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Multilevel Microdissection and Functional-Structural Profiling of Human Renal Arterial Branches
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Heart and kidneys: sharing more than just blood

Mark Stafford-Smith1

  • 1Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina 27710, USA. staff002@mc.duke.edu

Current Opinion in Anaesthesiology
|January 11, 2007
PubMed

Insights

Chronic kidney disease and metabolic syndrome are linked to cardiovascular disease. Uremic toxins, like asymmetric dimethyl arginine, accumulate with declining kidney function, increasing cardiovascular risk and mortality.

Area of Science:

  • Nephrology
  • Cardiology
  • Metabolic Disorders

Background:

  • Metabolic syndrome and chronic kidney disease (CKD) share complex interrelations.
  • CKD can be both a cause and a mediator of metabolic syndrome's adverse cardiovascular effects.

Purpose of the Study:

  • To elucidate the relationship between renal disease, metabolic syndrome, and cardiovascular disease (CVD).
  • To explore the role of retained toxic solutes in renal impairment as mediators of cardiovascular risk.

Main Methods:

  • Review of current literature on the interplay between CKD, metabolic syndrome, and CVD.
  • Identification and analysis of specific uremic toxins implicated in cardiovascular events.

Main Results:

  • Strong association found between metabolic syndrome and CKD.
  • Identification of uremic toxins, such as asymmetric dimethyl arginine (ADMA), a nitric oxide synthase inhibitor.
  • ADMA accumulation correlates with declining renal function, increased cardiovascular events, and mortality.
  • ADMA's role in promoting arterial stiffness provides a mechanistic link to vascular disease risk.

Conclusions:

  • A clear pathophysiology linking renal impairment to cardiovascular risk is emerging.
  • Uremic toxins are key mediators in the progression of cardiovascular disease in patients with renal impairment.
Abstract

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