الفهرس | Only 14 pages are availabe for public view |
Abstract Cardiovascular disease is the leading cause of morbidity and mortality in CKD patients, with incidence of cardiac related mortality increasing as renal function declines. The complex relationship between CVD and kidney disease is thought to be due to shared traditional risk factors, as well as the influence o novel uremia-specific risk factors.Cardiovascular calcification in patients with CKD is more prevalent,progressive, extensive and severe compared with the non-CKD population, and its prevalence increases steadily through the stages of CKD peaking in CKD 5D patients. CVC is recognized as an active process involving a complex interaction of inducers and inhibitors with dysregulation of the normal equilibrium. A bidirectionan interplay between bone loss and vascular calcification in CKD has been documented. Patients with end stage renal disease are at a greater risk for incident myocardial infarction and death from CHD compared with the general population. Silent coronary ischemia may be responsible for the development of heart failure and sudden cardiac death and strongly associated with incident stroke in patients with CKD. Cardiac troponin T level is associated with cardiovascular events and all-cause mortality in asymptomatic patients with CKD. hs-cTnT assay detects troponin T with higher sensitivity and precision at an earlier point of time than the conventional assays. Elevated hs-cTnT concentrations are highly prevalent and highly prognostic of adverse events in CKD patients.Osteoprotegerin is a soluble protein of the tumor necrosis factor receptor superfamily and is classed as an osteoclastogenesis inhibitory factor.OPG has been shown to be associated with CVD onset and progression. It is positively correlated with markers of vascular damage such as endothelial dysfunction, vascular stiffness and coronary calcification. Alteration of RANKL/OPG axis appears as a promising prognostic biomarker of the initiation and progression of vascular calcifications and of cardiovascular morbidity and mortality in CKD patients. |