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Updated: May 5, 2026
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
[Risk factors for cardiovascular system damage in chronic kidney disease]
Insights
Cardiorenal syndrome is prevalent in early chronic kidney disease (CKD). Both traditional and kidney-related risk factors contribute to cardiovascular damage in CKD patients.
Area of Science:
- Nephrology
- Cardiology
- Diabetology
Context:
- Cardiovascular system damage is a significant complication in patients with chronic kidney disease (CKD).
- Understanding the risk factors associated with cardiovascular damage in predialysis diabetic and nondiabetic CKD is crucial for patient management.
Purpose:
- To investigate the prevalence of cardiovascular system damage and associated risk factors in predialysis diabetic and nondiabetic CKD patients.
- To evaluate the influence of both population-wide and renal failure-associated risk factors on the cardiovascular system in CKD.
Summary:
- Atherosclerosis was observed in 60% of nondiabetic CKD patients, with increased cardiovascular events correlating with lesion progression. Left ventricular hypertrophy (LVH) affected 37.3% of nondiabetic CKD patients, influenced by traditional and renal factors.
- In diabetic CKD patients, LVH was diagnosed in 36%, linked to albuminuria, obesity, and metabolic abnormalities. Diabetic nephropathy showed associations with left ventricular remodeling and a history of cardiovascular events.
- The study highlights that cardiorenal syndrome develops in early CKD stages, driven by a combination of traditional cardiovascular risk factors and renal dysfunction-specific factors.
Impact:
- This research underscores the importance of managing both traditional and renal-specific risk factors to mitigate cardiovascular complications in early-stage CKD.
- Findings can inform clinical practice by emphasizing comprehensive cardiovascular risk assessment and tailored interventions for CKD patients.
- Early identification and management of cardiorenal syndrome can potentially improve patient outcomes and reduce the burden of cardiovascular disease in CKD populations.
Aim:
To study the prevalence of and risk factors (RF) associated with cardiovascular system damage in patients with predialysis diabetic and nondiabetic chronic kidney disease (CKD).
Subjects And Methods:
The investigation enrolled 317 patients with CKD of various etiologies. In Group 1 (165 patients with CKD: 54% of men, 46% of women; mean age 46 +/- 15 years), the glomerular filtration rate (GFR) was 37.2 ml/min; the serum creatinine level was 2.9 mg/dl. Group 2 included 152 (41%) patients with type 2 diabetes mellitus (DM) (41% of men and 59% of women; mean age 57.3 +/- 7.1 years). The duration of DM averaged 10.4 +/- 7.1 years. All the patients underwent physical examination; the levels of glycated hemoglobin and adipose tissue hormones, urinary albumin excretion were additionally determined in the diabetic patients. Echocardiography was performed in 172 patients. The influence of populationwide and renal failure-associated RFs on the cardiovascular system was evaluated in CKD.
Results:
Clinical and instrumental examinations of 165 patients with Stages II-IV nondiabetic CKD revealed atherosclerosis of the aorta and the vessels of the heart, brain, kidney, and lower extremities in 60 (37%), 35 (24%), 30 (18%), 23 (14%), and 8 (5%), respectively. As atherosclerotic vascular lesion progressed, the incidence of cardiovascular events (CVE) increased. Left ventricular hypertrophy (LVH) was diagnosed in 37.3% of the patients with nondiabetic CKD. Along with traditional cardiovascular RFs (age, smoking, gender, arterial hypertension), the renal dysfunction-related factors (anemia, diminished glomerular filtration rate, elevated creatitine levels, and abnormal phosphorus and calcium metabolism) are of importance. An association was found between LVH, atherosclerotic vascular lesion, and heart valve calcification. According to EchoCG data, 36% of the patients with type 2 DM were diagnosed as having LVH. The RFs of the latter were albuminuria, obesity, and abnormal carbohydrate and purine metabolisms. There was an association of diabetic nephropathy with left ventricular remodeling processes and a history of CVE.
Conclusion:
The development of cardiorenal syndrome is observed in early-stage CKD and related to both traditional and renal RFs.
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