慢性肾脏病患者发生心血管疾病的危险因素及干预

doi:10.3969/j.issn.1006-6233.2018.10.013

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Abstract Objective: To explore the risk factors for cardiovascular disease (CVD) in patients with chronic kidney disease (CKD) and to formulate interventions to provide evidence for early clinical prevention and treatment. Methods: We retrospectively analyzed the medical records of 498 patients who were treated for chronic kidney disease in our hospital from March 2016 to March 2017. According to whether the patients had cardiovascular events, they were divided into CVD group (192 cases) and non-CVD group (306 cases). To observe the past history of the two groups of patients, homocysteine (Hcy), hemoglobin (Hb), serum creatinine (Ser), estimated glomerular filtration rate (eGFR), electrolyte (blood potassium, serum calcium, phosphorus) Levels, glucose and lipid metabolism, heart function, and blood lipids were assessed using univariate and Logistic regression analysis to analyze risk factors for CVD in CKD patients. Results: There was no significant difference in the history of coronary heart disease, blood calcium, blood calcium, blood phosphorus, serum β2 microglobulin (β₂-M), parathyroid hormone (PTH), left ventricular ejection fraction (LVEF) and left ventricular end diastolic diameter (LVEDD) in two groups (P>0.05); The two groups were significantly different in Hb, Hcy, Scr, eGFR, fasting blood glucose, total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C), and the difference was statistically significant (P<0.05). Logistic regression analysis showed that hypertension, diabetes, blood lipids, Hcy, and eGFR were independent risk factors for cardiovascular events in CKD patients. Active intervention in hypertension, diabetes, blood lipids, Hcy levels, eGFR levels can significantly reduce the incidence of CVD in patients with CKD. Conclusion: Actively improve the risk factors associated with concurrent CVD, such as blood pressure, lipid-lowering, hypoglycemic, improve Hcy levels and eGFR levels, can significantly reduce the risk of CVD events in CKD patients, improve the prognosis of CKD patients. Conclusion: Patients with chronic kidney disease accompanied by hypertension, diabetes mellitus and serum hyperlipidemia, Hcy and eGFR should be closely monitored to guard against the occurrence of cardiovascular diseases.

Key words： Chronic kidney disease Cardiovascular disease Risk factors Intervene

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	ZHANG Li
	JIN Chun

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ZHANG Li,JIN Chun. Risk Factors and Intervention of Cardiovascular Disease in Patients with Chronic Kidney Disease[J]. HeBei Med, 2018, 24(10): 1634-1638.

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2018.10.013 OR http://www.hbyxzzs.cn/EN/Y2018/V24/I10/1634

[1] Pimentel A, Urena-Torres P, Zillikens MC, et al. Fractures in patients with CKD-diagnosis, treatment, and prevention: a review by members of the european calcified tissue society and the european renal association of nephrology dialysis and transplantation[J]. Kidney Int, 2017, 92(6):1343~1355.
[2] Hickson LJ, Negrotto SM, Onuigbo M, et al. Echocardiography criteria for structural heart disease in patients with end-stage renal disease initiating hemodialysis[J].Am Coll Cardiol, 2016, 67(10):1173~1182.
[3] 严陈燕, 邬步云,徐琳,等.慢性肾脏病患者不同eGFR公式的结果差异研究[J].中华肾脏病杂志,2017,33(4):249~257.
[4] Hafeez AR, Idrees MK1, Akhtar SF. Accuracy of GFR estimation formula in determination of glomerular filtration rate in kidney donors: Comparison with 24 h urine creatinine clearance[J]. Saudi Kidney Dis Transpl, 2016, 27(2):320~325.
[5] Burget F, Foltan O, Kraus J, et al. Influence of the weather on the incidence of fractures in the elderly[J]. Acta Chir Orthop Traumatol Cech, 2016, 83(4):269~273.
[6] Salinero-Fort MA, San Andrés-Rebollo FJ, de Burgos-Lunar C, et al. Cardiovascular and all-cause mortality in patients with type 2 diabetes mellitus in the MADIABETES Cohort Study: association with chronic kidney disease[J].Diabetes Complications, 2016, 30(2):227~236.
[7] Kim-Mitsuyama S, Soejima H, Yasuda O, et al. Cardiovascular and renal protective role of angiotensin blockade in hypertension with advanced CKD: a subgroup analysis of ATTEMPT-CVD randomized trial[J]. Sci Rep, 2018, 8(1):3150.
[8] Iimori S, Naito S, Noda Y, et al. Prognosis of chronic kidney disease with normal-range proteinuria: The CKD-ROUTE study[J]. PloS One, 2018, 13(1): e0190493.
[9] Adachi H, Nakayama K, Hayashi N, et al. Adiponectin fractions influence the development of posttransplant diabetes mellitus and cardiovascular disease in Japanese renal transplant recipients[J]. PloS One, 2016, 11(10): e0163899.
[10] Chaikriangkrai K, Jyothula S, Jhun HY, et al. Impact of pre-operative coronary artery disease on cardiovascular events following lung transplantation[J].Heart Lung Transplant, 2016, 35(1):115~121.
[11] Svensson AL, Christensen R, Persson F, et al. Multifactorial intervention to prevent cardiovascular disease in patients with early rheumatoid arthritis: protocol for a multicentre randomised controlled trial[J]. BMJ Open, 2016, 6(4): e009134.
[12] Fu Y, Sun Y, Zhou M, et al. Therapeutic potential of progranulin in hyperhomocysteinemia- induced cardiorenal dysfunction[J]. Hypertension, 2016, 69(2):259~266.