Ma K W, Greene E L, Raij L
Department of Medicine, Veterans Administration Medical Center, Minneapolis, MN 55417.
Am J Kidney Dis. 1992 Jun;19(6):505-13. doi: 10.1016/s0272-6386(12)80827-4.
Cardiovascular disease is the leading cause of death in patients with end-stage renal disease (ESRD). Risk factors for cardiovascular disease, including hypertension, lipid abnormalities, left ventricular hypertrophy (LVH), and glucose intolerance, are present more frequently in patients with chronic renal failure than in the general population, even before the onset of replacement therapy. The prevalence, pathogenesis, and significance of these factors in the uremic population are examined, and the potential roles of intervention are reviewed. Evidence suggests, but is not conclusive, that these factors are of predictive value for cardiovascular complications in patients with chronic renal failure. The effect of modification of these factors on cardiovascular morbidity and mortality in this population, especially in the early stages of renal failure, is an important area for further study.
心血管疾病是终末期肾病(ESRD)患者的主要死因。心血管疾病的危险因素,包括高血压、血脂异常、左心室肥厚(LVH)和糖耐量异常,在慢性肾衰竭患者中比普通人群更常见,甚至在替代治疗开始之前就是如此。本文探讨了这些因素在尿毒症人群中的患病率、发病机制及意义,并综述了干预措施的潜在作用。有证据表明,但尚无定论,这些因素对慢性肾衰竭患者的心血管并发症具有预测价值。这些因素的改善对该人群心血管发病率和死亡率的影响,尤其是在肾衰竭早期,是一个需要进一步研究的重要领域。