血液透析相關的心血管疾病－非傳統危險因素探討

Hemodialysis-Related Cardiovascular Disease-Focusing on Nontraditional Risk Factors

林慧貞(Huei-Jhen Lin) ； 徐邦治(Bang-Gee Hsu)

《腎臟與透析》 32卷2期 (2020/06) Pp. 79-82

https://doi.org/10.6340/KD.202006_32(2).0006

摘要

末期腎臟病（end stage renal disease, ESRD）患者最常見的死亡原因為心臟血管疾病。腎功能不全的心血管變化，包括體液容積過量、尿毒性心肌病變、次發性副甲狀腺功能亢進、貧血、脂質代謝改變及腸道微生物群產生的尿毒素堆積，例如三甲胺N- 氧化酶（trimethylamine N-oxidase, TMAO）會導致ESRD患者發生心血管疾病的高風險。此外，血液透析本身對尿毒症患者已經受損的心血管系統造成心肌傷害。這篇綜述將概述ESRD非傳統危險因素的心血管變化、血液透析造成的心肌損傷，以及可能的治療策略。

關鍵字

心血管疾病 ； 末期腎臟病 ； 血液透析 ； 非傳統危險因素

並列摘要

Cardiovascular mortality is the most common cause of death in end stage renal disease (ESRD) patients. Kidney dysfunction caused cardiovascular changes such as fluid overload, uremic myopathy, secondary hyperparathyroidism, anemia, dyslipidemia, and uremic toxins accumulation like trimethylamine N-oxidase may lead to cardiovascular disease in ESRD patients. Furthermore, myocardial injury and cardiovascular damage may also result in hemodialysis per se. We reviewed the nontraditional risk factors of cardiovascular changes in ESRD, hemodialysis-induced myocardial injury, and possible management strategies.

並列關鍵字

cardiovascular disease ； end stage renal disease ； hemodialysis ； nontraditional risk factors