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대한소아신장학회지 = Journal of the Korean society of pediatric nephrology, v.18 no.1, 2014년, pp.7 - 12
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Cardiovascular disease (CVD) has been identified as one of the most important factors influencing the long-term prognosis of patients with chronic kidney disease (CKD). However, in pediatric CKD, the clinical importance of CVD tends to be overlooked due to the lack of typical manifestations of CVD i...
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| 핵심어 | 질문 | 논문에서 추출한 답변 |
|---|---|---|
| 만성 콩팥병의 전통적인 위험 인자 외에 새로운 개념의 위험 인자는 무엇이 있는가? | 최근에는 앞서 언급한 전통적인 위험 인자 외에 새로운 개념의 위험 인자들이 밝혀지고 있는데 예를 들면, 산화 스트레스, 염증, 내피세포 기능부전, 빈혈, 이차성 부갑 상선 기능항진증, 심혈관 석회화 등이 여기에 해당된다. 산화 스트레스는 초기 만성 콩팥병에서 이미 나타나는 현상으로 비타민 C, 셀레니움, 세포 내 비타민 E, 글루타치온 (glutathione)과 같은 항산화계 물질들은 감소하고 고령, 당뇨병, 만성 염증, 요독증과 같은 산화 활성도가 증가되는 상황이 늘어나 결국 산화 스트레스가 증가된다고 보고되었 으며 혈관벽 내 활성산소(reactive oxygen species, ROS) 의 생산 증가가 동맥경화의 특징적인 소견으로 확인된다고 보고되었다[17]. | |
| 만성 콩팥병의 심혈관계 합병증으로 발생되는 임상 소견은 무엇이 있는가? | 심혈관계 합병증으로 발생되는 임상 소견으로는 흉통을 동반한 관상동맥 질환, 급성 심근경색, 말초동맥 질환, 뇌혈관 질환, 심막염, 자율신경계 장애, 심판막 질환, 감염성 심내막염, 급사 등이 해당된다. 그러나 이러한 소견들은 성인에 비해 소아에서는 아주 드문 것으로 알려져 있으며, 대신 임상 증상 전 단계의 병적 변화들이 심장과 혈관에서 나타나는 것으로 보고되었다[25]. | |
| 만성 콩팥병에서 전통적으로 알려진 심혈관계 위험 인자는 무엇이 있는가? | 만성 콩팥병에서 전통적으로 알려진 심혈관계 위험 인자 로는 나이, 성별, 흡연, 당뇨병, 고혈압, 이상지질혈증, 비만, 동맥경화증, 인슐린 저항성 등이 있다. 2008년 USRDS 연례 보고에 따르면 만성 콩팥병의 단계가 높을수록, 나이가 많을수록 심혈관계 합병증의 빈도는 현저히 증가됨을 확인할수 있다[7]. |
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