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Updated: Jun 28, 2026
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
[Chronic renal disease as cardiovascular risk factor]
M M H Hermans1, J P Kooman, C D A Stehouwer
1Maastricht Universitair Medisch Centrum, afdeling Interne Geneeskunde, Postbus 5800, 6202 AZ Maastricht. mherm@sint.azm.nl
Insights
Chronic kidney disease, indicated by reduced glomerular filtration rate (GFR) or albuminuria, significantly elevates cardiovascular risks. Addressing non-traditional risk factors is crucial for mitigating this increased cardiovascular morbidity and mortality.
Area of Science:
- Nephrology
- Cardiology
- Vascular Biology
Context:
- Chronic kidney disease (CKD) is characterized by decreased glomerular filtration rate (GFR) and/or albuminuria.
- These markers are independently linked to increased cardiovascular morbidity and mortality.
- Albuminuria signifies endothelial dysfunction, while decreased GFR is associated with non-traditional risk factors.
Purpose:
- To elucidate the relationship between CKD markers and cardiovascular risks.
- To identify non-traditional risk factors associated with decreased GFR.
- To understand how these factors contribute to cardiovascular complications.
Summary:
- Reduced GFR and albuminuria are key indicators of CKD, independently increasing cardiovascular risk.
- Non-traditional risk factors like renal anemia, uremic toxins, hyperhomocysteinemia, sympathetic nervous system overactivation, oxidative stress, and dyslipidemia contribute to cardiovascular damage.
- These factors, alongside traditional risks, exacerbate endothelial dysfunction and arterial damage, leading to higher cardiovascular morbidity and mortality.
Impact:
- Highlights the critical link between kidney function and cardiovascular health.
- Emphasizes the importance of managing non-traditional risk factors in CKD patients.
- Supports the need for tailored therapeutic strategies based on CKD stage and associated risks.
Abstract:
A lowering of the glomerular filtration rate (GFR) and/or the presence of albuminuria are signs of chronic renal disease. Both variables are for the most part independently associated with an increased risk of cardiovascular morbidity and mortality. Albuminuria is a marker of endothelial dysfunction. A decrease of the GFR is associated with non-traditional risk factors, e.g. renal anaemia, uraemic toxins due to a decrease of the renal clearance, hyperhomocysteinaemia caused by a diminished homocysteine metabolism, excessive activation of the sympathetic nervous system which is related to sleep apnoea syndrome, oxidative stress and dyslipidaemia associated with the formation of vasotoxic, oxidised LDL cholesterol. These non-traditional risk factors may, alone or in combination with traditional atherogenic risk factors (e.g. age, male gender, smoking, hypercholesterolaemia, hypertension, obesity, positive family history and diabetes mellitus), partially via endothelial dysfunction, result in harmful effects on arterial function, increasing cardiovascular morbidity and mortality. Different stages of chronic kidney disease are associated with specific risk factors, making a specific therapeutic approach essential.
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