Cardiovascular disease in chronic renal insufficiency

被引:92
作者
Levin, A
Foley, RN
机构
[1] Univ British Columbia, St Pauls Hosp, Vancouver, BC V62 1Y6, Canada
[2] Hope Hosp, Salford Royal Hosp NHS Trust, Salford M6 8HD, Lancs, England
关键词
kidney disease; chronic renal insufficiency (CRI); anemia; cardiovascular disease (CVD); left ventricular hypertrophy (LVH); congestive heart failure (CHF);
D O I
10.1053/ajkd.2000.19928
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Cardiovascular illness is an important contributor to the morbidity of kidney disease. The spectrum of cardiovascular disease (CVD) in patients with chronic renal insufficiency (CRI) includes left ventricular hypertrophy (LVH) and dilatation, ischemic heart disease, and peripheral vascular disease. Both "traditional" and "uremia-specific" factors contribute to the occurrence and progression of cardiac disease in renal patients. A growing body of recent evidence indicates that the processes contributing to CVD commence early in CRI, leading to concentric LVH, left ventricular dilatation, congestive heart failure, and ischemic heart disease. Many of the coexisting conditions that have been identified consistently as contributing to the burden of cardiovascular illness in renal populations can be modified through medical interventions. Specific therapies exist for hypertension, anemia, hyperparathyroidism, and dyslipidemia. Studies to date have demonstrated that treatment of many of these factors-such as anemia and hypertension during end-stage renal disease-appear to benefit the cardiovascular system. Earlier intervention may offer the best opportunity to reduce the burden of illness in all groups of CRI patients. Identification of patients at the onset of kidney disease and attention to the known traditional and "uremic" risk factors are emerging as promising strategies. Long-term interventional studies are needed to determine costs, benefits, and risks of such strategies. (C) 2000 by the National Kidney Foundation, Inc.
引用
收藏
页码:S24 / S30
页数:7
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