El Husseini Nada, Kaskar Omran, Goldstein Larry B
Department of Neurology, Duke University Medical Center, Durham, NC; and Department of Neurology, Wake Forest University Baptist Medical Center, Winston-Salem, NC.
Department of Neurology, Duke University Medical Center, Durham, NC; and Department of Neurology, Wake Forest University Baptist Medical Center, Winston-Salem, NC.
Adv Chronic Kidney Dis. 2014 Nov;21(6):500-8. doi: 10.1053/j.ackd.2014.09.001. Epub 2014 Oct 24.
Chronic kidney disease (CKD) is associated with an increased risk of both ischemic and hemorrhagic stroke. In addition to shared risk factors, this higher cerebrovascular risk is mediated by several CKD-associated mechanisms including platelet dysfunction, coagulation disorders, endothelial dysfunction, inflammation, and increased risk of atrial fibrillation. CKD can also modify the effect of treatments used in acute stroke and in secondary stroke prevention. We review the epidemiology and pathophysiology that link CKD and stroke and the impact of CKD on stroke outcomes. Interdisciplinary collaboration between nephrologists, pharmacists, hematologists, nutrition therapists, primary care physicians, and neurologists in providing care to these subjects may potentially improve outcomes.
慢性肾脏病(CKD)与缺血性和出血性中风风险增加相关。除了共同的风险因素外,这种较高的脑血管风险还由多种与CKD相关的机制介导,包括血小板功能障碍、凝血紊乱、内皮功能障碍、炎症以及心房颤动风险增加。CKD还可改变急性中风和二级中风预防中所用治疗的效果。我们综述了将CKD与中风联系起来的流行病学和病理生理学,以及CKD对中风结局的影响。肾病学家、药剂师、血液学家、营养治疗师、初级保健医生和神经学家在为这些患者提供护理方面的跨学科合作可能会改善结局。