Chronic kidney disease and cardiovascular risk: epidemiology, mechanisms, and prevention

被引：1649

作者：

Gansevoort, Ron T. ^{[1
]}

Correa-Rotter, Ricardo ^{[2
]}

Hemmelgarn, Brenda R. ^{[3
]}

Jafar, Tazeen H. ^{[4
]}

Heerspink, Hiddo J. Lambers ^{[5
]}

Mann, Johannes F. ^{[6
,7
]}

Matsushita, Kunihiro ^{[8
]}

Wen, Chi Pang ^{[9
,10
]}

机构：

[1] Univ Groningen, Univ Med Ctr Groningen, Dept Nephrol, Groningen, Netherlands

[2] Natl Med Sci & Nutr Inst Salvador Zubiran, Dept Nephrol & Mineral Metab, Mexico City, DF, Mexico

[3] Univ Calgary, Dept Med, Calgary, AB, Canada

[4] Duke NUS Grad Med Sch, Programme Hlth Serv & Syst Res, Singapore, Singapore

[5] Univ Groningen, Univ Med Ctr Groningen, Dept Clin Pharmacol, NL-9700 RB Groningen, Netherlands

[6] Munich Gen Hosp, Dept Nephrol, Munich, Germany

[7] Univ Erlangen Nurnberg, Dept Med, Clin 4, Nurnberg, Germany

[8] Johns Hopkins Univ, Dept Epidemiol, Bloomberg Sch Publ Hlth, Baltimore, MD USA

[9] China Med Univ Hosp, Taichung, Taiwan

[10] Natl Hlth Res Inst, Inst Populat Hlth Sci, Zhunan, Taiwan

来源：

LANCET | 2013年 / 382卷 / 9889期

基金：

美国国家卫生研究院;

关键词：

STAGE RENAL-DISEASE; GLOMERULAR-FILTRATION-RATE; ALL-CAUSE MORTALITY; ELEVATION MYOCARDIAL-INFARCTION; LEFT-VENTRICULAR HYPERTROPHY; COMMUNITY-BASED POPULATION; ACUTE CORONARY SYNDROME; BLOOD-PRESSURE CONTROL; VITAMIN-D THERAPY; ATHEROSCLEROSIS RISK;

D O I：

10.1016/S0140-6736(13)60595-4

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Since the first description of the association between chronic kidney disease and heart disease, many epidemiological studies have confirmed and extended this finding. As chronic kidney disease progresses, kidney-specific risk factors for cardiovascular events and disease come into play. As a result, the risk for cardiovascular disease is notably increased in individuals with chronic kidney disease. When adjusted for traditional cardiovascular risk factors, impaired kidney function and raised concentrations of albumin in urine increase the risk of cardiovascular disease by two to four times. Yet, cardiovascular disease is frequently underdiagnosed and undertreated in patients with chronic kidney disease. This group of patients should, therefore, be acknowledged as having high cardiovascular risk that needs particular medical attention at an individual level. This view should be incorporated in the development of guidelines and when defining research priorities. Here, we discuss the epidemiology and pathophysiological mechanisms of cardiovascular risk in patients with chronic kidney disease, and discuss methods of prevention.

引用

页码：339 / 352

页数：14

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