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Updated: Mar 23, 2026
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Cardiovascular disease in chronic kidney disease in 2015
Maneesh Sud1, David M J Naimark
1aDivision of Cardiology bDivision of Nephrology, Sunnybrook Health Sciences Centre cInstitute of Health Policy Management and Evaluation, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Insights
Cardiovascular disease is a major cause of death in patients with chronic kidney disease (CKD). Recent studies offer new insights into cardiac death mechanisms and treatments for heart failure in CKD patients.
Area of Science:
- Nephrology
- Cardiology
- Internal Medicine
Background:
- Chronic kidney disease (CKD) significantly increases the risk of premature cardiovascular disease (CVD).
- CVD is the primary cause of mortality in CKD patients preceding end-stage renal disease.
- Understanding CVD in CKD is crucial for improving patient outcomes.
Purpose of the Study:
- To review recent literature (2014-2015) on cardiovascular outcomes in advanced or progressive CKD.
- To synthesize new data on mechanisms of cardiac death and associated risks.
- To examine emerging controversies and treatment strategies for CVD in CKD.
Main Methods:
- Literature review of studies published between 2014 and 2015.
- Focus on retrospective and registry data.
- Analysis of mechanisms, associations, and treatment controversies in CKD-related CVD.
Main Results:
- New data elucidates mechanisms of cardiac death in CKD patients.
- Novel associations between cardiac events and competing risks (ESRD, pre-ESRD death) identified.
- Controversies in multivessel revascularization and treatment of systolic heart failure in advanced CKD discussed, including defibrillator therapy.
Conclusions:
- Significant advancements in understanding CKD-related CVD have emerged from recent retrospective and registry data.
- Current evidence highlights an urgent need for randomized controlled trials.
- Future research should focus on generating high-quality evidence to guide clinical decision-making in CKD patients with CVD.
Purpose Of Review:
Chronic kidney disease (CKD) is strongly linked to premature cardiovascular disease, which is the leading cause of death before end-stage renal disease in these patients. Herein, we review recent literature from 2014 to 2015 that has advanced our understanding of cardiovascular outcomes in patients with advanced and/or progressive CKD.
Recent Findings:
We focus on new data describing the mechanisms of cardiac death in patients with CKD as well as the novel associations between cardiac events and the competing risks of end-stage renal disease and pre-end-stage renal disease death. We review new controversies in multivessel revascularization of complex coronary artery disease in CKD and, finally, the treatment of systolic heart failure in advanced CKD, including the use of implantable defibrillator therapy.
Summary:
Marked advances in the understanding of cardiovascular disease in CKD have occurred in the past year, namely from retrospective and registry data. Although exciting, these recent studies highlight the urgent need for randomized control trials to guide therapeutic decisions.
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