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Updated: Oct 31, 2025
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
A critical review of chronic kidney disease as a risk factor for coronary artery disease
Mark Coyle1,2, Gerard Flaherty1,2, Catriona Jennings1,2
1School of Medicine, National University of Ireland Galway, Galway, Ireland.
Insights
Chronic kidney disease (CKD) significantly elevates cardiovascular disease (CVD) risk by causing physiological changes that promote coronary artery disease (CAD) progression. Current guidelines overlook CKD, necessitating targeted research for high-risk patients.
Area of Science:
- Nephrology
- Cardiology
- Internal Medicine
Background:
- Chronic kidney disease (CKD) is a known independent risk factor for cardiovascular disease (CVD).
- CKD contributes to elevated cardiovascular risk beyond traditional risk factors.
- The interplay between CKD and coronary artery disease (CAD) requires further elucidation.
Purpose of the Study:
- To review and synthesize the association between CKD and CVD, specifically focusing on coronary artery disease (CAD).
- To investigate CKD's role in both primary and secondary CAD development and progression.
Main Methods:
- Systematic literature review of 94 articles.
- Searches conducted on PubMed and Google Scholar.
Main Results:
- CKD shares common risk factors with CVD but also induces unique physiological changes that increase cardiovascular risk.
- These changes contribute to the development of primary CAD in CKD patients.
- CKD accelerates CAD progression in patients with pre-existing cardiovascular pathology, acting as a risk factor for both primary and secondary CAD.
Conclusions:
- CKD is a significant risk factor for both the initiation and progression of coronary artery disease.
- Current cardiovascular guidelines do not adequately address the heightened risk in CKD patients.
- Further research is warranted to explore tighter risk factor management strategies for CKD individuals to mitigate cardiovascular events.
Abstract:
Chronic kidney disease (CKD) is a significant risk factor for cardiovascular disease (CVD). In addition to common CVD risk factors, the presence of CKD is independently associated with an elevated cardiovascular (CV) risk. We examined the association between CKD and CVD, focusing on coronary artery disease (CAD) in both primary and secondary CVD. A total of 94 articles were included for this review using search strategies on Pubmed and Google scholar. The main findings of our review included that besides sharing common risk factors, CKD induces several physiological microscopic changes leading to increased CV risk. These microscopic changes manifest macroscopically with evidence of the development of primary CAD in CKD patients, in addition to accelerating CAD in those with pre-established CV pathology, with CKD consequently being a risk factor for both primary and secondary CAD progression. Current CV guideline recommendations do not discriminate between those patients with and without CKD. Future research is needed in this area, examining if there may be a role for tighter modifiable risk factor targets in this high-risk population.
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