Coronary Artery Disease in End-Stage Renal Disease: No Longer a Simple Plumbing Problem

[摘要] The lifespan of patients with end-stage renal disease (ESRD) is reduced, and cardiovascular disease (CVD) accounts for a premature death in more than 50% of patients from Western Europe and North America undergoing regular dialysis (1). Actually, the risk for CVD in a 30-yr-old ESRD patient is similar to the calculated risk of a 70 to 80-yr-old subject from the nonrenal population. It is notable that the risk of cardiovascular disease seems to be substantially lower in ESRD patients of Asian origin (2). Though the prevalence of traditional Framingham risk factors is very high in ESRD, the extent and severity of cardiovascular complications is clearly disproportionate to the underlying risk factor profile (3). Therefore, much recent interest has focused on nontraditional risk factors, such as inflammation, malnutrition, and oxidative stress, all common phenomena of ESRD that may promote atherosclerosis (4,5⇓). Although non-atherosclerotic CVD may also contribute to the high cardiovascular mortality rate in ESRD, available evidence suggests that ESRD patients are subjected to a process of accelerated atherogenesis (6).

[学科分类] 泌尿医学

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