Hypertension and cardiomyopathy associated with chronic kidney disease: epidemiology, pathogenesis and treatment...

Area of Science:

• Nephrology
• Cardiology
• Internal Medicine

Background:

• Chronic kidney disease (CKD) affects 10-15% globally, showing a strong link between kidney function and cardiovascular outcomes.
• Cardiovascular mortality, particularly from heart failure and sudden cardiac death, rises with CKD progression.
• CKD-associated cardiomyopathy, characterized by cardiac structural and functional changes, contributes significantly to this mortality.

Purpose of the Study:

• To review the primary drivers of CKD-associated cardiomyopathy.
• To highlight the critical role of hypertension in the pathogenesis of this condition.
• To evaluate current and emerging therapeutic strategies for CKD-associated cardiomyopathy.

Main Methods:

• This is a review article, synthesizing existing literature on CKD-associated cardiomyopathy.
• Key drivers, pathogenesis, and therapeutic interventions are discussed based on published research.
• The review focuses on structural and functional cardiac changes in CKD patients across different stages of renal impairment.

Main Results:

• CKD-associated cardiomyopathy involves increased left ventricular mass, hypertrophy, diastolic/systolic dysfunction, and cardiac fibrosis.
• These cardiac changes are present even in mild to moderate CKD, not just advanced stages.
• Hypertension is identified as a major contributor to the development and progression of CKD-associated cardiomyopathy.

Conclusions:

• CKD-associated cardiomyopathy is a significant complication of chronic kidney disease, impacting cardiovascular outcomes.
• Understanding the drivers, especially hypertension, is crucial for effective management.
• Further research and development of targeted therapies are needed to address this complex condition.