Cardiovascular disease in end-stage renal disease patients
Cardiovascular disease in end-stage renal disease patients
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DOI：
10.1053/ajkd.2001.27392
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发表时间：
2001-10-01
影响因子：
13.2
通讯作者：
Herzog, C
中科院分区：
文献类型：
--
作者：
Collins, AJ;Li, SL;Herzog, C
本研究评估了患有心血管疾病的终末期肾病 (ESRD) 患者的危险因素监测。 ESRD 患者心血管疾病死亡率比普通人群高 20 至 40 倍，并且 72% 的患有急性心肌梗死 (AMI) 的 ESRD 患者在随访后 2 年内死亡。患有 AMI 的患者很少接受明确的测试来评估冠状动脉循环，即使在发生 AMI 高风险事件后，心导管插入率和血运重建率也很低。用于治疗 ESRD 人群血脂紊乱的危险因素干预措施很少受到关注，USRDS 报告称，1998 年，58% 的透析患者和 64% 的移植患者在一年内没有进行血脂监测。在接受测试的患者中，只有 33% 的透析患者和 27% 的移植患者在 1 年内接受了两次或以上测试。建议用于糖尿病管理的以 HbA1c 形式进行的血糖控制监测在 ESRD 患者中也没有得到充分利用，只有不到一半的患者在 1 年内接受了单次检测，只有 10% 的患者接受了 3 次或更多检测。这引起了人们的担忧，即终末期肾病人群中糖尿病血糖控制监测可能不够理想。糖尿病眼科检查和糖尿病血糖监测的使用率也很低，流感疫苗接种率也很低。这些数据提示ESRD患者心血管疾病的临床护理需要更多关注。 (C) 2001 年，国家肾脏基金会 (National Kidney Foundation, Inc.)
This study evaluates risk factor monitoring in end-stage renal disease (ESRD) patients with cardiovascular disease. Death rates from cardiovascular disease in ESRD patients are 20 to 40 times higher than in the general population, and 72% of ESRD patients with an acute myocardial infarction (AMI) are dead within 2 years of follow-up. Patients who have sustained an AMI rarely receive definitive testing to assess coronary circulation, and cardiac catheterization rates and revascularization rates are low, even after the high-risk event of an AMI. Risk factor intervention to treat lipid disorders in the ESRD population has received little attention, with the USRDS reporting that In 1998, 58% of dialysis and 64% of transplant patients had no lipid monitoring performed within a year. Of those tested, only 33% of dialysis and 27% of transplant patients had two or more tests within 1 year. Glycemic control monitoring in the form of HbA1c, recommended for diabetes management, is also underutilized in ESRD patients, with fewer than half receiving a single test within 1 year and only 10% receiving three or more tests. This raises concerns that diabetic glycemic control monitoring may be suboptimal in the ESRD population. The use of diabetic eye examinations and diabetic glucose monitoring is also low, as are influenza vaccination rates. These data suggest that the clinical care of cardiovascular disease in the ESRD patients needs more attention. (C) 2001 by the National Kidney Foundation, Inc.