Lima José Jayme Galvão de
Instituto do Coração, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
Sao Paulo Med J. 2006 Jan 5;124(1):36-41. doi: 10.1590/s1516-31802006000100008. Epub 2006 Apr 3.
Cardiovascular disease is the main cause of death among hemodialysis patients. Although uremia by itself may be considered to be a cardiovascular risk factor, a significant proportion of dialysis patients die because of cardiovascular disease not directly attributable to uremia. Indeed, many of the cardiovascular diseases and cardiovascular risk factors in these patients are common to those occurring in the general population and are amenable to intervention. Lack of proper medical care during the early stages of renal insufficiency and present-day dialysis routines, by failing to correct hypertension, hypervolemia and left ventricular hypertrophy in many patients, may also add to the cardiovascular burden. The author suggests that, in addition to early treatment and referral to a specialist, chronic renal failure patients should undergo intensive cardiovascular screening and treatment, and correction of cardiovascular risk factors based on guidelines established for the general population.
心血管疾病是血液透析患者的主要死因。虽然尿毒症本身可被视为一种心血管危险因素，但相当一部分透析患者死于并非直接由尿毒症导致的心血管疾病。实际上，这些患者中的许多心血管疾病和心血管危险因素与普通人群中出现的情况相同，并且可以进行干预。在肾功能不全早期缺乏适当的医疗护理以及当前的透析程序，由于未能纠正许多患者的高血压、血容量过多和左心室肥厚，也可能加重心血管负担。作者建议，除了早期治疗和转诊至专科医生外，慢性肾衰竭患者应接受强化的心血管筛查和治疗，并根据针对普通人群制定的指南纠正心血管危险因素。
