MRC Centre for Transplantation and Renal Unit, Guy's & St. Thomas' NHS Foundation Trust, King's College Academic Health Partners, London, UK.
Int J Clin Pract. 2013 Jan;67(1):14-31. doi: 10.1111/j.1742-1241.2012.02954.x. Epub 2012 Jul 11.
Chronic kidney disease (CKD) affects around 10-13% of the general population, with only a small proportion in end stage renal disease (ESRD), either on dialysis or awaiting renal transplantation. It is well documented that CKD patients have an extremely high risk of developing cardiovascular disease (CVD) compared with the general population, so much so that in the early stages of CKD patients are more likely to develop CVD than they are to progress to ESRD. Various pathophysiological pathways and explanations have been advanced and suggested to account for this, including endothelial dysfunction, dyslipidaemia, inflammation, left ventricular hypertrophy and cardiac autonomic dysfunction. In this review, we try to understand and further explore the link between CKD and CVD, as well as offering interventional advice where available, while exposing the current lack of RCT-based research and trial evidence in this area. We also suggest pragmatic Interim measures we could take while we wait for definitive RCTs.
慢性肾脏病（CKD）影响大约 10-13%的普通人群，只有一小部分处于终末期肾病（ESRD），要么在透析，要么在等待肾移植。有大量文献记录表明，与普通人群相比，CKD 患者患心血管疾病（CVD）的风险极高，以至于在 CKD 的早期阶段，患者发生 CVD 的可能性比进展为 ESRD 的可能性更大。已经提出并提出了各种病理生理途径和解释来解释这一点，包括内皮功能障碍、血脂异常、炎症、左心室肥厚和心脏自主神经功能障碍。在这篇综述中，我们试图理解和进一步探讨 CKD 和 CVD 之间的联系，并提供可用的干预建议，同时揭示该领域目前缺乏基于 RCT 的研究和试验证据。我们还建议在等待明确的 RCT 时，我们可以采取务实的临时措施。
