Abstract：
The 2021 guidelines on the prevention of vascular disease (VD) in clinical practice published by the European Society of Cardiology (ESC) and supported by 13 other European scientific societies recognize the key role of screening for chronic kidney disease (CKD) in the prevention of VD. Vascular risk in CKD is categorized based on measurements of estimated glomerular filtration rate (eGFR) and urine albumin to creatinine ratio (ACR). Thus, moderate CKD is associated with a high vascular risk and severe CKD with a very high vascular risk requiring therapeutic action, and there is no need to apply other vascular risk scores when vascular risk is already very high due to CKD. Moreover, the ESC indicates that vascular risk assessment and the subsequent decision algorithm should start with measurement of eGFR and ACR. To optimize the implementation of the ESC 2021 guidelines on the prevention of CVD in Spain, we consider that: 1) Urine testing for albuminuria using ACR should be part of the clinical routine at the same level as blood glucose, cholesterolemia, and GFR estimation when these are used to make decisions on CVD risk. 2) Spanish public and private health services should have the necessary means and resources to optimally implement the ESC 2021 guidelines for the prevention of CVD in Spain, including ACR testing.
摘要：
由欧洲心脏病学会（ESC）发布并得到其他13个欧洲科学学会支持的2021年临床实践中血管疾病（VD）预防指南认识到筛查慢性肾脏疾病（CKD）在预防中的关键作用。VD。根据估算的肾小球滤过率（eGFR）和尿白蛋白与肌酐比（ACR）的测量结果对CKD中的血管风险进行分类。因此，中度CKD与高血管风险相关，重度CKD与非常高的血管风险相关，需要采取治疗措施。当CKD引起的血管风险已经非常高时,无需应用其他血管风险评分.此外，ESC表明,血管风险评估和后续决策算法应从eGFR和ACR的测量开始.为了优化西班牙预防CVD的ESC2021指南的实施，我们认为：1）使用ACR的尿蛋白检测应成为临床常规的一部分，与血糖水平相同，胆固醇血症,和GFR估计，当这些被用来对CVD风险做出决定时。2）西班牙公共和私人卫生服务应具有必要的手段和资源，以最佳地实施ESC2021指南，以预防西班牙的CVD，包括ACR测试。
