Myette Robert L, Lamarche Caroline, Odutayo Ayodele, Verdin Nancy, Canney Mark
Division of Nephrology, Children's Hospital of Eastern Ontario, Ottawa, Canada.
The Ottawa Hospital Research Institute, Ottawa, ON, Canada.
Can J Kidney Health Dis. 2024 Feb 22;11:20543581241232472. doi: 10.1177/20543581241232472. eCollection 2024.
Cardiovascular (CV) disease is a major cause of morbidity and mortality for patients with glomerular disease. Despite the fact that mechanisms underpinning CV disease risk in this population are likely distinct from other forms of kidney disease, treatment and preventive strategies tend to be extrapolated from studies of patients with undifferentiated chronic kidney disease (CKD). There is an unmet need to delineate the pathophysiology of CV disease in patients with glomerular disease, establish unique risk factors, and identify novel therapeutic targets for disease prevention. The aims of this narrative review are to summarize the existing knowledge regarding the epidemiology, molecular mechanisms, and management of CV disease in patients with common glomerular disease, highlight the patient perspective, and propose specific areas for future study.
The literature for this narrative review was accessed using common research search engines, including PubMed, PubMed Central, Medline, and Google Scholar. Information for the patient perspective section was collected through iterative discussions with a patient partner.
We reviewed the epidemiology, molecular mechanisms of disease, management approaches, and the patient perspective in relation to CV disease in patients with glomerulopathies. Throughout, we have highlighted the current knowledge and have discussed future research approaches, both clinical and translational, while integrating the patient perspective.
Patients with glomerular disease have significant CV disease risk driven by multifactorial, molecular mechanisms originating from their glomerular disease but complicated by existing comorbidities, kidney disease, and medication side effects. The current approach to risk stratification and treatment relies heavily on existing data from CKD patients, but this may not always be appropriate given the unique pathophysiology and mechanisms associated with CV disease risk in patients with glomerular disease. We highlight the need for ongoing glomerular disease-focused studies aimed to better delineate CV disease risk, while integrating the patient perspective.
This is a narrative review and does not represent a comprehensive and systematic review of the literature.
心血管（CV）疾病是肾小球疾病患者发病和死亡的主要原因。尽管该人群中CV疾病风险的潜在机制可能与其他形式的肾脏疾病不同，但治疗和预防策略往往是从未分化慢性肾脏病（CKD）患者的研究中推断而来。目前仍未满足的需求是明确肾小球疾病患者CV疾病的病理生理学，确定独特的危险因素，并识别疾病预防的新治疗靶点。本叙述性综述的目的是总结关于常见肾小球疾病患者CV疾病的流行病学、分子机制和管理的现有知识，突出患者视角，并提出未来研究的具体领域。
本叙述性综述的文献通过常用的研究搜索引擎获取，包括PubMed、PubMed Central、Medline和谷歌学术。患者视角部分的信息是通过与患者伙伴的反复讨论收集的。
我们回顾了肾小球疾病患者CV疾病的流行病学、疾病分子机制、管理方法以及患者视角。在整个过程中，我们突出了当前的知识，并讨论了未来的研究方法，包括临床和转化研究，同时纳入了患者视角。
肾小球疾病患者存在显著的CV疾病风险，这是由源于其肾小球疾病的多因素分子机制驱动的，但因现有合并症、肾脏疾病和药物副作用而变得复杂。目前的风险分层和治疗方法严重依赖于CKD患者的现有数据，但鉴于肾小球疾病患者CV疾病风险相关的独特病理生理学和机制，这可能并不总是合适的。我们强调需要持续开展以肾小球疾病为重点的研究，旨在更好地明确CV疾病风险，同时纳入患者视角。
这是一篇叙述性综述，并不代表对文献的全面系统综述。
