Reverse epidemiology: paradoxical observations in haemodialysis patients.

摘要: Traditional risk factors, such as high blood pressure (BP), obesity and hypercholesterolaemia, play an important role in the development of cardiovascular disease (CVD), not only general population but also patients with chronic renal disease. In recent years, it has become less clear whether these conventional factors are responsible for extremely CVD haemodialysis (CHD) patients. Recent studies have shown that low BP, body mass index (BMI) serum cholesterol often correlated unfavourable clinical outcome. Thus, whereas traditional outcome failure yet on dialysis, CHD appear to be protective associated improved survival. Therefore, phenomena been referred 'paradoxical or reverse epidemiology'. The aetiology this inverse relationship is clear. Interestingly, patients, both C-reactive protein, a marker inflammation, (pre)albumin, nutrition, independent predictors mortality. It speculated what known malnutrition-inflammation-atherosclerosis complex underlies, at least partly, phenomenon epidemiology, since malnutrition causes BMI hypocholesterolaemia. Hence, besides care adequate attempts should made reduce inflammation. respect, various haemodialysis-related purity dialysate several characteristics dialyser, deserve attention.