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经血液透析或腹膜透析治疗的终末期肾脏病(end-stage renal failure,ESRD)患者,常常合并左心室肥厚(left ventricular hypertrophy,LVH)、纤维化和毛细血管减少。导致CKD(chronic kidney disease,CKD)患者发生心肌病和左心室衰竭的主要机制有三个:压力超负荷、容量超负荷、以及CKD相关的非血液动力学因素。LVH的晚期事件包括泵衰竭和心律失常性猝死。因此,需要一种新的治疗模式来预防和逆转ESRD患者的LVH和心肌纤维化。据报道,盐皮质激素受体拮抗剂能够改善慢性心力衰竭和心肌梗塞后心力衰竭患者的生存期,并能减少左心室的质量。然而,有关盐皮质激素受体阻断剂对透析患者的作用报道很少,样本也小,尚不足以得出相关结论。
Patients with end-stage renal failure (ESRD) who undergo hemodialysis or peritoneal dialysis often have left ventricular hypertrophy (LVH), fibrosis, and decreased capillaries. There are three main mechanisms leading to cardiomyopathy and left ventricular failure in patients with chronic kidney disease (CKD): stress overload, volume overload, and CKD-related non-hemodynamic factors. Late events of LVH include pump failure and sudden cardiac arrhythmia. Therefore, a new therapeutic modality is needed to prevent and reverse LVH and myocardial fibrosis in ESRD patients. It has been reported that mineralocorticoid receptor antagonists can improve the survival of patients with chronic heart failure and heart failure after myocardial infarction and reduce the quality of the left ventricle. However, the effect of mineralocorticoid receptor blockers on dialysis patients is poorly reported and the samples are small, which is not enough to draw the conclusion.