Der Nephrologe

, Volume 1, Issue 4, pp 225–232

Zusammenhang zwischen kardiovaskulären Erkrankungen und Progression von Nierenerkrankungen

Leitthema
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Zusammenfassung

Patienten mit chronischer Niereninsuffizienz weisen eine vielfach erhöhte kardiovaskuläre Morbidität und Mortalität auf. Der akzelerierten Atherosklerose liegt ein chronisch inflammatorischer Prozess zugrunde, der durch zahlreiche mit der Niereninsuffizienz assoziierte Faktoren (z. B. oxidativer Stress, gestörter Ca2+/PO4-Stoffwechsel, aktiviertes RAA-System) verstärkt wird. Entscheidende Progressionsfaktoren sind Hypertonie und Proteinurie, die früh und konsequent behandelt werden müssen, um auch kardiovaskuläre Komplikationen zu reduzieren. Die Diagnostik kardialer Erkrankungen bei Niereninsuffizienz kann bei fehlenden klassischen Symptomen (z. B. Angina pectoris) erschwert sein, deshalb sollte die Indikation zur kardialen Diagnostik großzügig gestellt werden. Neben der medikamentösen Therapie kardialer Erkrankungen kommen bei Patienten mit Niereninsuffizienz auch interventionelle oder operative Therapien zum Einsatz, sowohl Kurzzeit- als auch Langzeiterfolge sind vom Ausmaß der Nierenfunktionseinschränkung abhängig.

Schlüsselwörter

Chronische Niereninsuffizienz Kardiovaskuläre Erkrankungen Interleukine Fetuin-A Matrix-GLA-Protein (MPG) Endotheliale Dysfunktion 

Association between cardiovascular diseases and progression of chronic kidney disease

Abstract

Patients with chronic kidney disease (CKD) have an increased risk of cardiovascular morbidity and mortality. Accelerated atherosclerosis in renal insufficiency is due to chronic inflammation which is strengthened by several uremia-related risk factors, such as oxidative stress, disorders in calcium and phosphate metabolism and an activated renin-angiotensin-aldosterone system. Most important factors for the progression of renal disease are hypertension and proteinuria which must be treated early and consistently in order to reduce cardiovascular complications. The diagnosis of cardiac disease by renal insufficiency can be difficult in the absence of classical symptoms such as angina pectoris, therefore the diagnosis of cardiovascular disease should be made with caution. In addition to medical therapy of cardiovascular disease in patients with renal insufficiency there are also interventional or operative therapies available. For both procedures short-term and long-term survival are largely dependent on the degree of kidney impairment.

Keywords

Chronic renal insufficiency Cardiovascular diseases Interleukin Fetuin A Matrix GLA protein Endothelial dysfunction 

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Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  1. 1.Klinik für NephrologieHeinrich-Heine-Universität DüsseldorfDüsseldorf

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