Traditional and emerging cardiovascular and renal risk factors: an epidemiologic perspective

Area of Science:

• Nephrology
• Cardiology
• Public Health

Background:

• Chronic kidney disease (CKD) affects 7-10% of the population, posing significant cardiovascular risks.
• Both traditional and non-traditional risk factors contribute to renal dysfunction and cardiovascular damage in CKD patients.
• Current management of CKD patients is suboptimal, with few achieving guideline-recommended treatment goals.

Purpose of the Study:

• To highlight the public health importance of CKD detection and treatment.
• To review the roles of traditional and non-traditional risk factors in CKD progression and cardiovascular complications.
• To emphasize the need for optimizing CKD patient follow-up using available knowledge.

Main Methods:

• Secondary analyses of controlled clinical trials were used to investigate the role of inflammation.
• Observational data were considered for risk factors like homocysteine, sympathetic activity, and asymmetric dimethylarginine (ADMA).
• Literature review on current clinical management and treatment goals for CKD patients.

Main Results:

• Inflammation is suggested as a modifiable risk factor for cardiac ischemia and renal disease progression.
• Homocysteine predicts renal function loss and cardiovascular events, but direct implication in CKD progression is not yet proven.
• High sympathetic activity and ADMA are associated with reduced GFR and cardiovascular complications, but clinical trials are lacking.

Conclusions:

• CKD management requires a focus on both established and emerging risk factors.
• Further research and clinical trials are needed to target factors like inflammation, homocysteine, sympathetic activity, and ADMA.
• Optimizing patient follow-up with existing knowledge is essential for improving CKD outcomes.