The careful correction of renal insufficiency abnormalities: early is good

Cardiovascular disease in end-stage renal disease (ESRD) patients starts early in the course of renal insufficiency and may be aggravated by renal replacement therapy. Many potential reversible risk factors are present in renal insufficiency. The identification and correction of these risk factors, in part delaying progression of renal failure, may reduce their role in ESRD cardiovascular disease significantly. Early referral of renal insufficiency patients to a nephrologist may be the real answer to the cardiovascular morbidity and mortality of ESRD patients.