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Enfermedad cardiovascular en la enfermedad renal crónica: perspectivas fisiopatológicas y opciones terapéuticas
Joachim Jankowski1,2, Jürgen Floege3, Danilo Fliser4
1Institute for Molecular Cardiovascular Research (J.J.), University Hospital, Rheinisch-Westfälische Technische Hochschule Aachen (RWTH), Aachen, Germany.
Circulation
|March 15, 2021
Resumen
Los pacientes con enfermedad renal crónica (ERC) se enfrentan a riesgos cardiovasculares significativamente más altos, especialmente en etapas avanzadas. Las enfermedades cardiovasculares, no la insuficiencia renal, son la principal causa de muerte, lo que pone de relieve la necesidad urgente de intervenciones específicas.
Área de la Ciencia:
- Nefrología
- Cardiología
- Médico interno
Sus antecedentes:
- Los pacientes con enfermedad renal crónica (ERC) tienen un riesgo sustancialmente mayor de eventos cardiovasculares como insuficiencia cardíaca y muerte cardíaca súbita.
- Este riesgo aumenta significativamente con la progresión de la ERC, especialmente en las etapas avanzadas (etapas 4-5 de la ERC).
Objetivo del estudio:
- Resumir la comprensión actual de las enfermedades cardiovasculares (ECV) en pacientes con ERC.
- Describir las consecuencias clínicas de las ECV en esta población de alto riesgo.
Principales métodos:
- Este artículo es una visión general que sintetiza la investigación existente y el conocimiento clínico.
- Se centra en los mecanismos que vinculan la ERC a la patología cardiovascular.
Principales resultados:
- La ERC induce un estado proinflamatorio crónico, acelerando el envejecimiento cardiovascular.
- Los cambios patológicos incluyen aterosclerosis, calcificación vascular y miocárdica, senescencia vascular y fibrosis miocárdica.
Conclusiones:
- La enfermedad cardiovascular es la principal causa de mortalidad en la ERC avanzada, superando a la enfermedad renal terminal.
- La ERC acelera el envejecimiento cardiovascular, lo que requiere un enfoque en la salud cardiovascular en el manejo de la ERC.
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