Gao Pan, Zou Xingjian, Sun Xin, Zhang Chun
Department of Nephrology, Union Hospital, Tongji Medical College, Huazhong University of Technology, 430022 Wuhan, Hubei, China.
Rev Cardiovasc Med. 2023 Aug 8;24(8):227. doi: 10.31083/j.rcm2408227. eCollection 2023 Aug.
Patients with chronic kidney disease treated by dialysis (CKD-G5D) are characterized by a high prevalence of coronary artery disease (CAD). Such patients differ from non-uremic CAD patients and have been excluded from several clinical CAD trials. CKD-G5D patients may be asymptomatic for their CAD, making their risk stratification and management challenging. This review will focus on the incidence, epidemiology, pathophysiology, screening tools, and management/treatment of CAD in CKD-G5D patients. It will also review recent studies concerning the screening tools and management strategies available for these patients. The need for improved evaluation of cardiovascular risk factors, screening and early intervention for symptomatic CAD in CKD-G5D patients will be highlighted.
接受透析治疗的慢性肾脏病患者(CKD-G5D)的特征是冠状动脉疾病(CAD)的高患病率。这类患者与非尿毒症CAD患者不同,并且被排除在多项临床CAD试验之外。CKD-G5D患者的CAD可能没有症状,这使得他们的风险分层和管理具有挑战性。本综述将聚焦于CKD-G5D患者CAD的发病率、流行病学、病理生理学、筛查工具以及管理/治疗。还将回顾有关这些患者可用的筛查工具和管理策略的近期研究。将强调改善对CKD-G5D患者心血管危险因素评估、对有症状CAD进行筛查和早期干预的必要性。