[Renal disease as a cardiovascular risk factor].
نویسندگان
چکیده
Mailing Address: Roberto Jorge da Silva Franco • Rua Carlos Guadanini, 1805 18610-120 – Botucatu, SP Brazil E-mail: [email protected] An estimated 10% of the American population has some degree of renal disease, although asymptomatic. In Brazil, no data are available on the prevalence of chronic renal disease. A number of studies show a direct and close relationship between the degree of renal dysfunction and cardiovascular risk. This increased cardiovascular risk, despite being maximal in end-stage renal failure, begins to be noticed with slight declines in renal function. In addition, the presence of renal injury, even with normal renal function, evidenced by proteinuria or microalbuminuria, is also a potent cardiovascular risk factor. At present, the primary causes of renal disease are diabetic nephropathy and hypertensive nephrosclerosis, accelerated by cigarette smoking and dyslipidemia. Hence, increased cardiovascular risk in patients with chronic renal disease may be secondary to the accumulation of these classical risk factors; however, frequency of cardiovascular events in these patients is higher than that predicted by equations that take into account such classical factors. Therefore, there may be mechanisms intrinsic to renal lesion capable of accelerating systemic atherosclerosis. Accordingly, uremic toxicity itself, increased oxidative stress, change in the coagulation cascade, changes in lipid levels and hypervolemia are involved in the genesis of early atherosclerosis in patients with chronic renal disease. It is incumbent on clinicians, nephrologists, hypertension specialists, and cardiologists to identify these patients through urinalysis, serum creatinine measurement, and microalbuminuria screening in order to reduce, through intensive treatment, to revert at least in part, the high cardiovascular risk of that diseased portion of the population.
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ورودعنوان ژورنال:
- Arquivos brasileiros de cardiologia
دوره 85 6 شماره
صفحات -
تاریخ انتشار 2005