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慢性肾脏病中的心血管疾病

Cardiovascular disease in chronic kidney disease.

作者信息

Marx-Schütt Katharina, Cherney David Z I, Jankowski Joachim, Matsushita Kunihiro, Nardone Massimo, Marx Nikolaus

机构信息

Department of Internal Medicine I, University Hospital Aachen, RWTH Aachen, Pauwelsstraße 30, Aachen D-52074, Aachen, Germany.

Department of Medicine, Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario, Canada.

出版信息

Eur Heart J. 2025 Jun 16;46(23):2148-2160. doi: 10.1093/eurheartj/ehaf167.

Abstract

Individuals with chronic kidney disease (CKD) exhibit an increased risk for the development of cardiovascular disease (CVD) with its manifestations coronary artery disease, stroke, heart failure, arrhythmias, and sudden cardiac death. The presence of both, CVD and CKD has a major impact on the prognosis of patients. This association likely reflects the involvement of several pathophysiological mechanisms, including shared risk factors (e.g. diabetes and hypertension), as well as other factors such as inflammation, anaemia, volume overload, and the presence of uraemic toxins. Identifying and characterizing CKD is crucial for appropriate CVD risk prediction. Mitigating CVD risk in patients with CKD mandates a multidisciplinary approach involving cardiologists, nephrologists, and other health care professionals. The present State-of-the-Art Review addresses the current understanding on the pathophysiological link between CVD and CKD, clinical implications and challenges in the treatment of these patients.

摘要

慢性肾脏病(CKD)患者发生心血管疾病(CVD)的风险增加,其表现包括冠状动脉疾病、中风、心力衰竭、心律失常和心源性猝死。CVD和CKD并存对患者的预后有重大影响。这种关联可能反映了多种病理生理机制的参与,包括共同的危险因素(如糖尿病和高血压),以及其他因素,如炎症、贫血、容量超负荷和尿毒症毒素的存在。识别和表征CKD对于准确的CVD风险预测至关重要。降低CKD患者的CVD风险需要心脏病专家、肾病专家和其他医疗保健专业人员参与的多学科方法。本最新综述阐述了目前对CVD与CKD之间病理生理联系的理解,以及这些患者治疗中的临床意义和挑战。

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