循環器ジャーナル68巻1号

2020年01月発行

特集 U40世代が描く心不全診療の現状と未来—基礎研究を識り，臨床を素心深考する Ⅲ．臓器関連

—臨床編—慢性腎臓病が心不全に及ぼす影響と病態はどのようなものですか？

著者： 相澤直輝¹

所属機関： ¹大浜第一病院内科

ページ範囲：P.134 - P.138

Point
・慢性腎臓病は心血管疾患発症の独立したリスク因子であり，心不全の予後規定因子である．
・慢性腎臓病における心血管疾患発症には，古典的リスク因子（高血圧・糖尿病など）非古典的リスク因子（炎症・酸化ストレスなど）が関与する．
・リスク因子への介入により心・腎予後の改善が期待される．

参考文献

1) Schrier RW, Abraham WT:Hormones and Hemodynamics in Heart Failure. N Engl J Med 341:577-585, 1999

2) Go AS, Chertow GM, Fan D, et al:Chronic Kidney Disease and the Risks of Death, Cardiovascular Events, and Hospitalization. N Engl J Med 351:1296-1305, 2004

3) Kottgen A, Russell SD, Loehr LR, et al:Reduced kidney function as a risk factor for incident heart failure:the atherosclerosis risk in communities（ARIC）study. J Am Soc Nephrol 18:1307-1315, 2007

4) Hillege HL, Girbes AR, de Kam PJ, et al:Renal Function, Neurohormonal Activation, and Survival in Patients With Chronic Heart Failure. Circulation 102:203-210, 2000

5) Sarnak MJ, Levey AS, Schoolwerth AC, et al:Kidney Disease as a Risk Factor for Development of Cardiovascular Disease. Circulation 108:2154-2169, 2003

6) Perkovic V, Jardine MJ, Neal B, et al:Canagliflozin and Renal Outcomes in Type 2 Diabetes and Nephropathy. N Engl J Med 380:2295-2306, 2019

7) Scrutinio D, Passantino A, Santoro D, et al:The cardiorenal anaemia syndrome in systolic heart failure:prevalence, clinical correlates, and long-term survival. Eur J Heart Fail 13:61-67, 2011

8) Silverberg DS, Wexler D, Sheps D, et al:The effect of correction of mild anemia in severe, resistant congestive heart failure using subcutaneous erythropoietin and intravenous iron:A randomized controlled study. J Am Coll Cardiol 37:1775-1780, 2001

9) Scialla JJ, Xie H, Rahman M, et al:Fibroblast Growth Factor-23 and Cardiovascular Events in CKD. J Am Soc Nephrol 25:349-360, 2014

10) EVOLVE Trial Investigators, Chertow GM, Block GA, et al:Effect of cinacalcet on cardiovascular disease in patients undergoing dialysis. N Engl J Med 367:2482-2494, 2012

11) Moe SM, Chertow GM, Parfrey PS, et al:Cinacalcet, Fibroblast Growth Factor-23, and Cardiovascular Disease in Hemodialysis. Circulation 132:27-39, 2015

12) http://www.uremic-toxins.org

13) Schulman G, Berl T, Beck GJ, et al:Randomized Placebo-Controlled EPPIC Trials of AST-120 in CKD. J Am Soc Nephrol 26:1732-1746, 2015