Akzelerierte Atherosklerose - Chronische Niereninsuffizienz ist ein etablierter kardiovaskulärer Risikofaktor

Akzelerierte Atherosklerose, K. Ivens, B. Grabensee
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Abstract

accelerated atherosclerosis in renal insufficency. Nevertheless, there are several uremia-related risk factors such as proteinuria, anemia, or disorders in calcium-phosphate metabolism (hyperparathyroidism) contributing to an increased cardiovascular mortality. In patients with impaired renal function there is a high incidence of asymptomatic coronary artery disease. Coronary angiography should be performed as frequent as done in patients with normal kidney function. To the treatment strategy of coronary artery disease in patients with impaired kidney function account medical therapy, percutaneous transluminal coronary angioplasty (PTCA/stent) or revascularization with coronary artery bypass surgery (CABG). For both interventional procedures the degree of impairment of kidney function is significantly associated with increased morbidity and mortality. To improve the poor prognosis of patients with any degree of renal insufficiency and coronary artery disease everything should be done to preserve kidney function at first and secondly to treat them as good as patients with normal kidney function and coronary artery disease.
慢性肾功能衰竭是有计划心血管功能衰竭的风险因子
肾功能不全加速动脉粥样硬化。然而,有一些尿毒症相关的危险因素,如蛋白尿、贫血或磷酸钙代谢障碍(甲状旁腺功能亢进)导致心血管死亡率增加。肾功能受损的患者无症状冠状动脉疾病的发生率很高。冠状动脉造影应与肾功能正常的患者一样频繁。对于肾功能受损患者冠状动脉疾病的治疗策略包括药物治疗、经皮冠状动脉腔内成形术(PTCA/stent)或冠状动脉搭桥手术(CABG)重建术。对于这两种介入手术,肾功能损害的程度与发病率和死亡率的增加显著相关。要改善任何程度肾功能不全和冠心病患者的不良预后,首先要保持肾功能,其次要像正常肾功能和冠心病患者一样治疗。
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