慢性肾脏病患者心血管疾病的临床特点及其病理生理学基础

doi:10.3877/cma.j.issn.2095-3216.2021.03.007

慢性肾脏病(CKD)是全球范围内的严重公共卫生问题。心血管疾病(CVD)是影响CKD患者预后的重要因素和首位死亡原因。CKD患者心血管疾病(CKD-CVD)十分常见，且常伴不良预后。临床研究发现，控制传统CVD危险因素在降低CKD患者的CVD死亡率方面不如预期，这表明着CKD-CVD可能具有其独特的危险因素。本文通过整理近年来CKD-CVD的相关文献，对CKD-CVD的分类、不典型临床表现、非传统危险因素以及相关病理生理学基础进行综述。目前的研究结果可以解释部分CKD-CVD诊断和治疗的难点，但仍需要更多高质量的基础实验和临床试验为CKD-CVD的防治提供依据。

关键词: 慢性肾脏病, 心血管疾病, 危险因素, 尿毒症毒素, 微循环

Chronic kidney disease (CKD) is a serious public health issue worldwide. Cardiovascular disease (CVD) has been identified as an important factor for the prognosis of patients with CKD and a leading cause of death. CKD-CVD is a very common disease which is often accompanied with poor anticipations. As shown in clinical studies, expected results were not obtained in reducing the CVD mortality of CKD patients by reducing traditional CVD risk factors, indicating that CKD-CVD may have its unique risk factors. Based on recent studies on CKD-CVD, this review presented the classification, atypical clinical manifestations, non-traditional risk factors, and basic pathophysiology-related knowledge of CKD-CVD. Current research conclusions can only explain part of the difficulties in the diagnosis and treatment of CKD-CVD. More high-quality basic experiments and clinical trials are still needed to provide evidences for the prevention and treatment of CKD-CVD.

Key words: Chronic kidney disease, Cardiovascular disease, Risk factors, Uremic toxins, Microcirculation

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Clinical characteristics and pathophysiological basis of cardiovascular disease in patients with chronic kidney disease

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Clinical characteristics and pathophysiological basis of cardiovascular disease in patients with chronic kidney disease