Hyperhomocysteinemia in Chronic Renal Disease

[摘要] Cardiovascular disease (CVD) is the major cause of death both in the general population and in patients with end-stage renal disease (ESRD). CVD is responsible for approximately 40% of all deaths in both demographic groups (1, 2). Although the proportion of people dying of cardiovascular causes is similar, the risk of CVD is far greater for patients with ESRD. Even after stratification by age, gender, race, and presence of diabetes, CVD mortality in dialysis patients is 10 to 20 times higher than in the general population (3). Renal transplant recipients (RTR) experience at least twofold increases in the annual death rate from CVD, and fourfold increases in pooled nonfatal and fatal CVD incidence relative to population-based estimates (1, 3,4,5) (Table 1). The excess risk of CVD in chronic renal disease is due in part to a higher prevalence of established arteriosclerotic risk factors, including older age, hypertension, diabetes, dyslipidemia, and physical inactivity (4, 6,7,8). However, unique renal-related risk factors, including hemodynamic and metabolic factors characteristic of chronic renal disease, also likely contribute to this excess CVD risk (4, 6,7,8).

[学科分类] 泌尿医学

[关键词] Bone marrow necrosis;Sickle cell disease;Hyperhemolysis syndrome