Ritz Eberhard
University of Heidelberg, Department of Nephrology, Heidelberg, Germany.
Blood Purif. 2004;22(1):28-37. doi: 10.1159/000074921.
In the recent HEMO study, the most common cause of death in dialyzed patients was ischemic heart disease. In Europe there are regional differences, but the mortality due to cardiovascular disease is also very high. The long-lasting controversy whether the high incidence and prevalence of atherosclerotic manifestations (particularly ischemic heart disease) may be explained by known risk factors, or non-traditional risk factors are also involved seems to be partially solved with the increasing evidence that the latter hypothesis is true. Thus, together with classic risk factors such as hypertension, dyslipidemia and diabetes, other situations such as microinflammation, increased concentration of asymmetrical dimethyl-L-arginine, disturbed phosphate metabolism and anemia may represent important risk factors for accelerated atherosclerosis in dialyzed patients.
在最近的血液透析(HEMO)研究中,透析患者最常见的死亡原因是缺血性心脏病。在欧洲存在地区差异,但心血管疾病导致的死亡率也非常高。关于动脉粥样硬化表现(尤其是缺血性心脏病)的高发病率和高患病率是由已知危险因素解释,还是也涉及非传统危险因素的长期争议,似乎随着越来越多证据表明后一种假设成立而得到了部分解决。因此,除了高血压、血脂异常和糖尿病等经典危险因素外,微炎症、不对称二甲基-L-精氨酸浓度升高、磷酸盐代谢紊乱和贫血等其他情况可能是透析患者动脉粥样硬化加速的重要危险因素。