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慢性肾脏病儿科患者的心血管风险

Cardiovascular risks in chronic kidney disease pediatric patients.

作者信息

Tian Jing, Niu Ling, An Xinjiang

机构信息

Department of Pediatric Internal Medicine, Xuzhou Children's Hospital, Xuzhou, Jiangsu 221002, P.R. China.

出版信息

Exp Ther Med. 2017 Nov;14(5):4615-4619. doi: 10.3892/etm.2017.5117. Epub 2017 Sep 15.

Abstract

One of the common factors for the premature death in children is advanced chronic kidney disease (CKD). Most often cardiovascular disease (CVD) is the reason for mortality. The cardiovascular (CV) morbidity starts early in the disease process and renal transplanted children (CKD-T) are also at risk. The present review is focused on the current views of the cardiovascular risks during CKD in pediatric patients. Variable data sources for the latest literature collection were explored which mainly included PubMed and Google Scholar. The most important risk factors for subclinical CVD were a young age, elevated BMI and systolic blood pressure z-scores as well as a low GFR and present albuminuria. Increasing blood pressure and BMI over follow-up were also important cardiac risk factors longitudinally. The present review concludes that altered cardiac function and remodeling are a concurrent part of the CKD process, start early in the disease development, and persist after renal transplantation. The findings suggest that children with CKD or CKD-T are at high risk for future CVD where younger patients with elevated BMI and slightly increased blood pressures, as well as present albuminuria, are those at greatest risk, thus indicating targets for future interventions.

摘要

儿童过早死亡的常见因素之一是晚期慢性肾脏病(CKD)。最常见的死亡原因是心血管疾病(CVD)。心血管(CV)疾病在疾病进程早期就会出现,肾移植儿童(CKD-T)也有风险。本综述聚焦于儿科患者CKD期间心血管风险的当前观点。探索了用于最新文献收集的多种数据来源,主要包括PubMed和谷歌学术。亚临床CVD的最重要风险因素是年龄小、BMI升高和收缩压z评分,以及低肾小球滤过率(GFR)和蛋白尿。随访期间血压和BMI的升高也是纵向重要的心脏风险因素。本综述得出结论,心脏功能改变和重塑是CKD进程的一部分,在疾病发展早期就开始,并在肾移植后持续存在。研究结果表明,CKD或CKD-T儿童未来发生CVD的风险很高,其中BMI升高和血压略有升高以及有蛋白尿的年轻患者风险最大,因此指明了未来干预的目标。

相似文献

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Cardiovascular risks in chronic kidney disease pediatric patients.慢性肾脏病儿科患者的心血管风险
Exp Ther Med. 2017 Nov;14(5):4615-4619. doi: 10.3892/etm.2017.5117. Epub 2017 Sep 15.

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