Российское диализное общество

Просмотр статьи

<< Вернуться к списку статей журнала

Том 3 №3 2001 год - Нефрология и диализ

Ишемическая болезнь сердца после трансплантации почки


Стюарт Г. Джардин А.Г. Бригс Дж.Д.

Аннотация: Вступление Ранние сердечно-сосудистые заболевания (ССЗ) в настоящее время являются ведущей причиной смерти больных с пересаженной почкой [1, 2] и, как следствие, одной из основных причин потерь почечных трансплантатов [3]. Из этого следует, что более эффективное лечение ССЗ должно улучшить как выживаемость реципиентов почечного трансплантата (ПТ), так и выживаемость трансплантатов. Однако проблема состоит в том, что существующие методы лечения ССЗ у «не почечных» больных не всегда подходят реципиентам ПТ. Как и в общей популяции, после трансплантации почки ССЗ имеют комплексную природу. Последняя обусловлена процессами ускоренного атеросклероза, ведущего к развитию коронарной болезни сердца, и патологией миокарда (особенно гипертрофией левого желудочка - ГЛЖ), которая, в свою очередь, может быть причиной хронической сердечной недостаточности и внезапной смерти от аритмии. Более того, ССЗ (коронарная болезнь сердца или кардиомиопатия), развиваясь уже на ранних стадиях прогрессирующего почечного заболевания, после трансплантации почки могут стать необратимыми. Вопрос о естественном течении ССЗ у реципиентов ПТ остается предметом изучения. ** Публикуется по согласованию с автором и с разрешения Oxford University Press ** Перевод И.Г. Ким

Для цитирования: Стюарт Г., Джардин А.Г., Бригс Дж.Д. Ишемическая болезнь сердца после трансплантации почки. Нефрология и диализ. 2001. 3(3):381-389. doi:


Весь текст



Список литературы:
  1. US Renal Data System. USRDS 1997 Annual Data Report. Bethesda, MD: National Institute of Health, National Institute of Diabetes and Digestive and Kidney Diseases; April 1997.
  2. Aakhus S., Dahl K., Wideroe T. Cardiovascular morbidity and mortality in renal transplant recipients. Results from a 5 year follow-up. Nephrol Dial Transplant 1999; 14: 648-654.
  3. Lindholm A., Albreehtsen D., Frodin L., Turfveson G., Persson N.H., Lundgren G. Ischemic heart disease-major cause of death and graft loss after renal transplantation in Scandinavia. Transplantation 1995; 60: 451-457.
  4. Levey A.S. Controlling the epidemic of cardiovascular disease in chronic renal failure: where do we start? Am J Kid Disease 1998; 32 [suppl 3]: S5-S13.
  5. Kasiske B.L., Guijarro C., Massy Z.A., Wiederkehr M.R., Ma J.Z. Cardiovascular Disease after renal transplantation. J Am Soc Neph 1996; 7: 158-165.
  6. Vesco L., Busson M., Bedrossian J., Biitker M.O., Hiesse C., Lang P. Diabetes mellitus after renal transplantation. Transplantation 1996;61: 1475-1478.
  7. DCCT Research Group: The effect of intensive treatment of diabetes on the development and progression of long term complications in insulin dependant diabetes mellitus. New Engl J Meet 1993; 329: 977.
  8. Opelz G., Wujciak T., Ritz E. for the collaborative transplant study. Association of chronic kidney graft survival with recipient blood pressure. Kidney Int 1998; 53: 217 222.
  9. Stewan G.A., Tan C.C., Rodger R.S.C., Jardine A.G. New targets for blood pressure control post transplantation. J Am Soc Nephrol 1998; 9: (abstract A3567).
  10. Stewart G.A., McGregor E.M., Briggs J.D., Junor B.J.R., Jardine A.G. Pre and post transplant echocardiographic abnormalities are predictors of survival. Kidney Int 1998; (abstract).
  11. Mall G., Huther W., Schneider J., Lundin P., Ritz E. Diffuse intermyocardiocytic fibrosis in uraemic patients. Nephrol Dial Transplant 1990; 5: 39-44.
  12. Rockstroh J.K., Schobel H.P., Vogt-Ladner G., Hauser I., Ncumayer H.H., Schmieder R.E. Blood pressure independent effects of nitrendipine on cardiac structure in patients after renal transplantation. Nephrol Dial Transplant 1997; 12: 1441-1447.
  13. Verdechi P., Porcellati C., Schillachi G. Ambulatory blood pressure. An independent predictor of prognosis in essential hypertension. Hypertension 1994; 24: 793-801.
  14. Tucker B., Fabbian F., Giles M., Thuraisingham R.C., Raine A.E.G., Baker L.R.I. Left ventricular hypertrophy and ambulatory blood pressure monitoring in chronic renal failure. Nephrol Dial Transplant 1997; 12: 724-728.
  15. Lipkin G.W., Tucker B., Giles M., Raine A.E.G. Ambulatory blood pressure and left ventricular mass in cyclosporin and non-cyclosporin treated renal transplant recipients. J Hypertens 1993; 1l: 439-442.
  16. Scandinavian Simvastatin Survival Study Group. Randomised trial of cholesterol lowering in 4444 patients with coronary heart disease: Scandinavian Simvastatin Survival Study (4S). Lancet 1994; 344: 1383-1389.
  17. Pyorala K., Pedersen T.R., Kjekshus J. et al. Effect of pravastatin on cardiovascular events in women after myocardial infarction: the cholesterol and recurrent events (CARE) trial. J Am Coil Cardiol 1998; 32: 140-146.
  18. Downs J.R., Clearfield M., Weis S. et al. for the AFCAPS/ TexCAPS Research group. Primary prevention of acute coronary events with lovastatin in men and women with average cholesterol levels: results of AFCAPS/TexCAPS. J Am Med Assoc 1998; 279: 1615-1622.
  19. Sheperd J., Cobbe S.M., Ford I. et al. for the West of Scotland Coronary Prevention Study Group. Prevention of coronary heart disease with pravastatin in patients with hypercholesterolaemia. N Engl J Med 1995; 333: 1301-1307.
  20. Cholesterol lowering with simvastatin improves prognosis of diabetic patients with coronary heart disease. A subgroup ana-lysis of the Scandinavian Simvastatin Survival Study (4S). Diabetes Care 1997; 20: 614-620.
  21. Jardine A.G., Morris S.T.W., Holdaas H. The use of statins in transplant recipients. Am J Cardiol (in press).
  22. Holdaas H., Fellstrom B., Hoime I. et al. Multicentre, randomised, double blind, placebo-controlled study on the effects of Fluvaststin on cardiac events in renal transplant patients:.
  23. ALERT (Assessment of Lescol in renal transplantation). Study design and baseline data. Kidney Int 1999; (abstract).
  24. Rajman I., Harper L., McPake D., Kendall M.J., Wheeler D.C. Low-density lipoprotein subtraction profiles in chronic renal failure. Nephrol Dial Transplant 1998; 13: 2281-2287.
  25. Attman P.O., Samuelson О., Alaupovic P. Lipoprotein metabolism and renal failure. Am J Kidney Dis 1993; 21: 573-592.
  26. Ritz E., Benck U., Franek E., Keller C., Seyfarth M., Clonus J. Effects of smoking on renal haemodynamics in healthy volunteers and in patients with glomerular disease. J Am Soc Nephrol 1998; 9:1798-1804.
  27. Woo Y.M., Jardine A.J., Dark A.F. et al. Early graft function and patient survival following cadaveric renal transplantation. Kidney Int 1999; 55: 692-699.
  28. Rodgers G.M., Conn T.M. Homocysteine, an atherogenic stimulus, reduces protein-C activation by arterial and venous endothelial cells. Blood 1990; 75: 895-901.
  29. Stampfer M.J., Malinow M.R., Willett W.C. et al. A prospective study of plasma homocysteine and risk of myocardial infarction in US physicians. JAMA 1992; 268: 877-881.
  30. Bostom A.G., Gohh R.Y., Tsai M.Y., Hopkins-Garcia B.J., Nadeau M.R., Bianchi L.A. Excess prevalence of fasting and post-methionine loading hyperhomocysteinemia in stable renal transplant recipients. Arterioscler Thrombos Vase Biol 1997; 17:1894-1900.
  31. Ridker P.M., Cushman M., Stampfer M.J., Tracy R.P., Hennekens C.H. Inflamation, aspirin, and the risk of cardiovascular disease in apparently healthy men. New Engi J Med 1997; 336: 973-979.
  32. Yarnell J.W.G., Baker I.A., Sweetnam P.M. Fibrinogen, viscosity and white blood cell count are major risk factors for ischaemic heart disease: the Caerphilly and Speedwell collaborative heart disease studies. Circulation 1991; 83: 836 844.
  33. Thompson S.G., Kienast J., Pyke S.D.M., Havcrkate F., Van der Loo J.C.W. for the European concerted action on thrombosis and disabilities angina pectoris study group. Hemostatic factors and the risk of myocardial infarction or sudden death in schaemic heart disease following renal transplantation patients with angina pectoris. New Engl J Med 1995; 332: 635-641.
  34. Koch M., Kutkuhn B., Trenkwalder E. et al. Apolipoprotein B, fibrinogen, HDL cholesterol, and apolipoprotein (a) phenotypes predict coronary artery disease in haemodialysis patients. J Am Soc Nephrol 1997; 8; 1889-1898.
  35. Zimmerman J., Herrlinger S., Pruy A., Metzger T., Wanner C. Inflamation enhances cardiovascular risk and mortality in haemodialysis patients. Kidney Int 1999; 55: 648-658.
  36. Bergstrom J., Heimburger O., Lindholm B., Qureshi A.R. Elevated serum C-reactive protein is a strong predictor of increased mortality and low serum albumin in haemodialysis (HD) patients. J Am Soc Nephrol 1995; 6: 573 (abstract).
  37. Grady D., Rubin S.M., Pettiti D.M. Hormone therapy to prevent disease and prolong life in post-menopausal women. Ann Intern Med\992; 117: 1016-1037.
  38. Hulley S., Grady D., Bush T., Furberg C., Herrington D., Riggs B., Vittinghoff E. for the heart and estrogen/progestin replacement study (HERS) research group. Randomised trial of estrogen plus progestin for secondary prevention of coronary heart disease in postmenopausal women. JAMA 1998; 280: 605-613.
  39. Ramos E., Kasiske B., Alexander S. et al. The evaluation of candidates for renal transplantation. Transplantation 1994; 57: 490-497.
  40. Philipson J., Carpenter B., Itzkoff J., Hakala T.R., Rosenthal J.T., Taylor R.J., Puschett J.B. Evaluation of cardiovascular risk for renal transplantation in diabetic patients. Am J Med 1986; 81: 630-634.
  41. Dahan M., Viron B.M., Faraggi M. et al. Diagnostic imaging and prognostic value of combined dipyridamole-exercise thallium imaging in haemodialysis patients. Kidney Int 1998; 54: 255-262.
  42. Rutsky E.A., Rostand S.G. The management of coronary artery disease in patients with end stage renal disease. In: Cardiac Dysfunction in Chronic Uremia. Kluwer Academic Publishers, Boston/Basle: 1992: 233-235.
  43. Reis G., Markovitz P., Leichtman A. et al. Usefulness of Dobutamine stress echocardiography in detecting coronary artery disease in end stage renal disease. Am J Cardiol 1995; 75: 707-710.
  44. Ko W., Kreiger K., Isam O. Cardiopulmonary bypass procedures in dialysis patients. Ann Thorac Surg 1993; 55: 667-684.
  45. Owen C., Cummings R., Sell T., Schwab S., Jones R., Glower D. Coronary artery bypass grafting in patients with dialysis dependant renal failure. Ann Thorac Surg 1994; 58: 1729-1733.
  46. Kaul T., Fields B., Reddy M., ICahn D. Cardiac operations in patients with end stage renal disease. Am Thorac Surg 1994; 57: 691-696.
  47. Rostand S., Kirk K., Rutsky E., Pacifico A. Results of coronary artery bypass grafting in end stage renal disease. Am J Kid Dis 1988;12: 266-270.
  48. Weinrauch L., D’Elia J., Healy R. et al. Asymptomatic coronary artery disease: Angiography in diabetic patients before renal transplantation. Ann Intern Med 1978; 88: 346-348.
  49. Reusser L., Osbom L., White H., Sexson R., Crawford M. Increased morbidity after coronary angioplasty in patients on chronic haemodialysis. Am J Cardiol 1994; 73: 965-967.
  50. Kahn J., Rutherford B., MeConahay D., Johnson W., Giorgi L., Hartzlcr G. Short- and long-term outcome of percutaneous transluminal coronary angioplasty in chronic dialysis patients. Am Heart J 1990; 119: 484-489.
  51. Rinchart A., Herzog C., Collins A., Flack J., Ma J., Opsahl J. A comparison of coronary angioplasty and coronary artery bypass grafting outcomes in chronic dialysis patients. Am J Kidney Dis 1995; 25: 281-290.
  52. Fischman D.L., Leon M.B., Bairn D.S. et al. for the stent restenosis study investigators. A randomised comparison of coronary stent placement and balloon angioplasty in the treatment of coronary artery disease. New Engl J Med 1994; 331: 496-501.
  53. Manske C., Wang Y., Rector T., Wilson R., White C. Coronary revascularisation in insulin-dependant diabetic patients with chronic renal failure. Lancet 1992; 340: 998-1002.
  54. Verheught F.W.A. Acute coronary syndromes: drug treatments. Lancet 1999; 353 [suppi 11]: 20-23.
  55. PRISM-PLUS Study Investigators. Inhibition of platelet glyco-protein IIb/IlIa receptor with tirofibin in unstable angina and non Q-wave myocardial infarction. N Engi J Med 1998; 338: 1488-1497.
  56. Fibrinolytie Therapy Trialists’ (FTT) Collaborative Group. Indications for fibrinolytic therapy in suspected myocardial infarction:collaborative overview of early mortality and major morbidity results from all randomised trials of more than 1000 patients. Lancet 1994; 343: 311-322.
  57. Acute Infarction Ramipril Efficacy (AIRE) Study Investigators. Effect of Ramipril on mortality and morbidity of survivors of acute myocardial infarction with clinical evidence of heart failure. Lancet 1993; 342: 821-828.
  58. Swedberg K., Kjekshus J., Snappin S. Long term survival in severe heart failure in patients treated with enalapril-ten year follow-up of CONSENSUS-1. Eur Heart J 1999; 20: 136-139.
  59. Pitt B., Segal R., Martinez F.A. et al. Randomised trial of Losartan versus Captopril in patients over 65 with heart failure. (Evaluation of Losartan In the Elderly Study, ELITE). Lancet 1997; 349: 747-752.
  60. Isles C.G., Walker L.M., Beevers G.D. et al. Mortality in patients of the Glasgow blood pressure clinic. J Hypertension 1986; 4: 141-156.
  61. Brown J.H., Hunt L.P., Vites N.P., Short C., Gokal R., Malik N.P. Comparative mortality from cardiovascular disease in patients with chronic renal failure. Nephrol Dial Transplant 1994; 9: 1136-1142.
  62. Raine A.E.G., Margreiter R., Brunner F.P. et al. Report on management of renal failure in Europe, XXII, 1991. Nephrol Dial Transplant 1992; 7: 7-35.

Навигация по статьям
Разделы журнала
Наиболее читаемые статьи
Журнал "Нефрология и диализ"