{"id":62784,"date":"2026-01-30T15:05:20","date_gmt":"2026-01-30T14:05:20","guid":{"rendered":"https:\/\/www.invarena.cz\/?p=62784"},"modified":"2026-01-30T15:05:54","modified_gmt":"2026-01-30T14:05:54","slug":"zmeny-v-prevenci-zachyti-selhani-srdce-a-ledvin","status":"publish","type":"post","link":"https:\/\/www.invarena.cz\/?p=62784","title":{"rendered":"Zm\u011bny v prevenci zachyt\u00ed selh\u00e1n\u00ed srdce a ledvin"},"content":{"rendered":"\n

Specialist\u00e9 se p\u0159ipravuj\u00ed na p\u0159\u00edliv pacient\u016f, ale v \u010dasn\u011bj\u0161\u00edch stadi\u00edch nemoci<\/em><\/p>\n\n\n\n

Praha, 29. ledna 2026 \u2013 Tis\u00edce lid\u00ed nav\u00edc o\u010dek\u00e1vaj\u00ed letos ve sv\u00fdch ordinac\u00edch kardiologov\u00e9 a nefrologov\u00e9. D\u016fvodem je zm\u011bna preventivn\u00edch prohl\u00eddek u praktick\u00fdch l\u00e9ka\u0159\u016f. Ti od nov\u00e9ho roku preventivn\u011b vy\u0161et\u0159uj\u00ed u vybran\u00fdch pacient\u016f srdce a ledviny \u2013 pokud testy nedopadnou \u201ena jedni\u010dku\u201c, sm\u011bruj\u00ed pacienta ke specialistovi na dal\u0161\u00ed vy\u0161et\u0159en\u00ed.<\/strong><\/p>\n\n\n\n

Prakti\u010dt\u00ed l\u00e9ka\u0159i nyn\u00ed p\u0159i preventivn\u00edch prohl\u00eddk\u00e1ch d\u016fkladn\u011bji zkoumaj\u00ed, zda jejich pacient\u016fm neselh\u00e1vaj\u00ed ledviny nebo srdce. Selh\u00e1n\u00ed ledvin odhal\u00ed za pomoci testu z mo\u010di a z krve. Oslaben\u00e9 srdce zase prozrad\u00ed krevn\u00ed marker NT-proBNP.<\/p>\n\n\n\n

Preventivn\u00ed vy\u0161et\u0159en\u00ed ledvin se nyn\u00ed prov\u00e1d\u00ed jednou za dva roky u v\u0161ech osob star\u0161\u00edch 50 let. N\u00e1rok na n\u011bj maj\u00ed i lid\u00e9 s diabetem, onemocn\u011bn\u00edm srdce \u010di c\u00e9v a pacienti s vysok\u00fdm krevn\u00edm tlakem.<\/p>\n\n\n\n

Preventivn\u00ed vy\u0161et\u0159en\u00ed funkce srdce se pak t\u00fdk\u00e1 50let\u00fdch lid\u00ed se dv\u011bma rizikov\u00fdmi faktory srde\u010dn\u00edho selh\u00e1n\u00ed, a tak\u00e9 t\u011bch, kte\u0159\u00ed maj\u00ed alespo\u0148 jeden rizikov\u00fd faktor srde\u010dn\u00edho selh\u00e1n\u00ed ve v\u011bku nad 60 let. Ka\u017ed\u00e9 dva roky jim m\u016f\u017ee praktikzm\u011b\u0159it hladinu hormonu NT-proBNP v krvi. Kdy\u017e je vysok\u00e1, mus\u00ed pacient na echokardiologick\u00e9 vy\u0161et\u0159en\u00ed.<\/p>\n\n\n\n

\u201eC\u00edlem je zachytit v\u010das<\/em> pacienty, kte\u0159\u00ed se zat\u00edm s \u017e\u00e1dn\u00fdm civiliza\u010dn\u00edm onemocn\u011bn\u00edm systematicky nel\u00e9\u010d\u00ed, a zabr\u00e1nit p\u0159\u00edpadn\u00e9mu rozvoji srde\u010dn\u00edho a ledvinov\u00e9ho selh\u00e1n\u00ed,\u201c <\/em>\u0159\u00edk\u00e1 MUDr. Petr \u0160onka, p\u0159edseda Sdru\u017een\u00ed praktick\u00fdch l\u00e9ka\u0159\u016f. \u201eNov\u00e1 podoba preventivn\u00edch prohl\u00eddek posouv\u00e1 l\u00e9\u010dbu do f\u00e1ze, kdy pacient je\u0161t\u011b \u201anic nec\u00edt\u00ed\u2018. Zdravotn\u00ed stav se hodnot\u00ed podle laboratorn\u00edch marker\u016f, ne podle obt\u00ed\u017e\u00ed.\u201c<\/em><\/p>\n\n\n\n

Specialist\u00e9 zm\u011bny v preventivn\u00edch prohl\u00eddk\u00e1ch v\u00edtaj\u00ed, i kdy\u017e je to zat\u00ed\u017e\u00ed. \u201eSelh\u00e1n\u00ed ledvin nebol\u00ed. T\u00fdk\u00e1 se p\u0159ibli\u017en\u011b ka\u017ed\u00e9ho des\u00e1t\u00e9ho \u010cecha. V\u011bt\u0161ina se ale dost\u00e1v\u00e1 k l\u00e9\u010db\u011b pozd\u011b, ve chv\u00edli, kdy ledviny pracuj\u00ed u\u017e jen omezen\u011b nebo v\u016fbec. V p\u0159\u00edpad\u011b nezvratn\u00e9ho selh\u00e1n\u00ed je nutn\u00e9 funkci ledvin nahradit \u2013 dial\u00fdzou <\/em>nebo<\/em> transplantac\u00ed. Ka\u017edoro\u010dn\u011b u n\u00e1s zah\u00e1j\u00ed dialyza\u010dn\u00ed l\u00e9\u010dbu v\u00edce ne\u017e 2 200 nemocn\u00fdch,\u201c<\/em> \u0159\u00edk\u00e1 prof. MUDr. Ond\u0159ej Viklick\u00fd, CSc., p\u0159ednosta Kliniky nefrologie a Transplantcentra Institutu klinick\u00e9 a experiment\u00e1ln\u00ed medic\u00edny (IKEM). V roce 2025 l\u00e9ka\u0159i v \u010cesku transplantovali ledviny 579 pacient\u016fm, co\u017e je zat\u00edm nejv\u00edce v historii.<\/p>\n\n\n\n

Neradostn\u00e1 je tak\u00e9 situace v kardiologii \u2013 po\u010det lid\u00ed se srde\u010dn\u00edm selh\u00e1n\u00edm stoup\u00e1, ro\u010dn\u011b asi o 40 000. A r\u016fst se neda\u0159\u00ed zbrzdit. Nyn\u00ed se v \u010cR l\u00e9\u010d\u00ed kolem 400 000 nemocn\u00fdch, srde\u010dn\u00ed selh\u00e1n\u00ed je nej\u010dast\u011bj\u0161\u00ed p\u0159\u00ed\u010dinou, pro\u010d kon\u010d\u00ed lid\u00e9 star\u0161\u00ed 65 let v nemocnici.<\/p>\n\n\n\n

\u201eV ide\u00e1ln\u00edm p\u0159\u00edpad\u011b by se k n\u00e1m letos m\u011bly, na popud praktika, dostavit na vy\u0161et\u0159en\u00ed srdce tis\u00edce lid\u00ed nav\u00edc \u2013 odhadujeme to na 10% n\u00e1r\u016fst. To jsou ti, kter\u00e9 obvykle dostaneme do p\u00e9\u010de, a\u017e kdy\u017e se v\u00fdrazn\u011b zhor\u0161\u00ed, a v mnoha p\u0159\u00edpadech skon\u010d\u00ed p\u0159\u00edmo v nemocnici. Od nov\u00fdch preventivn\u00edch prohl\u00eddek s testem na NT-pro BNP si slibujeme, \u017ee spole\u010dn\u011b s praktick\u00fdmi l\u00e9ka\u0159i stav pacient\u016f stabilizujeme a odsuneme jejich pot\u00ed\u017ee ide\u00e1ln\u011b a\u017e o des\u00edtky let,\u201c<\/em> \u0159\u00edk\u00e1 prof. MUDr. Ale\u0161 Linhart, DrSc., p\u0159ednosta II. intern\u00ed kliniky kardiologie a angiologie VFN a 1. LF UK v Praze. Kardiologov\u00e9 sestavili krit\u00e9ria, za jak\u00fdch okolnost\u00ed maj\u00ed prakti\u010dt\u00ed l\u00e9ka\u0159i pacienta k dal\u0161\u00edmu vy\u0161et\u0159en\u00ed poslat. Stejn\u011b to ud\u011blali i nefrologov\u00e9.<\/p>\n\n\n\n

Nefrologov\u00e9 a kardiologov\u00e9 p\u0159ipom\u00ednaj\u00ed, \u017ee v \u010cesku jsou k dispozici l\u00e9ky, jimi\u017e lze rozvoji selh\u00e1n\u00ed org\u00e1n\u016f zabr\u00e1nit nebo jej odd\u00e1lit. \u201eV kardiologii jsou to l\u00e9ky na vysok\u00fd tlak (zejm\u00e9na ACE inhibitory a sartany), glifloziny, ale i l\u00e9ky na obezitu, kter\u00e9 si sice zat\u00edm mus\u00ed pacient hradit s\u00e1m, ale pomohou mu dostat nemoc pod kontrolu. Obezita je pal\u010div\u00fdm probl\u00e9mem \u010desk\u00e9 spole\u010dnosti a stoj\u00ed za ohromn\u00fdm mno\u017estv\u00edm zdravotn\u00edch obt\u00ed\u017e\u00ed,\u201c<\/em> p\u0159ipom\u00edn\u00e1 prof. Linhart. Selh\u00e1n\u00ed srdce se \u00fazce poj\u00ed pr\u00e1v\u011b s hypertenz\u00ed, obezitou a diabetem. Stejn\u011b tak spolu souvis\u00ed nemoci ledvin a srdce, p\u0159i\u010dem\u017e jedno ovliv\u0148uje druh\u00e9. \u201eV nefrologii m\u00e1me \u0159adu renoprotektivn\u00edch l\u00e9k\u016f, kter\u00e9 p\u0159i v\u010dasn\u00e9m nasazen\u00ed v\u00fdznamn\u011b odd\u00e1l\u00ed selh\u00e1n\u00ed ledvin,\u201c <\/em>dopl\u0148uje prof. Viklick\u00fd.<\/p>\n\n\n\n

Kardiologov\u00e9 a nefrologov\u00e9 se shoduj\u00ed, \u017ee jedna v\u011bc je nemoc v\u010das zachytit a druh\u00e1 dostat pacienta ke specialistovi. \u201eLh\u016fta, do kdy by se m\u011bl pacient u ambulantn\u00edch kardiolog\u016f \u201ado\u0161et\u0159it\u2018, se pohybuje mezi 6\u201312 t\u00fddny. To b\u00fdv\u00e1 probl\u00e9m, proto\u017ee kardiologick\u00e9 ambulance jsou p\u0159epln\u011bn\u00e9 a funguj\u00ed na hran\u011b sv\u00e9 kapacity. Pacient v\u0161ak nesm\u00ed bloudit syst\u00e9mem, proto jedn\u00e1me se zdravotn\u00edmi poji\u0161\u0165ovnami o bonifikaci p\u0159echodu pacienta od praktika ke kardiologovi,\u201c <\/em>\u0159\u00edk\u00e1 prof. Linhart.Podobnou v\u011bc \u0159e\u0161\u00ed nefrologov\u00e9 \u2013 \u010dlov\u011bk, kter\u00fd je dle test\u016f ve stadiu 4 chronick\u00e9ho onemocn\u011bn\u00ed ledvin, mus\u00ed b\u00fdt vy\u0161et\u0159en specialistou co nejd\u0159\u00edve. \u201eTady se uplatn\u00ed telemedic\u00edna, d\u00edky n\u00ed\u017e m\u016f\u017ee praktik konzultovat stav pacienta a v\u00fdsledky test\u016f p\u0159\u00edmo s nefrologem a domlouvat se na dal\u0161\u00edm postupu. Bohu\u017eel doposud nemohou praktici p\u0159edepisovat \u0159adu b\u011b\u017en\u00fdch l\u00e9k\u016f na ledviny, co\u017e je podle n\u00e1s nesmysln\u00e9. Mohli by toti\u017e pe\u010dovat o leh\u010d\u00ed p\u0159\u00edpady,\u201c<\/em> dod\u00e1v\u00e1 prof. Viklick\u00fd.<\/p>\n\n\n\n

Nov\u00e1 doporu\u010den\u00ed pro vy\u0161et\u0159en\u00ed ledvin a srdce jsou sou\u010d\u00e1st\u00ed vyhl\u00e1\u0161ky \u010d. 70\/2012 Sb., kter\u00e1 upravuje sou\u010dasnou podobu preventivn\u00edch prohl\u00eddek.<\/p>\n","protected":false},"excerpt":{"rendered":"

Specialist\u00e9 se p\u0159ipravuj\u00ed na p\u0159\u00edliv pacient\u016f, ale v \u010dasn\u011bj\u0161\u00edch stadi\u00edch nemoci Praha, 29. ledna 2026 \u2013 Tis\u00edce lid\u00ed nav\u00edc o\u010dek\u00e1vaj\u00ed letos ve sv\u00fdch ordinac\u00edch kardiologov\u00e9 a nefrologov\u00e9. […]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":21357,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[9],"tags":[],"class_list":["post-62784","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-zpravy"],"_links":{"self":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/62784","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=62784"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/62784\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/21357"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=62784"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=62784"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=62784"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}