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预测慢性肾脏病(CKD)患者的心血管死亡率。

Predicting cardiovascular mortality in chronic kidney disease (CKD) patients.

作者信息

Sun Wenhui, Liu Dahai, Gong Ping, Shi Xiaoyu, Wang Yong, Wang Ping, Gong Weihua

机构信息

Department of Surgery, Fuyang People's Hospital, Hangzhou, China (mainland).

Center for Stem Cell and Translational Medicine, School of Life Sciences, Anhui University, Hefei, China (mainland).

出版信息

Ann Transplant. 2014 Oct 14;19:513-8. doi: 10.12659/AOT.891207.

Abstract

Cardiovascular mortality in chronic kidney disease (CKD) patients is a critical clinical challenge due to poor clinical outcome and increasing prevalence. Nephrologists and transplant specialists need suitable biomarkers to predict the occurrence of cardiovascular events and/or mortality in practice. At the technical level, development of a non-invasive repetitive sampling procedure is required to develop applicable biomarkers, offering a platform for clinicians to dynamically monitor the alteration of patient condition. Apart from specificity and sensitivity, the ideal biomarkers should be independent of various confounders such as sex, sex, age, kidney function, diabetes, and blood pressure. This article reviews recent studies on the identified potential biomarkers to analyze their predictive value and significance. The present study revealed that the identified potential biomarkers are involved in magnesium and phosphate metabolism, hormone dysregulation, pro-inflammatory process, and cardiovascular pathogenesis. Combined use of those biomarkers might allow early identification of subclinical cardiovascular system organ damage, effectively predict cardiovascular mortality, and significantly deepen our mechanistic understanding of the occurrence of cardiovascular events and mortality, which will help to develop preventive measures.

摘要

由于临床预后不佳且患病率不断上升,慢性肾脏病(CKD)患者的心血管死亡率是一项严峻的临床挑战。肾病学家和移植专家在实践中需要合适的生物标志物来预测心血管事件的发生和/或死亡率。在技术层面,需要开发一种非侵入性重复采样程序来开发适用的生物标志物,为临床医生提供一个动态监测患者病情变化的平台。除了特异性和敏感性外,理想的生物标志物应独立于各种混杂因素,如性别、年龄、肾功能、糖尿病和血压。本文综述了近期关于已确定的潜在生物标志物的研究,以分析其预测价值和意义。本研究表明,已确定的潜在生物标志物涉及镁和磷代谢、激素失调、促炎过程和心血管发病机制。联合使用这些生物标志物可能有助于早期识别亚临床心血管系统器官损伤,有效预测心血管死亡率,并显著加深我们对心血管事件和死亡率发生机制的理解,这将有助于制定预防措施。

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