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Assessment of Vascular Function in Patients With Chronic Kidney Disease
08:50

Assessment of Vascular Function in Patients With Chronic Kidney Disease

Published on: June 16, 2014

16.6K

Accelerated and intensified calcific atherosclerosis and microvascular dysfunction in patients with chronic kidney

Meer Fakhry1, Mandeep S Sidhu2, Sripal Bangalore3

  • 1Department of Medicine, University of South Carolina School of Medicine, Columbia, SC 29208, USA.

Reviews in Cardiovascular Medicine
|July 25, 2020
PubMed

Insights

Coronary artery disease (CAD) in chronic kidney disease (CKD) patients presents uniquely, often silently. Key features include increased coronary artery calcification (CAC) and microcirculatory dysfunction, impacting heart function.

Area of Science:

  • Nephrology
  • Cardiology
  • Vascular Biology

Background:

  • Cardiovascular disease (CVD), especially coronary artery disease (CAD), is a major cause of death in chronic kidney disease (CKD) patients.
  • CAD in CKD exhibits distinct features compared to the general population, including reduced symptom presentation and therapeutic response.
  • Unique pathological characteristics of CAD in CKD include heightened coronary artery calcification (CAC) and impaired coronary microcirculatory function.

Purpose of the Study:

  • To investigate the unique characteristics of coronary artery disease (CAD) in patients with chronic kidney disease (CKD).
  • To explore the roles of coronary artery calcification (CAC) and coronary microcirculatory dysfunction in CAD among CKD patients.
  • To understand the combined impact of CAC and microcirculatory dysfunction on myocardial function and silent myocardial infarction in CKD.

Main Methods:

  • Review of existing literature on CAD in CKD patients.
  • Analysis of pathophysiological pathways contributing to CAC in CKD.
  • Examination of the pathophysiology of coronary microcirculatory dysfunction in CKD.
  • Assessment of the relationship between CAC and microcirculatory dysfunction.

Main Results:

  • Patients with CKD exhibit increased calcific density of atherosclerotic plaques and vessels (CAC).
  • Coronary microcirculatory dysfunction is prevalent in CKD patients with CAD.
  • The interplay between CAC and microcirculatory dysfunction contributes to more severe impacts on myocardial function.
  • These factors may explain the higher incidence of silent myocardial infarction in CKD.

Conclusions:

  • CAD in CKD possesses unique features, notably increased CAC and microcirculatory dysfunction.
  • Further research is essential to elucidate the pathophysiology and therapeutic strategies for CAD in CKD.
  • Understanding these unique aspects is crucial for managing cardiovascular risk in CKD patients.

Keywords:
Chronic kidney diseasecoronary artery calcificationcoronary artery diseasecoronary microvascular dysfunctiondialysisend stage renal disease

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