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Updated: Jul 31, 2026
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Coronary artery disease and peripheral vascular disease in chronic kidney disease: an epidemiological perspective
1Regional Kidney Centre, Department of Medicine, Floor D, Letterkenny General Hospital, County Donegal, Ireland, and Internal Medicine, University of Texas Health Science Center, 6431 Fanin Street, Houston, TX 77030, USA. Austin.Stack@mailb.hse.ie
Insights
Patients with chronic kidney disease (CKD) face high risks of cardiovascular events due to coronary artery disease (CAD) and peripheral vascular disease (PVD). Despite proven benefits, cardioprotective medications are underused, necessitating urgent attention and improved management strategies.
Area of Science:
- Nephrology
- Cardiology
- Vascular Medicine
Background:
- Chronic kidney disease (CKD) significantly increases morbidity and mortality in patients with coronary artery disease (CAD) and peripheral vascular disease (PVD).
- Cardiovascular risk in CKD patients is multifactorial, involving traditional and non-traditional risk factors.
- Despite established benefits, cardioprotective medications are underutilized in high-risk CKD populations.
Purpose of the Study:
- To highlight the significant burden of cardiovascular disease in CKD patients.
- To address the puzzling underuse of cardioprotective medications in this population.
- To call for improved management strategies and research for CKD patients with vascular disease.
Main Methods:
- Review of current evidence on cardiovascular risk in CKD.
- Analysis of trends in the management of CKD patients with vascular disease.
- Identification of gaps in care and research needs.
Main Results:
- CKD patients with CAD and PVD experience substantially increased morbidity and mortality.
- Multifactorial cardiovascular risk factors contribute to poor outcomes in CKD.
- Significant progress has been made in organizing approaches to manage these patients, but much work remains.
Conclusions:
- National guidelines for managing high-risk CKD patients are needed.
- Randomized clinical trials evaluating multitargeted interventions for cardiovascular risk reduction are essential.
- The low use of cardioprotective strategies in this high-risk group requires immediate local and national attention.
Abstract:
The enormous burden of CAD and PVD inpatients who have CKD contributes substantially to increased morbidity and mortality. The increased risk of vascular disease observed in CKD patients is likely to be multifactorial, with contributions from traditional and nontraditional cardiovascular factors. Given the overwhelming evidence on the known benefits of cardioprotective medications, their underuse remains puzzling in a population at enormous risk. During the past 5 years, the research community and national interest groups have made significant progress in organizing a concerted approach to improve the management of patients who have CKD and vascular disease. Much work remains to be done. The development of national guidelines in the management of these patients at high risk for future cardiovascular events will be a welcome step. The evaluation of multitargeted interventions for reduction of cardiovascular risk through randomized clinical trials is desperately needed. Finally, the low use of known cardioprotective strategies in this high-risk group is a serious issue and warrants immediate attention at local and national levels.
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