透析中の心臓と血管系

Christoph Wanner¹, Kerstin Amann², Tetsuo Shoji³

¹Comprehensive Heart Failure Center and Renal Division, University Hospital of Würzburg, Würzburg, Germany.

Lancet (London, England)

|May 27, 2016

まとめ

腎臓病は心臓と血管の老化を加速し,重要な心臓機能障害と透析患者の死亡率を増加させます. 腎臓置換療法の有効な心臓保護策については,新しい大規模な試験が必要である.

科学分野:

腎臓科
心臓病科
血管生物学

背景:

腎機能低下と腎置換療法 (RRT) は心臓血管の大きな変化を早める.
RRTを受けた患者は,左心房の縮,機能障害,線維症,血管疾患 (動脈硬化症,動脈硬化症) を含む心血管の老化が加速している.
心臓発作の主な原因は液体の過剰摂取と高血圧で心臓発作の主な原因は心臓発作の主な原因は心臓発作の主な原因です

研究の目的:

腎臓機能の低下でRRTが必要な患者の心血管の構造的および機能的変化を要約する.
この集団の加速老化現象と心血管死亡率の増加を強調する.
現在の薬学的介入の限界と大規模な心臓保護試験の必要性を強調する.

主な方法:

腎疾患とRRTに関連した心血管変化のレビュー
流体過負荷,高血圧,イントラダイアリスティックストレスを含むリスク要因の分析.
薬理学的介入に関する既存の試験の限界の評価

主要な成果:

左心室の大幅な縮,膨張,シストリック/ダイアストリック機能障害,および心筋線維症が一般的です.
血管樹は動脈硬化や動脈硬化に罹患し,介質は化している.
心臓および血管疾患による死亡率は,特に若い患者では,一般患者と比較してかなり高い.

結論:

RRT患者における心血管疾患は,加速された老化と潜在的心不全を模倣する.
現在の薬理学的介入 (スタチンなど) は限界を示しています.
RRTにおける効果的な心臓保護には,心臓活性介入に焦点を当てた大規模な実用的な試験が不可欠です.

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