Kücükköylü S, Rump L C
Klinik für Nephrologie, Universitätsklinikum der Heinrich-Heine-Universität Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland.
Internist (Berl). 2012 Jul;53(7):791-801. doi: 10.1007/s00108-011-3010-5.
Chronic kidney disease (CKD) is a strong cardiovascular risk factor. Microalbuminuria is an early indicator of renal and cardiac damage. Optimal blood pressure therapy and reduction of proteinuria are important measures in order to reduce increased cardiovascular morbidity and mortality in this cohort. Secondary prevention by optimal medical as well as interventional therapy is employed in an inadequate number of CKD patients. In addition, CKD patients should be screened for sleep-related disorders and, if required, adequate therapy should be provided in order to improve cardiovascular outcome. Prospective data in advanced CKD patients concerning new therapeutical approaches such as oral factor Xa- or thrombin-inhibitor therapy are lacking. Optimal treatment of atrial fibrillation in dialysis patients with vitamin K antagonists is also unclear. Prospective studies of transcatheter aortic valve implantation for severe aortic stenosis in patients with advanced stages of renal insufficiency or dialysis therapy are still missing.
慢性肾脏病（CKD）是一种重要的心血管危险因素。微量白蛋白尿是肾脏和心脏损害的早期指标。最佳血压治疗和蛋白尿的减少是降低该队列中心血管发病率和死亡率增加的重要措施。在数量不足的CKD患者中采用了最佳药物治疗以及介入治疗进行二级预防。此外，CKD患者应接受睡眠相关障碍筛查，如有需要，应提供适当治疗以改善心血管结局。缺乏关于晚期CKD患者新治疗方法（如口服Xa因子或凝血酶抑制剂治疗）的前瞻性数据。维生素K拮抗剂用于透析患者心房颤动的最佳治疗也不明确。对于晚期肾功能不全或透析治疗患者严重主动脉瓣狭窄进行经导管主动脉瓣植入术的前瞻性研究仍然缺失。
