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Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Reducing cardiovascular mortality in chronic kidney disease: something borrowed, something new
1University of Tennessee Health Science Center, 956 Court Ave., Suite B226, Memphis, Tennessee, USA. dquarles@uthsc.edu
The Journal of Clinical Investigation
|January 10, 2013
Summary
Patients with advanced chronic kidney disease (CKD) on hemodialysis may benefit from additional therapies to reduce vascular calcification and cardiovascular mortality. Further interventions are explored to manage risks associated with diabetes and hypertension in CKD patients.
Area of Science:
- Nephrology
- Cardiology
- Vascular Biology
Background:
- Chronic kidney disease (CKD) stage five, often linked to diabetes mellitus and hypertension, necessitates hemodialysis initiation.
- Cardiovascular complications, including vascular calcification, are highly prevalent in CKD patients.
- Existing medications aim to manage blood pressure, bone metabolism, and anemia.
Observation:
- The patient presented with stage five CKD, hypertension, and type II diabetes mellitus.
- Physical examination revealed elevated blood pressure, a fourth heart sound (S4), and trace pedal edema.
- Diagnostic imaging and ECG indicated moderate aortic calcification and left ventricular hypertrophy.
Findings:
- The patient's current regimen includes antihypertensives, vitamin D, erythropoietin, and a phosphate binder.
- Despite current treatment, significant cardiovascular risk factors and indicators of vascular calcification persist.
- The clinical scenario prompts consideration of additional therapies to mitigate vascular calcification.
Implications:
- Identifying optimal therapeutic strategies is crucial for reducing cardiovascular mortality in hemodialysis patients.
- Targeting vascular calcification may improve long-term outcomes for individuals with CKD.
- Further research is needed to evaluate novel treatments for managing cardiovascular risk in this population.
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