Di Micco L, Mozzillo G R, Cianciaruso B
Nefrologia Medica, Facoltà di Medicina, Università Federico II, Napoli - Italy.
G Ital Nefrol. 2009 Nov-Dec;26 Suppl 49:S3-10.
Evidence has been accumulating in recent years that chronic kidney disease (CKD) is a common disease associated with a high risk of morbidity and mortality. Cardiovascular complications are the leading cause of death in patients with CKD, and the risk of cardiovascular mortality is 10-30-fold higher in dialysis patients than in age-, gender- and race-matched controls. On the basis of this evidence it has been suggested that the cardiovascular risk profile of CKD patients is different from that of the general population, resulting from a complex and peculiar interaction of risk factors. In fact, traditional risk factors such as hypertension, aging, smoking, diabetes, and lipid disorders do not fully explain the high frequency of cardiovascular disease in CKD, so other factors must be involved in the high mortality rate in uremic patients. In this article we will provide an overview of the epidemiology of the cardiovascular risk factors in CKD. Among the non-traditional risk factors we have focused particularly on those related to mineral metabolism, which contribute the high rates of cardiovascular events observed in CKD.
近年来,越来越多的证据表明,慢性肾脏病(CKD)是一种常见疾病,与高发病率和死亡率风险相关。心血管并发症是CKD患者的主要死因,透析患者的心血管死亡风险比年龄、性别和种族匹配的对照组高10至30倍。基于这些证据,有人提出CKD患者的心血管风险状况与普通人群不同,这是由风险因素的复杂而独特的相互作用导致的。事实上,高血压、衰老、吸烟、糖尿病和脂质紊乱等传统风险因素并不能完全解释CKD中心血管疾病的高发病率,因此其他因素必定与尿毒症患者的高死亡率有关。在本文中,我们将概述CKD中心血管风险因素的流行病学情况。在非传统风险因素中,我们特别关注了与矿物质代谢相关的因素,这些因素导致了CKD中观察到的心血管事件的高发生率。