Messa Piergiorgio, Barillà Francesco, Basile Christian, Basso Cristina, Cantaluppi Vincenzo, Capasso Giovambattista, Ciccone Marco Matteo, Contessi Stefano, Curcio Antonio, De Nicola Luca, Esposito Ciro, Imeraj Amantia, Lecis Dalgisio, Mancone Massimo, Marengo Marita, Mercuro Giuseppe, Merlo Marco, Metra Marco, Adamo Marianna, Muscoli Saverio, Nodari Savina, Pagura Linda, Paoletti Ernesto, Paolillo Stefania, Pedrinelli Roberto, Filardi Pasquale Perrone, Pertosa Giovanni Battista, Pezzato Andrea, Pontremoli Roberto, Romeo Francesco, Ruggenenti Piero, Ronco Claudio, Santoro Antonio, Sinagra Gianfranco, Spaccarotella Carmen, Zippo Dauphine, Zoccali Carmine, Indolfi Ciro
U.O.C. Nefrologia, Dialisi e Trapianti di Rene, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano.
Dipartimento di Medicina dei Sistemi, Università degli Studi "Tor Vergata", Roma.
G Ital Cardiol (Rome). 2022 Sep;23(9):716-727. doi: 10.1714/3860.38456.
Chronic kidney disease (CKD) and cardiovascular (CV) disease are highly prevalent conditions in the general population and are strictly connected to each other with a bidirectional interaction. In patients affected by CKD, the leading cause of morbidity and mortality is represented by CV disease, since CKD promotes the atherosclerotic process increasing inflammation, and modifying lipid and bone mineral metabolism. On the other side, a strict relationship exists between CKD and CV risk factors, which are prevalent in nephropathic patients and impose a stringent assessment of the risk of CV events in this population together with an optimized pharmacological approach, complicated by the coexistence of the two pathological conditions. The first part of this consensus document focuses on the mechanisms of cardio-renal damage and on the impact, as well as the management, of the main CV risk factors in the context of CKD.
慢性肾脏病(CKD)和心血管(CV)疾病在普通人群中高度流行,且通过双向相互作用紧密相连。在CKD患者中,发病和死亡的主要原因是CV疾病,因为CKD会促进动脉粥样硬化进程,增加炎症反应,并改变脂质和骨矿物质代谢。另一方面,CKD与CV危险因素之间存在密切关系,这些危险因素在肾病患者中普遍存在,这使得对该人群CV事件风险进行严格评估以及采取优化的药物治疗方法变得复杂,因为这两种病理状况并存。本共识文件的第一部分重点关注心肾损害的机制,以及在CKD背景下主要CV危险因素的影响和管理。