Cardiovascular disease in patients with chronic kidney disease

Abstract

Patients with chronic kidney disease have a high burden of cardiovascular morbidity and mortality. The vast majority of patients with chronic kidney disease do not progress to end stage renal failure, but do have a significantly higher incidence of all cardiovascular co-morbidities. Traditional cardiovascular risk factors only partially account for this increased incidence of cardiovascular disease. In patients with kidney disease the basic biology underlying cardiovascular disease may be similar to that in patients without kidney disease, but it would seem many more risk factors are involved as a consequence of renal dysfunction. Although emphasis is placed on delaying the progression of chronic kidney disease, it must be appreciated that for many patients it is vital to address their cardiovascular risk factors at an early stage to prevent premature cardiovascular death. This review examines available epidemiological evidence, discusses common cardiovascular risk factors in patients with chronic kidney disease, and suggests possible treatment strategies. Potential areas for important research are also described.

Circulating dendritic cell precursors in chronic kidney disease: a cross-sectional study

“…Chronic Kidney Disease (CKD) is associated with a high prevalence of distinct cardiovascular (CV) risk factors [ 12 , 13 ]. Moreover, CKD itself is an important CV risk factor.…”

“…Thus, elevated levels of inflammatory mediators and an increase in oxidative stress can be observed in CKD [ 14 ]. Vascular changes are initiated and perpetuated by the interaction of immune cells with cells of the vessel wall [ 12 , 13 , 15 ]. Atherosclerosis, vascular calcification, or development of left ventricular hypertrophy and congestive heart failure are the main causes of CV mortality in CKD [ 16 ].…”

“…Atherosclerosis, vascular calcification, or development of left ventricular hypertrophy and congestive heart failure are the main causes of CV mortality in CKD [ 16 ]. Most of the patients with CKD die from CV events (CVE), often before reaching end-stage renal disease (ESRD) [ 13 , 16 , 17 ]. Patients with CKD stage 3 have a 2 to 4 times higher risk of CV mortality as compared to patients without CKD depending on the stage of CKD, the underlying kidney disease and the extent of albuminuria [ 18 ].…”

“…In patients with ESRD, cardiovascular mortality is responsible for up to 45% of total mortality [ 14 , 19 ]. On that account, the CV health status of patients with earlier stages of CKD is of particular importance for the prevention of CVE [ 13 ].…”

Micronuclei and other nuclear anomalies in buccal epithelial cells of children with chronic kidney disease

“…Recent reviews indicate that the adverse healthrelated outcomes of CKD and/or end-stage renal disease (ESRD) are characterised by high incidences of cardiovascular morbidity and mortality (2), liver damage due to viral infections (3), chronic inflammation (4), oxidative stress (5), and an increased incidence of cancer (6,7).…”