影响心脏和肾脏的疾病, such as chronic kidney disease (CKD) and heart failure (HF), 落在心血管疾病的相互关联的光谱上, 肾脏和代谢(CVRM)状况.
CKD is a serious, progressive condition that gradually decreases a person’s kidney function.1 Nearly 850 million people worldwide are affected by CKD and the majority are still undiagnosed — in fact, 十分之九的慢性肾病患者甚至不知道自己得了慢性肾病.2,3 A silent disease in its early stages means CKD is often diagnosed late and left untreated for too long even though it affects more than 10% of the general population worldwide.4,5 目前还没有治愈慢性肾病的方法, 如果病情发展到肾衰竭, 患者需要透析或肾移植.6
CKD is expected to become the world’s fifth leading cause of mortality by 2040, making this condition a growing public health problem that presents a significant burden for patients and health systems.7,8 对于CKD患者, it’s possible to slow the progression through early diagnosis and intervention.9
While CKD can be difficult to diagnose and treat on its own, it can also increase the risk of cardiovascular (CV) diseases. Research continues to show the connection between cardiovascular and renal conditions, 由于心脏和肾脏关系如此密切, 慢性肾病可引起或加重心衰等心血管疾病.10,11
多达五分之一的CKD患者会发展为心衰, 使其成为CKD患者的主要心血管并发症. CKD has also been associated with increased mortality in patients with HF. 在每种类型的射血分数(降低), midrange, or preserved), patients with CKD had worse outcomes in both the short and long term (one and five years respectively).10-12
Patients more likely to develop CKD and HF typically have similar risk factors including diabetes, obesity, and hypertension.6,13,14 一旦患者发展为CKD和HF, they’re also likely to share similar related complications such as hyperkalaemia, 或者血液中钾含量升高. 15 如果这些并发症很严重而不及时治疗, they can be fatal and impact patients’ ability to continue guideline-recommended treatment options, 如RAAS抑制剂, an essential treatment for patients with CKD and/or HF in slowing the progression of CKD and reducing mortality in HF with reduced ejection fraction.16-18
The kidneys and heart are so closely connected that identifying CKD and intervening early can help slow disease progression, preserve renal function and reduce cardiovascular complications, 包括心力衰竭.6
Diagnosing kidney disease early can help prevent other complications or comorbidities such as heart disease.5,9,19
Early interventions for CKD patients can help improve outcomes and quality of life.9 Identifying CKD early helps slow the progression of the disease and reduce its complications.5 因为心衰和CKD是紧密相连的, slowing the progression of one may help slow the progression of the other disease. 9,10,20
In the early stages of CKD and HF patients can implement certain lifestyle changes to help manage their condition and slow disease progression such as exercising, 健康饮食, 戒烟并服用推荐药物.9,21,22 As CKD progresses, 护理团队可能会转向专注于医疗干预, 减缓疾病进展, reducing cardiovascular risk and managing other complications.9 As HF progresses, physicians and patients may focus on reducing hospital readmissions, 改善患者临床状况, quality of life and implementing tools such as guideline-directed medical therapy (GDMT).16,22
In the late stages of CKD, physicians continue to work to slow kidney damage as well as begin to plan ahead with patients for possible treatments for kidney failure like dialysis.7,9 一旦心衰发展到晚期, 重点仍然是医疗干预, 继续利用国内生产总值, and physicians may begin to assess patients for advanced HF therapies like transplants.22
Leveraging medical guidelines and guideline-directed medical therapies (GDMT) can help manage disease progression in CKD and HF patients.16,23
To overcome challenges and improve outcomes for patients with CKD and HF, we must continue to accelerate earlier detection and coordinated care that can help address the complexities and interconnectedness of cardiovascular and renal diseases. Medical guidelines and guideline-directed medical therapies are an important part of the solution as they help provide patient-centric recommendations for clinicians to diagnose and manage patients.
In the renal space, medical guidelines include the Kidney Disease Improving Global Outcomes (KDIGO) guidelines for CKD.23 For HF care teams, the 2021 ESC Guidelines for the Diagnosis and Treatment of Acute and Chronic Heart Failure and more recently the 2022 American College of Cardiology/American Heart Association/Heart Failure Society of America Guidelines for the Management of Heart Failure provide insights into the distinct types of HF, 如何治疗这种疾病, 以及如何及早诊断和干预.22,24
Leveraging these guidelines in tandem offers direction on the management of both CKD and HF —effective implementation of the guidelines is key to saving lives.
Scientists and the healthcare system can improve outcomes by advancing the science, 注重以病人为中心的护理, delivering innovative treatments and championing the use of GDMT. By continuing to build our collective understanding of CKD and HF, 澳门葡京赌博游戏可以改善获得更好护理的途径.
Addressing diseases across the cardiorenal continuum, from earliest detection to late stage.
Our ambition is to fundamentally transform CVRM care and advance patient outcomes by unravelling the underlying causes of disease, 制定诊断策略并提供创新, life-changing solutions for the millions of people affected by this interconnected spectrum of diseases.
Through partnering with organisations such as the International Society of Nephrology to create a 一分钟小测试 that offers insight into whether people may be at risk for CKD to working with physicians and researchers to create better outcomes for people facing CKD and HF — we are working to build a deeper understanding of the cardiorenal connection.
“Scientific advances are revealing the connection between cardiovascular, 肾脏和代谢性疾病, helping to drive earlier diagnosis and opportunities for integrated treatment approaches.”
Mene Pangalos, Executive Vice President, BioPharmaceuticals R&D, AstraZeneca
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References
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Veeva ID: Z4-49281
筹备日期:2022年11月