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Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Cardiovascular Disease in Chronic Kidney Disease: Pathophysiological Insights and Therapeutic Options
Joachim Jankowski1,2, Jürgen Floege3, Danilo Fliser4
1Institute for Molecular Cardiovascular Research (J.J.), University Hospital, Rheinisch-Westfälische Technische Hochschule Aachen (RWTH), Aachen, Germany.
Insights
Patients with chronic kidney disease (CKD) face significantly higher cardiovascular risks, especially in advanced stages. Cardiovascular disease, not kidney failure, is the primary cause of death, highlighting the urgent need for targeted interventions.
Area of Science:
- Nephrology
- Cardiology
- Internal Medicine
Background:
- Chronic kidney disease (CKD) patients have a substantially increased risk of cardiovascular events like heart failure and sudden cardiac death.
- This risk escalates significantly with CKD progression, particularly in advanced stages (CKD stages 4-5).
Purpose of the Study:
- To summarize the current understanding of cardiovascular disease (CVD) in CKD patients.
- To outline the clinical consequences of CVD in this high-risk population.
Main Methods:
- This article is an overview synthesizing existing research and clinical knowledge.
- It focuses on the mechanisms linking CKD to cardiovascular pathology.
Main Results:
- CKD induces a chronic proinflammatory state, accelerating cardiovascular aging.
- Pathological changes include atherosclerosis, vascular and myocardial calcification, vascular senescence, and myocardial fibrosis.
Conclusions:
- Cardiovascular disease is the leading cause of mortality in advanced CKD, surpassing end-stage kidney disease.
- CKD accelerates cardiovascular aging, necessitating a focus on cardiovascular health in CKD management.
Abstract:
Patients with chronic kidney disease (CKD) exhibit an elevated cardiovascular risk manifesting as coronary artery disease, heart failure, arrhythmias, and sudden cardiac death. Although the incidence and prevalence of cardiovascular events is already significantly higher in patients with early CKD stages (CKD stages 1-3) compared with the general population, patients with advanced CKD stages (CKD stages 4-5) exhibit a markedly elevated risk. Cardiovascular rather than end-stage kidney disease (CKD stage 5) is the leading cause of death in this high-risk population. CKD causes a systemic, chronic proinflammatory state contributing to vascular and myocardial remodeling processes resulting in atherosclerotic lesions, vascular calcification, and vascular senescence as well as myocardial fibrosis and calcification of cardiac valves. In this respect, CKD mimics an accelerated aging of the cardiovascular system. This overview article summarizes the current understanding and clinical consequences of cardiovascular disease in CKD.
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