Rutherford E, Mark P B
P Mark, BHF Cardiovascular Research Centre, University of Glasgow, 126 University Place, Glasgow G12 8TA, UK, Email:
J R Coll Physicians Edinb. 2017 Mar;47(1):76-82. doi: 10.4997/JRCPE.2017.117.
Cardiovascular disease is common in patients with chronic kidney disease. The increased risk of cardiovascular disease seen in this population is attributable to both traditional and novel vascular risk factors. Risk of sudden cardiac or arrhythmogenic death is greatly exaggerated in chronic kidney disease, particularly in patients with end stage renal disease where the risk is roughly 20 times that of the general population. The reasons for this increased risk are not entirely understood and while atherosclerosis is accelerated in the presence of chronic kidney disease, premature myocardial infarction does not solely account for the excess risk. Recent work demonstrates that the structure and function of the heart starts to alter early in chronic kidney disease, independent of other risk factors. The implications of cardiac remodelling and hypertrophy may predispose chronic kidney disease patients to heart failure, arrhythmia and myocardial ischaemia. Further research is needed to minimise cardiovascular risk associated with structural and functional heart disease associated with chronic kidney disease.
心血管疾病在慢性肾脏病患者中很常见。该人群中心血管疾病风险增加归因于传统和新型血管危险因素。慢性肾脏病患者心脏猝死或致心律失常性死亡的风险大大增加，尤其是终末期肾病患者，其风险约为普通人群的20倍。这种风险增加的原因尚不完全清楚，虽然在慢性肾脏病患者中动脉粥样硬化加速，但过早发生心肌梗死并不能完全解释这种额外风险。最近的研究表明，在慢性肾脏病早期，心脏的结构和功能就开始改变，与其他危险因素无关。心脏重塑和肥大的影响可能使慢性肾脏病患者易患心力衰竭、心律失常和心肌缺血。需要进一步研究以将与慢性肾脏病相关的结构性和功能性心脏病所带来的心血管风险降至最低。
