Nelson Adam J, Raggi Paolo, Wolf Myles, Gold Alexander M, Chertow Glenn M, Roe Matthew T
Division of Cardiology, Duke Clinical Research Institute, Durham, North Carolina.
Division of Cardiology, Department of Medicine, University of Alberta and Mazankowski Alberta Heart Institute, Edmonton, Alberta, Canada.
JACC Basic Transl Sci. 2020 Apr 27;5(4):398-412. doi: 10.1016/j.jacbts.2020.02.002. eCollection 2020 Apr.
Cardiovascular (CV) disease remains an important cause of morbidity and mortality for patients with chronic kidney disease (CKD). Although clustering of traditional risk factors with CKD is well recognized, kidney-specific mechanisms are believed to drive the disproportionate burden of CV disease. One perturbation that is frequently observed at high rates in patients with CKD is vascular calcification, which may be a central mediator for an array of CV sequelae. This review summarizes the pathophysiological bases of intimal and medial vascular calcification in CKD, current strategies for diagnosis and management, and posits vascular calcification as a risk marker and therapeutic target.
心血管(CV)疾病仍然是慢性肾脏病(CKD)患者发病和死亡的重要原因。尽管传统风险因素与CKD的聚集现象已得到充分认识,但人们认为肾脏特异性机制导致了心血管疾病负担过重。在CKD患者中经常高频率观察到的一种紊乱是血管钙化,它可能是一系列心血管后遗症的核心介质。本综述总结了CKD中内膜和中膜血管钙化的病理生理基础、当前的诊断和管理策略,并将血管钙化作为一种风险标志物和治疗靶点。