尿血相关心血管疾病的流行病学和机制
Marcello Tonelli1, S Ananth Karumanchi2, Ravi Thadhani2
1From Department of Medicine, University of Calgary, AB, Canada (M.T.); Department of Medicine and Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, and Howard Hughes Medical Institute, Chevy Chase, MD (S.A.K..); and Division of Nephrology, Massachusetts General Hospital, Harvard Medical School, Boston (R.T.). tonelli.admin@ucalgary.ca.
Circulation
|February 3, 2016
概括
患有慢性病 (CKD) 的患者面临显著更高的心血管疾病 (CVD) 风险. 除了传统风险之外,尿素特异性因素在CKD患者中驱动心血管疾病,需要有针对性的研究和改进的管理策略.
科学领域:
- 肝脏病学
- 心脏病学
- 流行病学
背景情况:
- 与同龄人相比,慢性病 (CKD) 和末期病 (ESRD) 的患者患心血管疾病 (CVD) 的风险增加了5至10倍.
- 在这一群体中,心血管疾病表现为冠状动脉疾病,心律失常,中风和充血性心力衰竭.
- 传统的风险因素,如糖尿病和高血压,在心血管疾病的发病过程中增加了尿素特异性因素.
研究的目的:
- 对慢性病患者的传统和尿素相关心血管疾病的流行病学进行审查.
- 探索尿血病特异性心血管疾病发病的推断机制.
- 确定目前对慢性病患者的诊断和治疗方法的缺陷,并建议未来的研究方向.
主要方法:
- 对慢性病中心血管疾病的流行病学研究的文献综述.
- 分析血与心血管疾病的联系机制.
- 在CKD管理的背景下评估当前和新兴的CVD诊断和治疗方法.
主要成果:
- 慢性瘤和ESRD显著增加心血管疾病的风险.
- 在这些患者心血管疾病的发展中,尿素特异性因素起着至关重要的作用.
- 在不断增长的CKD人口中,心血管疾病的医疗管理存在重大差距.
结论:
- 有针对性的流行病学和转化研究对于解决慢性病患者心血管疾病管理方面的缺陷至关重要.
- 在发达国家和发展中国家, 识别和管理与尿素相关的心血管疾病所面临的全球挑战需要注意.
- 为了有效治疗慢性病,需要综合了解传统和尿素特异性因素.
相关概念视频
01:24Chronic Kidney Disease II: Clinical Manifestations
927
Chronic Kidney Disease (CKD) progressively impairs multiple body systems due to the accumulation of uremic toxins, which disrupt cellular functions across various organs.Neurologic symptomsNeurologic symptoms often arise early in CKD, as uremic toxin buildup drives changes in cognitive and motor functions. Patients frequently experience fatigue, headache, confusion, difficulty concentrating, and, in severe cases, seizures. Peripheral neuropathy commonly manifests as burning sensations in the...
927
01:25Chronic Kidney Disease I: Introduction
1.1K
Chronic Kidney Disease (CKD) arises when the kidneys progressively lose their ability to function, ultimately leading to end-stage renal disease. At this advanced stage, the kidneys can no longer filter waste or maintain essential body functions, requiring renal replacement therapy (RRT) through dialysis or a kidney transplant for survival.Early-stage chronic kidney disease and detection challengesIn CKD's early stages, symptoms often remain absent because healthy nephrons compensate for...
1.1K
01:18Chronic Kidney Disease IV: Nursing Management
586
Nursing management is essential for preventing complications, maintaining stability, and improving patients' quality of life in chronic kidney disease (CKD). By using a structured approach, nurses help slow CKD progression and support effective patient care.1. Comprehensive patient assessmentEffective management begins with nurses reviewing the patient’s medical history, and identifying key risk factors like diabetes, hypertension, and nephrotoxic drug use. Nurses assess signs of...
586
01:18Hypertension and Regulation of Blood Pressure
4.8K
Hypertension, the most common cardiovascular disease, is diagnosed through repeated measurements of elevated blood pressure. Its risks, including damage to the kidney, heart, and brain, are directly proportional to blood pressure levels. Starting from 115/75 mm Hg, the risk of cardiovascular disease doubles with each increment of 20/10 mm Hg. The diagnosis relies on blood pressure measurements, not on patient symptoms, as hypertension is often asymptomatic until end-organ damage is imminent or...
4.8K
01:17Pathophysiology of Heart Failure
4.5K
Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
4.5K
01:29Acute Kidney Injury II: Pathophysiology
1.8K
Acute kidney injury (AKI) causes are categorized into three primary categories based on the location of the injury: prerenal, intrarenal (or intrinsic), and postrenal causes. This classification guides clinical management and illustrates how different pathways can impair kidney function.Etiology and Pathophysiology of Acute Kidney Injury1. Prerenal causesEtiology: Prerenal Acute Kidney Injury, the most common type, occurs when reduced blood flow to the kidneys decreases filtration capacity...
1.8K