El continuo cardiorrenal: una propuesta para la prevención de las enfermedades cardiovasculares y renales

Palabras clave: continuo cardiorrenal, enfermedad cardiovascular, enfermedad renal crónica, albuminuria, factores de riesgo, hipertensión arterial, dislipidemia, diabetes.

Resumen

Los factores de riesgo cardiovascular (FRCV) como hipertensión arterial (HTA), diabetes mellitus tipo 2 (DM2) y dislipidemia suelen estar involucrados con la enfermedad renal crónica (ERC) y su contribución a la morbilidad cardiovascular. La disfunción endotelial difusa y la aterosclerosis están conceptualizadas como parte de la fisiopatología de la ERC en diabéticos y no diabéticos, particularmente en ancianos. La edad es el principal determinante de la tasa de filtración glomerular (TFG) y flujo plasmático renal efectivo y se ha reportado que la presencia de HTA favorece la declinación en la depuración de creatinina. La dislipidemia puede afectar directamente el riñón causando trastorno renal lipídico (lipotoxicidad renal) e indirectamente a través de la inflamación sistémica y estrés oxidativo, agresión vascular y cambios humorales y de otras moléculas de señalización con acción renal. Varios estudios transversales han encontrado que el deterioro a la tolerancia glucosada y la presencia de hipertrofia ventricular izquierda están asociados con un aumento en la pendiente de la relación inversa entre edad y TFG en sujetos con HTA no tratada. La mayoría de las drogas empleadas para reducir la carga de los FRCV también son beneficiosas para la función renal. De tal forma que se propone al continuo cardiorrenal como una estrategia preventiva para proteger ambos órganos y reducir el impacto deletéreo de los FRCV sobre la función renal partiendo del punto de vista de un binomio funcional y fisiopatológico.

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Publicado
2020-01-07
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1.
Amair M P, Arocha Rodulfo I. El continuo cardiorrenal: una propuesta para la prevención de las enfermedades cardiovasculares y renales. Rev. Colomb. Nefrol. [Internet]. 7 de enero de 2020 [citado 14 de julio de 2020];7(1). Disponible en: https://revistanefrologia.org/index.php/rcn/article/view/356
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