Division of Baxter Novum, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
J Ren Nutr. 2012 Jan;22(1):120-7. doi: 10.1053/j.jrn.2011.10.021.
Cardiovascular disease (CVD) is the major cause of death in patients with advanced chronic kidney disease (CKD). Recent studies have suggested that novel risk factors, uremia- or dialysis-related, are of great importance, as they act synergistically with the highly prevalent traditional risk factors for CVD in CKD patients. Whereas an ideal single biomarker, i.e., one that adds relevant prognostic information in clinical practice over and above that provided by conventional (Framingham) risk factors, has yet to be identified, combinations of several biomarkers or repeated measurements of biomarkers may increase the explanatory power of prognostic information provided by traditional risk factors to predict cardiovascular outcomes. However, because the increase of predictive power is modest, clinical assessment of patient status still remains the cornerstone tool for predicting risk for CVD. On the other hand, the search for better biomarkers may reveal novel pathways linked to CVD that need to be explored in CKD patients. This brief review summarizes some emerging and potentially clinically applicable CVD biomarkers in CKD patients, especially focusing on inflammation and vascular calcification that may provide additional information to conventional risk factors.
心血管疾病（CVD）是晚期慢性肾脏病（CKD）患者死亡的主要原因。最近的研究表明，新型风险因素，包括尿毒症或透析相关的因素，非常重要，因为它们与 CKD 患者中普遍存在的传统 CVD 风险因素具有协同作用。虽然尚未确定理想的单一生物标志物（即在临床实践中提供比传统（弗雷明汉）风险因素更相关的预后信息的标志物），但几种生物标志物的组合或生物标志物的重复测量可能会增加传统风险因素提供的预后信息预测心血管结局的解释能力。然而，由于预测能力的提高幅度较小，因此临床评估患者状况仍然是预测 CVD 风险的基石工具。另一方面，寻找更好的生物标志物可能会揭示与 CKD 患者相关的 CVD 的新途径，这些途径需要进一步研究。这篇简要综述总结了一些在 CKD 患者中出现的潜在具有临床应用价值的 CVD 生物标志物，特别是关注炎症和血管钙化，它们可能为传统风险因素提供额外的信息。
