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Assessment of Vascular Function in Patients With Chronic Kidney Disease
08:50

Assessment of Vascular Function in Patients With Chronic Kidney Disease

Published on: June 16, 2014

The clinical epidemiology of cardiovascular disease in chronic kidney disease

John Shik1, Patrick S Parfrey

  • 1Health Sciences Centre, Memorial University of Newfoundland, St John's, Newfoundland, Canada.

Current Opinion in Nephrology and Hypertension
|October 6, 2005
PubMed

Insights

Cardiovascular disease risk increases with chronic kidney disease (CKD) stages. Management involves addressing traditional risk factors and emerging uraemia-related factors, though some interventions show limited benefit.

Area of Science:

  • Nephrology
  • Cardiology
  • Internal Medicine

Background:

  • Chronic kidney disease (CKD) significantly elevates risk for atherosclerotic and cardiomyopathic conditions.
  • Cardiovascular disease (CVD) mechanisms evolve across CKD stages.
  • Proteinuria and reduced glomerular filtration rate are independent CVD risk factors in CKD.

Purpose of the Study:

  • To synthesize recent findings on the epidemiology and management of cardiovascular disease in patients with chronic kidney disease.
  • To evaluate the impact of various risk factors and interventions in CKD-related CVD.

Main Methods:

  • Review of recent publications, including randomized controlled trials and cohort studies.
  • Analysis of epidemiological data and management strategies for cardiovascular disease in chronic kidney disease.

Main Results:

  • Traditional CVD risk factors are crucial predictors in CKD.
  • Interventions like smoking cessation, blood pressure control, renin-angiotensin system blockade, lipid management, and antiplatelet agents are supported.
  • Uraemia-related factors (hypoalbuminemia, inflammation, anemia, homocysteine) predict CVD, but trials on anemia correction and increased dialysis were negative.

Conclusions:

  • Further research is needed on oxidant stress, divalent ion abnormalities, and lipid abnormalities in CKD-CVD.
  • Distinguishing between uraemia-related CVD risk markers and cardiotoxic factors requires more randomized controlled trials.
Abstract

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