Mechanisms for increased cardiovascular disease in chronic kidney dysfunction.
Mechanisms for increased cardiovascular disease in chronic kidney dysfunction.
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DOI：
10.1097/mnh.0b013e328327b360
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发表时间：
2009-05
影响因子：
3.2
通讯作者：
Kon V
中科院分区：
文献类型：
--
作者：
Yamamoto S;Kon V
慢性肾脏病（CKD）患者发生动脉粥样硬化性心血管疾病（CVD）的风险最高。与其他高危人群相比，目前的干预措施在减少CKD患者CVD的过度发病率和死亡率方面效果不足。本文综述了传统的和CKD相关的风险以及巨噬细胞泡沫细胞形成的关键机制，这些机制是CKD背景下过量CVD的基础。高脂血症，特别是低密度脂蛋白（LDL）胆固醇升高，是一般人群中动脉粥样硬化形成的关键因素，但尚未发现是CKD患者更大CVD的首要风险，特别是随着肾损害的进展。虽然CKD患者CVD的发生率较高并不是因为血脂本身升高，但CKD与致动脉粥样硬化的脂质代谢异常有关。CKD相关的风险，包括炎症和矿物质代谢紊乱，已经被牵连。此外，巨噬细胞（动脉粥样硬化形成的中心细胞）的扰动可能是重要的。CKD患者CVD风险升高的潜在机制一直是深入研究的焦点，可能与涉及炎症和脂质代谢的传统和CKD特异性风险的联合作用有关，尤其是巨噬细胞胆固醇稳态的扰动。
Patients with chronic kidney disease (CKD) have the highest risk for atherosclerotic cardiovascular disease (CVD). Current interventions have been insufficiently effective in lessening excess incidence and mortality from CVD in CKD patients versus other high-risk groups. This review focuses on traditional and CKD-related risks as well as key mechanisms of macrophage foam cell formation that underlie the excess CVD in the setting of CKD. Hyperlipidemia, particularly increased low density lipoprotein (LDL) cholesterol, is the key factor in atherogenesis in the general population, but has not been found to be the overriding risk for greater CVD in CKD, especially as renal damage progresses. Although higher incidence of CVD in CKD is not due to higher serum lipids per se, CKD is associated with abnormal lipid metabolism that is proatherogenic. CKD-related risks, including inflammation and disturbances in mineral metabolism, have been implicated. In addition, perturbations of the macrophage, a cell that is central in atherogenesis, may be important. The mechanisms underlying the heightened risk for CVD in CKD have been the focus of intense study and may relate to the combined effects of traditional and CKD-specific risks involving inflammation and lipid metabolism, especially perturbation of macrophage cholesterol homeostasis.
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影响因子：
6.1
作者：
de Mutsert, Renee;Grootendorst, Diana C.;Dekker, Fniedo W.
通讯作者：
Dekker, Fniedo W.
影响因子：
19.6
作者：
Kalantar-Zadeh, K.;Kopple, J. D.;Navab, M.
通讯作者：
Navab, M.
影响因子：
6
作者：
Kalogerakis, G;Baker, AM;Jenkins, AJ
通讯作者：
Jenkins, AJ
影响因子：
120.7
作者：
Coresh, Josef;Selvin, Elizabeth;Levey, Andrew S.
通讯作者：
Levey, Andrew S.
DOI：
10.1097/01.asn.0000088024.72216.2e
发表时间：
2003-10-01
影响因子：
13.6
作者：
Bro, S;Bentzon, JF;Nielsen, LB
通讯作者：
Nielsen, LB