Cardiovascular Disease in Chronic Kidney Disease: Pathophysiological Insights and Therapeutic Options.
Cardiovascular Disease in Chronic Kidney Disease: Pathophysiological Insights and Therapeutic Options.
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DOI：
10.1161/circulationaha.120.050686
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发表时间：
2021-03-16
期刊：
影响因子：
37.8
通讯作者：
Marx N
中科院分区：
文献类型：
--
作者：
Jankowski J;Floege J;Fliser D;Böhm M;Marx N
慢性肾病 (CKD) 患者的心血管风险较高，表现为冠状动脉疾病、心力衰竭、心律失常和心源性猝死。尽管与一般人群相比，早期 CKD 分期（CKD 1-3 期）患者的心血管事件发生率和患病率已经显着较高，但晚期 CKD 分期（CKD 4-5 期）患者的风险显着升高。心血管疾病而非终末期肾病（CKD 5 期）是这一高危人群的主要原因。 CKD 引起全身慢性促炎症状态，导致血管和心肌重塑过程，导致动脉粥样硬化病变、血管钙化和血管衰老以及心肌纤维化和心脏瓣膜钙化。在这方面，慢性肾病模仿了心血管系统的加速老化。这篇概述文章总结了 CKD 中心血管疾病的当前认识和临床后果。
Patients with chronic kidney disease (CKD) exhibit an elevated cardiovascular risk manifesting as coronary artery disease, heart failure, arrhythmias, and sudden cardiac death. Although the incidence and prevalence of cardiovascular events is already significantly higher in patients with early CKD stages (CKD stages 1–3) compared with the general population, patients with advanced CKD stages (CKD stages 4–5) exhibit a markedly elevated risk. Cardiovascular rather than end-stage kidney disease (CKD stage 5) is the leading cause of death in this high-risk population. CKD causes a systemic, chronic proinflammatory state contributing to vascular and myocardial remodeling processes resulting in atherosclerotic lesions, vascular calcification, and vascular senescence as well as myocardial fibrosis and calcification of cardiac valves. In this respect, CKD mimics an accelerated aging of the cardiovascular system. This overview article summarizes the current understanding and clinical consequences of cardiovascular disease in CKD.