Studies over recent years have redeveloped our understanding of uremic cardiomyopathy, defined as left ventricular hypertrophy, congestive heart failure, and associated cardiac hypertrophy plus other abnormalities that result from chronic kidney disease and are often the cause of death in affected patients. Definitions of uremic cardiomyopathy have conflicted and overlapped over the decades, complicating the body of published evidence, and making comparison difficult. New and continuing research into potential risk factors, including uremic toxins, anemia, hypervolemia, oxidative stress, inflammation, and insulin resistance, indicates the increasing interest in illuminating the pathways that lead to UC and thereby identifying potential targets for intervention. Indeed, our developing understanding of the mechanisms of UC has opened new frontiers in research, promising novel approaches to diagnosis, prognosis, treatment, and management. This educational review highlights advances in the field of uremic cardiomyopathy and how they may become applicable in practice by clinicians. Pathways to optimal treatment with current modalities (with hemodialysis and angiotensin-converting enzyme inhibitors) will be described, along with proposed steps to be taken in research to allow evidence-based integration of developing investigational therapies.

近年来的研究重新发展了我们对尿毒症心肌病的理解，尿毒症心肌病被定义为左心室肥厚、充血性心力衰竭和相关的心脏肥大以及由慢性肾脏疾病引起的其他异常，这些异常通常是受影响患者的死亡原因。几十年来，尿毒症心肌病的定义一直存在冲突和重叠，使已发表的证据复杂化，并且使比较变得困难。对潜在危险因素（包括尿毒症毒素、贫血、血容量过多、氧化应激、炎症和胰岛素抵抗）的新的持续研究表明，人们越来越有兴趣阐明导致 UC 的途径，从而确定潜在的干预目标。事实上，我们对 UC 机制的不断深入的了解开辟了新的研究领域，为诊断、预后、治疗和管理提供了新的方法。这篇教育综述重点介绍了尿毒症心肌病领域的进展以及它们如何应用于临床医生的实践。将描述当前模式（血液透析和血管紧张素转换酶抑制剂）的最佳治疗途径，以及研究中拟采取的步骤，以允许基于证据的整合开发研究疗法。