Schulich School of Medicine and Dentistry, University of Western Ontario Division of Nephrology, University Hospital, London, Ontario, Canada.
Semin Nephrol. 2012 Jan;32(1):40-8. doi: 10.1016/j.semnephrol.2011.11.006.
Cardiovascular diseases such as coronary artery disease, congestive heart failure, arrhythmia, and sudden cardiac death represent the leading causes of morbidity and mortality in patients with CKD, increasing sharply as patients approach end-stage renal disease. The pathogenesis includes a complex, bidirectional interaction between the heart and kidneys that encompasses traditional and nontraditional risk factors, and has been termed cardio-renal syndrome type 4. In this review, an overview of the epidemiology and scope of this problem is provided, some suggested mechanisms for the pathophysiology of this disorder are discussed, and some of the key treatment strategies are described, with particular focus on recent clinical trials, both negative and positive.
心血管疾病，如冠状动脉疾病、充血性心力衰竭、心律失常和心源性猝死，是 CKD 患者发病率和死亡率的主要原因，随着患者接近终末期肾病，这些疾病的发病率急剧上升。发病机制包括心脏和肾脏之间复杂的双向相互作用，涵盖了传统和非传统的危险因素，并被称为 4 型心肾综合征。在这篇综述中，提供了该问题的流行病学和范围概述，讨论了该疾病病理生理学的一些建议机制，并描述了一些关键的治疗策略，特别关注了最近的临床试验，包括阴性和阳性试验。
