Sharma R, Pellerin D, Brecker S J D
Department of Cardiology, Southampton University Hospital, Southampton, UK.
Minerva Urol Nefrol. 2006 Jun;58(2):117-31.
Cardiovascular disease is common and is the major cause of mortality and morbidity in end stage renal disease (ESRD). This article explores some of the many factors responsible for the high prevalence and mortality of cardiac disease in patients with ESRD. The mechanisms for cardiotoxicity in ESRD are multiple and include coronary artery disease, cardiomyopathy, microvascular disease, arrhythmia, valvular disease, cardiac calcification, pericarditis, aortic stiffness, malnutrition, inflammation, abnormal myocardial metabolism. Identifying high-risk patients remains a challenge as many traditional risk factors and screening tools are less predictive of cardiac disease in ESRD. At present, the treatment of high-risk patients is largely based on data from the general population and observational studies of patients with ESRD.
心血管疾病很常见，是终末期肾病（ESRD）患者死亡和发病的主要原因。本文探讨了导致ESRD患者心脏病高患病率和高死亡率的诸多因素中的一些因素。ESRD中心脏毒性的机制是多方面的，包括冠状动脉疾病、心肌病、微血管疾病、心律失常、瓣膜疾病、心脏钙化、心包炎、主动脉僵硬、营养不良、炎症、心肌代谢异常。由于许多传统风险因素和筛查工具对ESRD患者心脏病的预测性较差，识别高危患者仍然是一项挑战。目前，高危患者的治疗很大程度上基于普通人群的数据以及对ESRD患者的观察性研究。
