Related Experiment Videos
Scope of cardiovascular complications in patients with kidney disease
1Departments of Basic Science and Internal Medicine, Cardiology Section, University of Missouri-Kansas City School of Medicine, Truman Medical Center, Kansas City, Missouri, USA. pmc@yahoo.com
Insights
Millions face combined heart and kidney disease, increasing risks for patients and clinicians. Renin-angiotensin system antagonism shows promise for treating cardiorenal conditions and preventing adverse outcomes.
Area of Science:
- Cardiology
- Nephrology
- Cardiorenal Medicine
Background:
- Growing epidemics of heart and kidney failure affect millions of Americans.
- The intersection of chronic cardiovascular and kidney disease presents unique clinical challenges and patient risks.
- Patients with chronic kidney disease (CKD) face elevated risks for atherosclerosis, myocardial infarction, heart failure, arrhythmias, and cardiac death.
Purpose of the Study:
- To address the scope of cardiovascular complications in patients with CKD.
- To discuss the rationale for expanded investigation into the cardiorenal patient population.
- To highlight therapeutic strategies targeting both the heart and kidneys.
Main Methods:
- Review of observational studies quantifying acute renal failure risk post-percutaneous intervention and bypass surgery.
- Analysis of evidence for therapeutic interventions in cardiorenal disease.
- Discussion of renin-angiotensin system antagonism as a potential treatment.
Main Results:
- While risks of acute renal failure are small for the general cardiovascular population, CKD patients have significantly higher risks.
- Conventional cardioprotective therapies can be challenging in CKD patients.
- Evidence suggests renin-angiotensin system antagonism benefits both renal and cardiac systems, reducing disease progression and preventing adverse endpoints.
Conclusions:
- Cardiorenal disease is a significant and growing health concern.
- Renin-angiotensin system antagonism offers a promising therapeutic avenue for cardiorenal patients.
- Further basic and clinical research is warranted to optimize care for this population.
Abstract:
Approximately 6 million Americans have combined chronic cardiovascular and kidney disease with growing epidemics of heart and kidney failure. This clinical intersection presents unique risks to the patient and unique challenges to the clinician. Observational studies have provided quantitative methods for estimating the risk of acute renal failure in patients undergoing percutaneous intervention and bypass surgery procedures. Fortunately, for the general cardiovascular population, these risks are small. On the other hand, patients with chronic kidney disease have increased risks of accelerated atherosclerosis, nonfatal myocardial infarction, congestive heart failure, atrial and ventricular arrhythmias, and cardiac death. Chronic kidney disease presents difficult scenarios in using conventional cardioprotective therapy. However, there are increasing bodies of evidence to suggest the kidney and the heart can be targeted with lines of therapy, specifically with renin-angiotensin system antagonism, which benefit both systems with respect to reduction in the progression of disease, and the prevention of hard kidney and cardiac endpoints. This paper will address the scope of cardiovascular complications in patients with chronic kidney disease and discuss the rationale for expanded basic and clinical investigation of the cardiorenal patient population.