Keywords: coronary heart disease
Coronary heart disease and kidney disease are two types of common surface they do not have anything to do, in fact, they affect each other, worse.
Epidemiological studies have found that about 8% of the elderly in presence of chronic kidney dysfunction, and in this age, cardiovascular disease, especially coronary heart disease, is also the most common. Renal function tests in a nearly 3000 acute coronary disease statistics, only 16% of normal, mild renal insufficiency, 43%, 32% moderate, severe 9%. Patients with cardiovascular disease associated with chronic kidney disease, the mortality is 10-30 times that of ordinary people.
Precisely because of the interaction between coronary heart disease and kidney disease, in the treatment of coronary heart disease, to protect the kidneys.
Commonly used in the treatment of patients with coronary heart disease is one of interventional treatment, which is put in the coronary artery stent. However, patients with poor kidney function, must take measures to protect the kidneys in the interventional treatment. Commonly used contrast agents, angiotensin converting enzyme inhibitors (ACEI) or angiotensin II receptor blocker (ARB) also may cause kidney damage, can not be ignored.
Commonly used indicator of serum creatinine to determine renal function is good or bad. Patients with coronary heart disease should check this indicator before interventional therapy. If the patient is the original existing renal impairment, or prior to angiography in patients with serum creatinine more than 1.5 mg / dL, or patients with a history of diabetes, are contrast-induced nephropathy is the major risk factor. Measures to protect the kidneys, one of the keys is to minimize the amount of contrast agent and select the appropriate contrast agent, or may cause contrast-induced nephropathy. In addition, age over 60 years, dehydration, a large amount of contrast agent and repetitive inspections, suffering from congestive heart failure, hypertension, patients with hyperuricemia and liver function abnormalities, are also risk factors.
In this regard, the most simple and effective measures to fully rehydration, including intravenous fluids, and drink plenty of water, it is both important and very convenient. Its purpose is to reduce the concentration of the contrast agent in the blood metabolites to reduce the burden on the kidneys, and protection of renal function.
Patients with coronary heart disease in the choice of drugs should also be concerned about his kidney function. Use of angiotensin-converting enzyme inhibitors or angiotensin II receptor antagonists, serum creatinine levels rise because the drug causes the rate of increase is less than 35%, is a normal reaction, do not stop
Drugs; over 35% when compared with abnormal, should be promptly discontinued, and try to improve renal function. Renal insufficiency with angiotensin converting enzyme inhibitors or angiotensin II receptor antagonists is still very easy to hyperkalemia, therefore, the medication when they close monitoring of serum potassium levels.
Another point to emphasize is that we should pay attention hypertension renal. On the one hand the high blood pressure can damage kidney function, on the other hand, renal insufficiency and can aggravate high blood pressure. Hypertension and arteriosclerosis causes the heart structure changes, heart failure, myocardial ischemia.