (95% confidence interval 3.40-55.3, P < 0.001). In conclusion, short-term ASV therapy was associated with the preservation of renal function, particularly when the dose of loop diuretics was concomitantly reduced.

心肾综合征是一个具有挑战性的临床实体，通常与发病率和死亡率增加有关。我们假设适应性伺服通气 (ASV)，即改善全身/肺充血的无创正压通气，可能会改善合并心肾综合征的症状性心力衰竭患者的肾功能。接受 ASV 治疗超过 1 个月的有症状的充血性心力衰竭患者被纳入这项回顾性研究。比较了前 1 个月期间和后 1 个月期间（在 ASV 上）之间估计的肾小球滤过率 (eGFR) 的轨迹。共纳入 81 名患者（中位年龄为 65 岁，65 名男性）。eGFR 在前 1 个月期间从 52.7 (41.7, 64.6) 降至 49.9 (37.3, 63.5) mL/分钟/1.73 m² ( P < 0.001) 而我们观察到 ASV 治疗一个月后增加至 53.4 (38.6, 68.6) mL/分钟/1.73 m ² ( P = 0.022)。开始 ASV 治疗后呋塞米等效剂量的减少与 eGFR 的增加独立相关，调整后的优势比为 13.72（95% 置信区间 3.40-55.3，P < 0.001）。总之，短期 ASV 治疗与肾功能的保护有关，特别是当袢利尿剂的剂量同时减少时。