Kardiorenalt syndrome - important usha fans aspects of internal medicine | Medicine guy
The duplex interaction of disease in kidney and cardiovascular system is called the Cardiorenal syndrome (1). Acute or chronic disease of one organ system will affect performance and could initiate disease in the other. There arises a vicious circle of declining function in both organ systems with increased morbidity and prognosis worsened as a result. This article discusses aspects of the Cardiorenal syndrome that is considered important in internal medicine practice. The goal is that the reader of the importance of assessing bodies collected in the face of patients presenting with primarily a heart or kidney usha fans problem. Kidney disease as a cause of cardiovascular disease incidence usha fans
Over 10% of the population in the Western world have chronic kidney disease (2), defined as estimated glomerular filtration rate (eGFR) below 60 ml / min / 1.73 m 2 and / or signs of structural kidney damage usha fans by imaging or urine examination. It has long been known that patients on dialysis have multiplied the risk of cardiovascular events usha fans compared to the normal population. Studies from the past decade have shown that the kidney in the early stages, usha fans even with normal serum creatinine, usha fans is an important independent risk factor for cardiovascular disease. Some argue that kidney disease is an important cardiovascular risk factor than diabetes mellitus in the general population (3).
Cardiovascular risk is more pronounced the more advanced usha fans kidney disease is, simultaneously changing the spectrum of cardiovascular usha fans disease with declining GFR. Atherosclerotic complications predominate in the general population and is accelerated in the early stages of kidney disease. With decreasing GFR apply vascular calcification and structural changes in the myocardium with hypertrophy and fibrosis. Heart failure and sudden arrhythmic cardiac death is the most common cardiovascular causes usha fans of death in dialysis patients (4). The fact that statinstudier usha fans have struggled to document the cardiovascular outcome and mortality in dialysis patients confirms that atherosclerotic disease is relatively less important usha fans the more severe kidney disease are (5, 6).
Figure 1 Causes of cardiovascular disease in kidney disease. Kidney disease and cardiovascular disease share many of the same risk factors. In addition, by decreasing glomerular filtration rate (GFR) apply specific renal risk factors that accelerate vascular calcification, myokardhypertrofi and fibrosis. Patients established on dialysis receive the additional procedure-related risk factors that contribute to increase the cardiovascular risk in dialysis usha fans patients multiplied relative to normalbefolkningen.Forklaring the abbreviations usha fans used in the figure: CKD: chronic kidney disease, RAAS: renin-angiotensin-aldosterone system, SNS: the sympathetic nervous system, PTH: parathyroid hormone.
Causes of Kidney disease and cardiovascular disease share many common risk factors such as hypertension, diabetes and obesity. Kidney disease is also an important cause of secondary hypertension, leading to neurohormonell activation, usha fans inflammation, oxidative usha fans stress and endothelial dysfunction, all of which may contribute to the increased cardiovascular risk (7) (Figure 1). Disruption of calcium-phosphate-parathyroid hormone-vitamin D homeostasis and accumulation of various uremic usha fans toxins are suspected causal usha fans variables. Currently, on the other hand did not come to a final breakthrough on how to intervene and stop the expressed cardiac and vascular changes that progression by decreasing GFR. Cardiovascular disease as a cause of kidney disease incidence
Hypertensive nephrosclerosis is now the leading cause of end stage renal disease in Norway has increased substantially as a cause of renal disease in the Western world in recent years. Causal to nephrosclerosis is not fully understood, but hypertension usha fans and established vascular disease is strongly related to disease progression. Increased longevity in coronary patients and chronic heart disease as a consequence of improved usha fans treatment has meant that the number of patients with renal disease secondary to cardiovascular disease increases. Among Norwegian outpatient heart failure patients have almost half of the patients decreased kidney function (eGFR <60 ml / min / 1.73 m 2), and renal function is an important prognostic factor for prognosis of patients (8). Patients with cardiovascular usha fans disease usha fans and concomitant kidney disease is common in the cardiology and internal medicine practice.
Figure 2: Renal hemodynamics. GFR is a product of renal blood flow (RBF) and filtration fraction (FF) in glomeruli. Various stimuli regulate vasomotor tone in afferent (aff) and efferent (eff) arteriole usha fans and affect RBF and FF, and as a consequence GFR.Forklaringer the abbreviations used in the figure: NSAIDs: non-steroidal anti-inflammatory drugs, Ca blocker: Calcium blocks α1 Blocks: alpha-1 symatikoadrenerg usha fans blocks, RAAS: renin-angiotensin-aldosterone system, ACEI: ACE inhibitor, ARB: angiotensin II blocker.
Reasons usha fans To understand how cardiovascular karsykd
The duplex interaction of disease in kidney and cardiovascular system is called the Cardiorenal syndrome (1). Acute or chronic disease of one organ system will affect performance and could initiate disease in the other. There arises a vicious circle of declining function in both organ systems with increased morbidity and prognosis worsened as a result. This article discusses aspects of the Cardiorenal syndrome that is considered important in internal medicine practice. The goal is that the reader of the importance of assessing bodies collected in the face of patients presenting with primarily a heart or kidney usha fans problem. Kidney disease as a cause of cardiovascular disease incidence usha fans
Over 10% of the population in the Western world have chronic kidney disease (2), defined as estimated glomerular filtration rate (eGFR) below 60 ml / min / 1.73 m 2 and / or signs of structural kidney damage usha fans by imaging or urine examination. It has long been known that patients on dialysis have multiplied the risk of cardiovascular events usha fans compared to the normal population. Studies from the past decade have shown that the kidney in the early stages, usha fans even with normal serum creatinine, usha fans is an important independent risk factor for cardiovascular disease. Some argue that kidney disease is an important cardiovascular risk factor than diabetes mellitus in the general population (3).
Cardiovascular risk is more pronounced the more advanced usha fans kidney disease is, simultaneously changing the spectrum of cardiovascular usha fans disease with declining GFR. Atherosclerotic complications predominate in the general population and is accelerated in the early stages of kidney disease. With decreasing GFR apply vascular calcification and structural changes in the myocardium with hypertrophy and fibrosis. Heart failure and sudden arrhythmic cardiac death is the most common cardiovascular causes usha fans of death in dialysis patients (4). The fact that statinstudier usha fans have struggled to document the cardiovascular outcome and mortality in dialysis patients confirms that atherosclerotic disease is relatively less important usha fans the more severe kidney disease are (5, 6).
Figure 1 Causes of cardiovascular disease in kidney disease. Kidney disease and cardiovascular disease share many of the same risk factors. In addition, by decreasing glomerular filtration rate (GFR) apply specific renal risk factors that accelerate vascular calcification, myokardhypertrofi and fibrosis. Patients established on dialysis receive the additional procedure-related risk factors that contribute to increase the cardiovascular risk in dialysis usha fans patients multiplied relative to normalbefolkningen.Forklaring the abbreviations usha fans used in the figure: CKD: chronic kidney disease, RAAS: renin-angiotensin-aldosterone system, SNS: the sympathetic nervous system, PTH: parathyroid hormone.
Causes of Kidney disease and cardiovascular disease share many common risk factors such as hypertension, diabetes and obesity. Kidney disease is also an important cause of secondary hypertension, leading to neurohormonell activation, usha fans inflammation, oxidative usha fans stress and endothelial dysfunction, all of which may contribute to the increased cardiovascular risk (7) (Figure 1). Disruption of calcium-phosphate-parathyroid hormone-vitamin D homeostasis and accumulation of various uremic usha fans toxins are suspected causal usha fans variables. Currently, on the other hand did not come to a final breakthrough on how to intervene and stop the expressed cardiac and vascular changes that progression by decreasing GFR. Cardiovascular disease as a cause of kidney disease incidence
Hypertensive nephrosclerosis is now the leading cause of end stage renal disease in Norway has increased substantially as a cause of renal disease in the Western world in recent years. Causal to nephrosclerosis is not fully understood, but hypertension usha fans and established vascular disease is strongly related to disease progression. Increased longevity in coronary patients and chronic heart disease as a consequence of improved usha fans treatment has meant that the number of patients with renal disease secondary to cardiovascular disease increases. Among Norwegian outpatient heart failure patients have almost half of the patients decreased kidney function (eGFR <60 ml / min / 1.73 m 2), and renal function is an important prognostic factor for prognosis of patients (8). Patients with cardiovascular usha fans disease usha fans and concomitant kidney disease is common in the cardiology and internal medicine practice.
Figure 2: Renal hemodynamics. GFR is a product of renal blood flow (RBF) and filtration fraction (FF) in glomeruli. Various stimuli regulate vasomotor tone in afferent (aff) and efferent (eff) arteriole usha fans and affect RBF and FF, and as a consequence GFR.Forklaringer the abbreviations used in the figure: NSAIDs: non-steroidal anti-inflammatory drugs, Ca blocker: Calcium blocks α1 Blocks: alpha-1 symatikoadrenerg usha fans blocks, RAAS: renin-angiotensin-aldosterone system, ACEI: ACE inhibitor, ARB: angiotensin II blocker.
Reasons usha fans To understand how cardiovascular karsykd
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