Department of Medicine, University of Chicago, Pritzker School of Medicine, Chicago, Illinois 60637, USA.
Kidney Int. 2010 Oct;78(8):726-36. doi: 10.1038/ki.2010.292. Epub 2010 Aug 18.
Cardiovascular disease (CVD) is the most common cause of death in industrialized nations. Type 2 diabetes is a CVD risk factor that confers risk similar to a previous myocardial infarction in an individual who does not have diabetes. In addition, the most common cause of chronic kidney disease (CKD) is diabetes. Together, diabetes and hypertension account for more than two-thirds of CVD risk, and other risk factors such as dyslipidemia contribute to the remainder of CVD risk. CKD, particularly with presence of significant albuminuria, should be considered an additional cardiovascular risk factor. There is no consensus on how to assess and stratify risk for patients with kidney disease across subspecialties that commonly treat such patients. This paper summarizes the results of a consensus conference utilizing a patient case to discuss the integrated management of hypertension, kidney disease, dyslipidemia, diabetes, and heart failure across disciplines.
心血管疾病(CVD)是工业化国家中最常见的死亡原因。2 型糖尿病是 CVD 的一个危险因素,它在没有糖尿病的个体中赋予与先前心肌梗死相似的风险。此外,慢性肾脏病(CKD)的最常见原因是糖尿病。糖尿病和高血压共同导致超过三分之二的 CVD 风险,而其他危险因素如血脂异常则导致剩余的 CVD 风险。CKD,特别是伴有大量白蛋白尿,应被视为另一个心血管危险因素。在通常治疗此类患者的各个亚专业中,对于患有肾脏病的患者如何进行评估和分层风险尚无共识。本文总结了一次共识会议的结果,该会议利用一个患者病例讨论了各学科之间高血压、肾脏病、血脂异常、糖尿病和心力衰竭的综合管理。