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Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
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慢性病中的心血管风险评估工具
Carmine Zoccali1,2,3, Vianda S Stel4,5, Francesca Mallamaci3
1Renal Research Institute, New York City, NY, USA.
Clinical journal of the American Society of Nephrology : CJASN
|February 9, 2026
概括
心血管风险计算器经常低估慢性病 (CKD) 的风险. 新的模型和指导方针现在推CKD特定的工具,以更准确地预测这些患者的CV事件.
科学领域:
- 腎病學和心血管醫學.
- 生物统计学和流行病学
- 医疗信息学 医疗信息学
背景情况:
- 标准的心血管 (CV) 风险计算器经常省略功能,低估了慢性病 (CKD) 患者的CV风险.
- 慢性病是心血管疾病的重要独立风险因素,传统模型无法考虑慢性病特异性因素,如炎症和矿物代谢障碍.
- 这种低估在晚期CKD和透析患者中尤其明显,因为竞争的非CV死亡风险使准确的评估变得复杂.
研究的目的:
- 对慢性病 (CKD) 患者的当前心血管风险预测工具进行审查和总结.
- 突出各种心血管风险计算器的优点和局限性,重点关注CKD人群的国际指导方针推的方法.
- 讨论CKD中CV风险评估的不断变化的格局,包括增强和CKD特定的模型以及新兴的AI/ML方法.
主要方法:
- 关于心血管风险计算器现有文献的叙述性综述.
- 专注于结合功能和CKD特定变量的工具.
- 分析主要国际指南推的模型,如KDIGO 2024.
主要成果:
- 一些增强型和CKD特定的模型 (例如SCORE2补充,QRISK,CKD-PC,PREVENT) 改善了CKD人群中的心血管风险预测.
- 2024年KDIGO指南建议在CKD中进行心血管风险评估时使用QRISK,CKD-PC和PREVENT.
- 人工智能和机器学习显示出潜力,但需要外部验证和临床实用性的评估.
结论:
- 特定于CKD的心血管风险计算器对于准确估计病患者的风险至关重要.
- 目前的指导方针越来越多地支持专门的工具,以考虑功能和CKD相关因素.
- 临床判断仍然至关重要,风险计算器作为综合管理策略中的支持工具.
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