Nanayakkara P W B, Gaillard C A J M
Department of Internal Medicine, VU University Medical Centre, Amsterdam, the Netherlands.
Neth J Med. 2010 Jan;68(1):5-14.
Premature cardiovascular disease (CVD) is a frequent complication in patients with chronic kidney disease (CKD). The traditional (Framingham) risk factors only partly explain the high prevalence of CVD in these patients and nontraditional risk factors/markers such as oxidative stress, persistent inflammation, cardiovascular ossification, endothelial dysfunction and anaemia are prevalent and seem to play an important role in the pathogenesis of CVD in CKD patients. In addition, the so-called reverse epidemiology phenomenon, which occurs in advanced kidney disease, complicates the search for causative mechanisms. Here we review a few recently developed concepts regarding the high incidence of CVD in CKD patients.
心血管疾病(CVD)过早发生是慢性肾脏病(CKD)患者常见的并发症。传统的(弗明汉)风险因素仅部分解释了这些患者中CVD的高患病率,而氧化应激、持续性炎症、心血管钙化、内皮功能障碍和贫血等非传统风险因素/标志物普遍存在,并且似乎在CKD患者CVD的发病机制中起重要作用。此外,在晚期肾病中出现的所谓逆流行病学现象,使寻找病因机制变得更加复杂。在此,我们综述一些最近提出的关于CKD患者CVD高发率的概念。