Hou Fan-Fan, Ma Zhi-Gang, Mei Chang-Lin, Rong Shu, Huang Song-Min, Liu Xian-Rong, Yuan Wei-Jie, Guo Yun-Shan, Wang Li, He Qiang, Wang Xiu-Ling, Sang Xiao-Hong, Li Xiao-Li
Department of Nephrology, Nanfang Hospital, Guangzhou 510515, China.
Zhonghua Yi Xue Za Zhi. 2005 Feb 23;85(7):458-63.
Cardiovascular (CV) disease (CVD) is the single most important cause of death among Chinese dialysis patients, accounting for 51% of overall mortality. The study was performed to investigate the prevalence and the spectrum of CVD in Chinese chronic kidney disease (CKD) patients.
The multicenter Chinese cohort study examined 1239 CKD patients from 7 main medical centers (distributed in 5 regions of China) who were hospitalized between 2002 and 2003.
(1) The most prevalent pathological form of CVD was left ventricular (LV) hypertrophy (LVH), accounting for 58.5% of total patients. The prevalence of coronary artery disease (CAD), congestive heart failure (CHF), and cerebrovascular accidents (CVA) was 16.5%, 27.7% and 5.6%, separately. (2) The cohort with minor renal dysfunction (stage 2-3) had higher prevalence of CAD (5.9%) and CVA (1.0%) compared with general population in the same regions. Up to 41.2% of minor CKD patients were complicated with LVH, and 13.8% of them had clinical evidence of CHF. The prevalence of CAD, LVH and CHF increased as glomerular filtration decline. (3) The prevalence of CAD (20.0%) was much lower and the prevalence of CVA (5.4%) was higher in Chinese dialysis patients than that in American dialysis population. There was significant geographical variations in CAD prevalence, but it was not different between genders.
The CV risk is significantly increased in patients with CKD. Even minor CKD has a major impact on the CV risk. The prevalence of CAD in Chinese dialysis patients is markedly lower than that in American dialysis population.
心血管疾病(CVD)是中国透析患者最重要的单一死因,占总死亡率的51%。本研究旨在调查中国慢性肾脏病(CKD)患者心血管疾病的患病率及疾病谱。
这项多中心中国队列研究对2002年至2003年间在中国7个主要医疗中心(分布于中国5个地区)住院的1239例CKD患者进行了检查。
(1)心血管疾病最常见的病理形式是左心室肥厚(LVH),占总患者数的58.5%。冠状动脉疾病(CAD)、充血性心力衰竭(CHF)和脑血管意外(CVA)的患病率分别为16.5%、27.7%和5.6%。(2)与同一地区的普通人群相比,轻度肾功能不全(2-3期)队列的CAD(5.9%)和CVA(1.0%)患病率更高。高达41.2%的轻度CKD患者合并LVH,其中13.8%有CHF的临床证据。CAD、LVH和CHF的患病率随肾小球滤过率下降而增加。(3)中国透析患者的CAD患病率(20.0%)远低于美国透析人群,而CVA患病率(5.4%)则高于美国透析人群。CAD患病率存在显著的地域差异,但在性别之间无差异。
CKD患者的心血管风险显著增加。即使是轻度CKD也对心血管风险有重大影响。中国透析患者的CAD患病率明显低于美国透析人群。