Groothoff Jaap W, Lilien Marc R, van de Kar Nicole C A J, Wolff Eric D, Davin Jean Claude
Emma Children's Hospital AMC, Amsterdam , The Netherlands.
Pediatr Nephrol. 2005 Mar;20(3):374-9. doi: 10.1007/s00467-004-1624-8. Epub 2004 Nov 10.
As in older adults, cardiovascular disease is the most important cause of death in adolescents and young adult patients with end-stage renal disease (ESRD) since childhood. This concerns patients on dialysis as well as transplant patients, despite the fact that a long duration of dialysis during childhood is an extra mortality risk factor. Left ventricular hypertrophy (LVH), aortic valve calcification, and increased arterial stiffness, but not increased arterial intima media thickening, are the most frequently observed alterations in young adult survivors with childhood ESRD. In transplanted patients a concentric LVH as a result of chronic hypertension is mostly observed; in dialysis patients a more asymmetric septal LVH is found as a result of chronic volume overload. These results suggest that in children and young adults with ESRD chronic pressure and volume overload, a high calcium-phosphate product, and chronic inflammation, but not dyslipidemia, play a role in the development of cardiovascular disease.
与老年人一样，心血管疾病是自儿童期起即患有终末期肾病（ESRD）的青少年和年轻成年患者最重要的死因。这涉及透析患者以及移植患者，尽管儿童期长期透析是一个额外的死亡风险因素。左心室肥厚（LVH）、主动脉瓣钙化和动脉僵硬度增加，但动脉内膜中层增厚未增加，是儿童期患ESRD的年轻成年幸存者中最常观察到的改变。在移植患者中，主要观察到由于慢性高血压导致的向心性LVH；在透析患者中，由于慢性容量超负荷，发现更不对称的间隔LVH。这些结果表明，在患有ESRD的儿童和年轻成年人中，慢性压力和容量超负荷、高钙磷乘积以及慢性炎症，而非血脂异常，在心血管疾病的发展中起作用。
