Niizuma Shinichiro, Iwanaga Yoshitaka, Yahata Takaharu, Miyazaki Shunichi
Department of Cardiology, Nihon University Hospital , Tokyo , Japan.
Division of Cardiology, Kindai University Faculty of Medicine , Osakasayama , Japan.
Front Cardiovasc Med. 2017 Mar 6;4:10. doi: 10.3389/fcvm.2017.00010. eCollection 2017.
Mortality among the patients with chronic kidney disease (CKD) and end-stage renal disease (ESRD) remains high because of the very high incidence of cardiovascular disease (CVD) such as coronary artery disease, cardiac hypertrophy, and heart failure. Identifying CVD in patients with CKD/ESRD remains a significant hurdle and the early diagnosis and therapy for CVD is crucial in these patients. Therefore, it is necessary for the better management to identify and utilize cardiovascular (CV) biomarkers in profiling CVD risk and enabling stratification of early mortality. This review summarizes current evidence about renocardiovascular biomarkers: CV biomarkers in patients with CKD as well as with ESRD, emphasizing on the emerging biomarkers: B-type natriuretic peptide, cardiac troponins, copeptin, the biomarker of renal injury (neutrophil gelatinase-associated lipocalin), and the mineral and bone disorder hormone/marker (fibroblast growth factor-23). Furthermore, it discusses their potential roles especially in ESRD and in future diagnostic and therapeutic strategies for CVD in the context of managing cardiorenal syndrome.
由于冠状动脉疾病、心脏肥大和心力衰竭等心血管疾病(CVD)的高发病率,慢性肾脏病(CKD)和终末期肾病(ESRD)患者的死亡率仍然很高。在CKD/ESRD患者中识别CVD仍然是一个重大障碍,而CVD的早期诊断和治疗对这些患者至关重要。因此,为了更好地进行管理,有必要识别和利用心血管(CV)生物标志物来评估CVD风险并实现早期死亡分层。本综述总结了有关肾心血管生物标志物的当前证据:CKD患者以及ESRD患者的CV生物标志物,重点关注新兴生物标志物:B型利钠肽、心肌肌钙蛋白、 copeptin、肾损伤生物标志物(中性粒细胞明胶酶相关脂质运载蛋白)以及矿物质和骨代谢紊乱激素/标志物(成纤维细胞生长因子-23)。此外,还讨论了它们的潜在作用,特别是在ESRD中以及在管理心肾综合征背景下未来CVD诊断和治疗策略中的作用。