Stroke and Chronic Kidney Disease: Epidemiology, Pathogenesis, and Management Across Kidney Disease Stages.
Stroke and Chronic Kidney Disease: Epidemiology, Pathogenesis, and Management Across Kidney Disease Stages.
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DOI：
10.1016/j.semnephrol.2015.06.003
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发表时间：
2015-07
影响因子：
3.3
通讯作者：
Weiner DE
中科院分区：
文献类型：
--
作者：
Dad T;Weiner DE
脑血管疾病和中风在慢性肾病（CKD）的所有阶段都很常见，可能代表了共同的风险因素以及风险因素之间的协同作用。更细微的缺血性脑病变可能在CKD人群中特别常见，具有包括认知障碍在内的细微表现。对于非透析CKD患者，卒中的预防、治疗方法、诊断和管理与一般非CKD人群相似。对于患有终末期肾病的个体，关于中风的预防知之甚少。尤其是在房颤透析患者中使用华法林预防卒中的获益仍不确定。终末期肾病患者在急性卒中的情况下可以积极治疗。中风后CKD各个阶段的结局都很差，改善这些结局应该成为未来临床试验的主题。
Cerebrovascular disease and stroke are very common at all stages of chronic kidney disease (CKD), likely representing both shared risk factors as well as synergy among risk factors. More subtle ischemic brain lesions may be particularly common in the CKD population, with subtle manifestations including cognitive impairment. For individuals with nondialysis CKD, the prevention, approach to, diagnosis, and management of stroke is similar to the general, non-CKD population. For individuals with end-stage renal disease, far less is known regarding the prevention of stroke. Stroke prophylaxis using warfarin in dialysis patients with atrial fibrillation in particular remains of uncertain benefit. End-stage renal disease patients can be managed aggressively in the setting of acute stroke. Outcomes after stroke at all stages of CKD are poor, and improving these outcomes should be the subject of future clinical trials.