Hojs Fabjan Tanja, Hojs Radovan
Dept. of Neurology, University Clinical Centre Maribor, Maribor, Slovenia; University of Maribor, Faculty of Medicine, Maribor, Slovenia.
Clinic for Internal Medicine, Dept. of Nephrology, University Clinical Centre Maribor, Maribor, Slovenia; University of Maribor, Faculty of Medicine, Maribor, Slovenia.
Eur J Intern Med. 2014 Jan;25(1):18-24. doi: 10.1016/j.ejim.2013.08.710. Epub 2013 Sep 23.
Stroke is the most frequent neurological disease and represents a continuously evolving medical and social problem. Chronic kidney disease (CKD) is also an important worldwide public health problem. Renal dysfunction carries a substantial risk of cardiovascular morbidity and mortality and an independent, graded association between renal function and cardiovascular events was found. In the last 15years the link between CKD and cerebrovascular disease has become more apparent. Patients with end stage renal disease treated with maintenance hemodialysis have a much higher incidence of stroke than the general population and stroke is one of the major causes of death in these patients. Nowadays ischemic subtype of stroke is present in approximately 70% of dialysis patients. In population based studies conflicting results have been reported about the association between stroke and CKD before replacement therapy. However, in high risk patients, defined by the presence of either cardiovascular disease or cardiovascular risk factors, different stages of CKD are clearly associated with subsequent stroke. In patients with stroke the exact prevalence of renal dysfunction is not known. Reported prevalence from a few published studies is up to 38% and it is higher than that in age-matched control groups. Furthermore, in patients suffering from stroke renal dysfunction is associated with short and long term mortality. The most effective treatment of stroke in patients with CKD is not known and further studies are needed.
中风是最常见的神经系统疾病，是一个不断演变的医学和社会问题。慢性肾脏病（CKD）也是一个重要的全球公共卫生问题。肾功能不全具有较高的心血管发病和死亡风险，并且发现肾功能与心血管事件之间存在独立的、分级的关联。在过去15年中，CKD与脑血管疾病之间的联系变得更加明显。接受维持性血液透析治疗的终末期肾病患者中风发生率远高于普通人群，中风是这些患者的主要死因之一。如今，约70%的透析患者患有缺血性中风亚型。在基于人群的研究中，关于替代治疗前中风与CKD之间的关联报道结果相互矛盾。然而，在由心血管疾病或心血管危险因素定义的高危患者中，不同阶段的CKD与随后的中风明显相关。中风患者中肾功能不全的确切患病率尚不清楚。一些已发表研究报告的患病率高达38%，高于年龄匹配的对照组。此外，中风患者的肾功能不全与短期和长期死亡率相关。CKD患者中风的最有效治疗方法尚不清楚，需要进一步研究。
