慢性腎不全における早発性心血管疾患

C Baigent¹, K Burbury, D Wheeler

¹Clinical Trial Service Unit, Radcliffe Infirmary, Oxford, UK.

Lancet (London, England)

|August 30, 2000

まとめ

慢性腎疾患の患者は,高い心血管疾患 (CVD) リスクに直面しています. このリスクを減らすために,コレステロールを下げる薬や抗高血圧薬などの治療法をテストするために大規模な試験が必要です.

科学分野:

ネフロロジーはネフロロジーを用います.
心臓病学心臓病学
クリニック・トライアル臨床試験

背景:

慢性腎不全 (CRF) の患者は,心血管疾患 (CVD) のリスクが高い.
CRF患者のCVDリスク決定因子に関する信頼できる情報は不足しています.
CRFの患者は,安全性上の懸念のため,臨床試験から除外されることが多い.

研究の目的:

慢性腎不全患者のCVDリスクに関するさらなる研究の必要性を強調する.
腎臓患者のCVDに対する介入を評価するための大規模なランダム化試験を提唱する.
この集団におけるCVDの治療による大きな利益の可能性を強調する.

主な方法:

概要では,大規模なランダム化試験の必要性について論じています.
コレステロールを下げる薬,抗高血圧薬,アスピリン,B族ビタミン,抗酸化ビタミンなどの介入を調査することを提案しています.
CRFにおける心臓病の根本的なメカニズムのさらなる調査を求めています.

主要な成果:

CRF患者におけるCVDの絶対的なリスクはかなり高い.
治療の潜在的絶対的な利益は,増加した危険を上回る可能性があります.
早期に特定され,早期に開始された効果的な治療は,CVDのリスクを減らすことができます.

結論:

慢性腎不全におけるCVDに対処するために,さらなる研究と大規模なランダム化試験の必要性が極めて高い.
脂質低下薬や抗高血圧薬などの介入の調査は極めて重要です.
腎臓疾患患者のCVDの早期かつ安全な治療は,罹病率と死亡率を大幅に減らすことができます.

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