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Assessment of Vascular Function in Patients With Chronic Kidney Disease
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Atherosclerosis in CKD: differences from the general population

Tilman B Drüeke1, Ziad A Massy

  • 1Inserm ERI-12, UFR de Médecine et de Pharmacie, Université de Picardie Jules Verne, 80037 Amiens, France. tilman.drueke@inserm.fr

Nature Reviews. Nephrology
|October 28, 2010
PubMed

Insights

Cardiovascular disease is more common in chronic kidney disease (CKD) patients. Atherosclerosis is aggravated by CKD, increasing the fatality of cardiovascular events.

Area of Science:

  • Nephrology
  • Cardiology
  • Pathophysiology

Background:

  • Cardiovascular morbidity and mortality are significantly higher in patients with chronic kidney disease (CKD), particularly end-stage renal disease.
  • The precise role of atherosclerosis in CKD-related cardiovascular disease has been debated, with early theories emphasizing its primary role and accelerated progression due to uremia.
  • More recent research suggests other mechanisms like arteriosclerosis, vascular calcification, and cardiac myocyte issues are also involved.

Purpose of the Study:

  • To clarify the contribution of atherosclerosis to cardiovascular disease in patients with chronic kidney disease (CKD).
  • To elucidate the interplay between CKD, aging, and the development and progression of cardiovascular abnormalities.

Main Methods:

  • Review of clinical and experimental findings.
  • Analysis of imaging and morphological studies related to cardiovascular disease in CKD.
  • Hypothesis formulation based on existing evidence.

Main Results:

  • Initial cardiovascular abnormalities in CKD include arteriosclerosis, left ventricular diastolic dysfunction, and hypertrophy.
  • Atherosclerosis prevalence increases with age and is aggravated, but not solely induced, by CKD.
  • Cardiovascular events linked to atherosclerosis are more frequently fatal in CKD patients.

Conclusions:

  • CKD aggravates atherosclerosis, contributing to increased cardiovascular event fatality.
  • Arteriosclerosis and ventricular dysfunction are key early cardiovascular changes in CKD.
  • Understanding these mechanisms is crucial for managing cardiovascular risk in CKD patients.

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