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Cardiovascular disease and chronic renal disease: a new paradigm
1Division of Nephrology, New England Medical Center, Boston, MA 02111, USA. msarnak@lifespan.org
Insights
Cardiovascular disease (CVD) is significantly higher in chronic renal disease (CRD) patients. Early risk factor reduction may prevent both CVD and CRD progression.
Area of Science:
- Nephrology
- Cardiology
- Public Health
Background:
- Cardiovascular disease (CVD) is a leading cause of death in patients with chronic renal disease (CRD).
- CVD mortality is disproportionately high (15x) in dialysis patients compared to the general population.
- CVD development likely starts in earlier stages of CRD, indicating a need for early intervention.
Purpose of the Study:
- To investigate the relationship between CVD and CRD progression.
- To propose a paradigm where CVD and CRD share common underlying disorders.
- To advocate for early implementation of risk factor reduction strategies in CRD patients.
Main Methods:
- Comparative analysis of CVD and CRD progression.
- Literature review on risk factors for both conditions.
- Development of a theoretical paradigm linking CVD and CRD.
Main Results:
- CVD is a major comorbidity and cause of mortality in CRD patients.
- The high prevalence of CVD in early CRD suggests a common etiology with renal disease.
- Parallels exist between the progression of cardiovascular and renal diseases.
Conclusions:
- CVD and CRD may arise from the same underlying pathological processes.
- Applying CVD risk factor reduction strategies to CRD patients could prevent both conditions.
- Early intervention in CRD patients is crucial for mitigating cardiovascular risk and slowing renal disease progression.
Abstract:
Cardiovascular disease (CVD) is a major cause of morbidity and mortality among patients with chronic renal disease (CRD). Despite Improvement in treatment for CVD over the past 30 years, CVD mortality is approximately 15 times higher in dialysis patients than in the general population. The high prevalence of CVD among Incident dialysis patients suggests that CVD begins in earlier stages of CRD, and that implementation of risk factor reduction strategies earlier in the course of CRD may provide an opportunity to prevent CVD in CRD. Based on parallels between CVD and renal disease progression, we have proposed a paradigm that CVD and CRD are outcomes of the same underlying disorders. We propose that risk factor reduction strategies used to prevent CVD in the general population also be applied to patients with CRD, with the hope of preventing progression of renal disease, as well as preventing CVD.