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Updated: Apr 25, 2026
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Chronic renal disease and risk of cardiovascular morbidity-mortality
Antonio Santoro1, Marcora Mandreoli
1Department of Nephrology , Dialysis and Hypertension Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
Insights
Cardiovascular disease (CVD) in chronic kidney disease (CKD) has unique risk factors and requires tailored management. Optimizing traditional risk factors and addressing CKD-specific mechanisms are crucial for preventing CVD in these patients.
Area of Science:
- Nephrology
- Cardiology
- Internal Medicine
Background:
- Cardiovascular disease (CVD) pathogenesis differs in chronic kidney disease (CKD) patients compared to those without CKD.
- Declining renal function alters the efficacy of managing traditional cardiovascular risk factors.
Purpose of the Study:
- To highlight the distinct cardiovascular risk profile in CKD.
- To emphasize the need for optimized management of traditional and CKD-specific risk factors for cardiovascular disease prevention.
Main Methods:
- Review of existing literature on cardiovascular disease in CKD.
- Analysis of the impact of renal function decline on cardiovascular risk factor management.
- Consideration of CKD-specific mechanisms contributing to vascular pathology.
Main Results:
- Traditional risk factors like hypertension and hypercholesterolemia require intensified management in CKD, often needing multiple agents.
- Hypertension control in CKD patients is frequently suboptimal.
- CKD itself acts as a significant cardiovascular risk factor due to unique pathological mechanisms.
Conclusions:
- CKD necessitates a distinct approach to cardiovascular disease prevention.
- Early stages of CKD require comprehensive preventive measures.
- Advanced CKD demands a multifactorial strategy, informed by studies like STENO-2, to mitigate cardiovascular risk.
Abstract:
The pathogenesis of cardiovascular disease in CKD differs subtly from that of non-CKD patients. As renal function declines, the role and impact of treating classical risk factors may change and diminish. However, hypertension, hypercholesterolaemia and smoking cessation management should be optimized and may require multiple agents and approaches, particularly as CKD advances. Hypertension treatment would appear to be one management area in which performance is less than ideal. Moreover there are mechanisms and risk factors that are specific to CKD, capable of triggering a vascular pathology and that justify the surplus of CV morbidity in CKD patients and that require we consider CKD as a CV risk factor per se. In the initial stages of CKD it would be advisable to implement all the preventative measures to stem the onset of CV disease, whereas in the more advanced stages a multifactorial approach is likely to be necessary, as we have learned from the STENO-study within the diabetes.
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