Redefying the therapeutic strategies against cardiorenal morbidity and mortality:Patient phenotypes  

作　　者：Dimitra Bacharaki Ioannis Petrakis Kostas Stylianou 

机构地区：[1]Nephrology Unit,2^(nd)Department of Internal Medicine,Attikon University Hospital,Chaidari 12462,Greece [2]Department of Nephrology,Heraklion University Hospital,University of Crete,Heraklion 71500,Greece

出　　处：《World Journal of Cardiology》2023年第3期76-83,共8页世界心脏病学杂志（英文版）（电子版）

摘　　要：Chronic kidney disease(CKD)patients face an unacceptably high morbidity and mortality,mainly from cardiovascular diseases.Diabetes mellitus,arterial hypertension and dyslipidemia are highly prevalent in CKD patients.Established therapeutic protocols for the treatment of diabetes mellitus,arterial hypertension,and dyslipidemia are not as effective in CKD patients as in the general population.The role of non-traditional risk factors(RF)has gained interest in the last decades.These entail the deranged clinical spectrum of secondary hyperparathyroidism involving vascular and valvular calcification,under the term“CKDmineral and bone disorder”(CKD-MBD),uremia per se,inflammation and oxidative stress.Each one of these non-traditional RF have been addressed in various study designs,but the results do not exhibit any applied clinical benefit for CKD-patients.The“crusade”against cardiorenal morbidity and mortality in CKD-patients is in some instances,derailed.We propose a therapeutic paradigm advancing from isolated treatment targets,as practiced today,to precision medicine involving patient phenotypes with distinct underlying pathophysiology.In this regard we propose two steps,based on current stratification management of corona virus disease-19 and sepsis.First,select patients who are expected to have a high mortality,i.e.,a prognostic enrichment.Second,select patients who are likely to respond to a specific therapy,i.e.,a predictive enrichment.

关 键 词：Cardiorenal MORBIDITY Mortality PHENOTYPE Precision medicine Personalized medicine 

分 类 号：R54[医药卫生—心血管疾病] R692[医药卫生—内科学]