慢性肾脏病的心血管并发症危险因素及其防治进展

近年来心血管疾病(CVD)正在成为慢性肾脏病(CKD)患者的常见并发症和首要死亡原因,传统的心血管危险因素(如男性、年龄、家族史、吸烟、肥胖、血脂紊乱、高血压等)显然不能解释其全部的发病机制,而一些非传统危险因素,如肾素-血管紧张素系统激活、氧化应激、高同型半胱氨酸血症、蛋白尿、钙磷代谢紊乱、贫血、慢性微炎症状态等及透析相关的特异性危险因素,如L-肉碱缺乏、动静脉内瘘、透析膜生物不相容性、透析不充分等,可能在CKD患者CVD并发症的发病中占据更重要的地位。

New Points on Risk Factors and Management of Cardiovascular Complications in Chronic Kidney Disease

In the recent years,cardiovascular disease( CVD) has been becoming a common compli- cation and the major cause of mortality in patients with chronic kidney disease( CKD) . Traditional cardiovascular risk factors( male,age,smoking,obesity,dyslipidemia,hypertension,and family history) apparently cannot interpret the whole pathogenic mechanism. Whereas non-traditional risk factors( reninangiotensin system activation,oxidative stress,hyperhomocysteinemia,proteinuria,disorders of calcium- phosphorus metabolism,anaemia,chronic microinflammation state,and dialysis-related specific risk factors,such as L-carnitine deficiency,internal arteriovenous fistula,dialysis-membrane biologic incompatibility,and dialysis insufficiency) may make the more contribution to the development of CVD complication in CKD patients. This paper reviews risk factors and management of cardiovascular complication in CKD.