Related Experiment Video
Updated: Jul 2, 2025
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Cardiovascular Risk in Patients With Glomerular Disease: A Narrative Review of the Epidemiology, Mechanisms,
Robert L Myette1,2, Caroline Lamarche3, Ayodele Odutayo4
1Division of Nephrology, Children's Hospital of Eastern Ontario, Ottawa, Canada.
Insights
Cardiovascular disease in glomerular disease patients has unique risks not fully addressed by current chronic kidney disease guidelines. More research is needed to understand specific mechanisms and improve prevention strategies.
Area of Science:
- Nephrology
- Cardiology
- Internal Medicine
Background:
- Cardiovascular disease (CV) is a leading cause of death in patients with glomerular diseases.
- Existing treatment strategies for CV risk in these patients are often extrapolated from broader chronic kidney disease (CKD) populations.
- There's a critical need to understand the distinct pathophysiology and risk factors for CV disease in glomerular disease.
Purpose of the Study:
- To review current knowledge on the epidemiology, molecular mechanisms, and management of CV disease in glomerular disease.
- To highlight the patient perspective on CV disease risk and management.
- To identify gaps and propose future research directions.
Main Methods:
- A narrative review of existing literature accessed via PubMed, PubMed Central, Medline, and Google Scholar.
- Inclusion of patient insights gathered through discussions with a patient partner.
- Synthesis of information on epidemiology, molecular mechanisms, management, and patient experience.
Main Results:
- Glomerular disease patients face significant CV risk due to multifactorial mechanisms, comorbidities, and medications.
- Current risk stratification and treatment approaches based on general CKD data may be insufficient for glomerular disease.
- Unique pathophysiological drivers of CV risk in glomerular disease require further investigation.
Conclusions:
- Glomerular disease necessitates tailored approaches to CV disease prevention and management.
- Further focused research is essential to delineate specific CV risk factors and therapeutic targets.
- Integrating the patient perspective is crucial for developing effective strategies.
Purpose Of Review:
Cardiovascular (CV) disease is a major cause of morbidity and mortality for patients with glomerular disease. Despite the fact that mechanisms underpinning CV disease risk in this population are likely distinct from other forms of kidney disease, treatment and preventive strategies tend to be extrapolated from studies of patients with undifferentiated chronic kidney disease (CKD). There is an unmet need to delineate the pathophysiology of CV disease in patients with glomerular disease, establish unique risk factors, and identify novel therapeutic targets for disease prevention. The aims of this narrative review are to summarize the existing knowledge regarding the epidemiology, molecular mechanisms, and management of CV disease in patients with common glomerular disease, highlight the patient perspective, and propose specific areas for future study.
Sources Of Information:
The literature for this narrative review was accessed using common research search engines, including PubMed, PubMed Central, Medline, and Google Scholar. Information for the patient perspective section was collected through iterative discussions with a patient partner.
Methods:
We reviewed the epidemiology, molecular mechanisms of disease, management approaches, and the patient perspective in relation to CV disease in patients with glomerulopathies. Throughout, we have highlighted the current knowledge and have discussed future research approaches, both clinical and translational, while integrating the patient perspective.
Key Findings:
Patients with glomerular disease have significant CV disease risk driven by multifactorial, molecular mechanisms originating from their glomerular disease but complicated by existing comorbidities, kidney disease, and medication side effects. The current approach to risk stratification and treatment relies heavily on existing data from CKD patients, but this may not always be appropriate given the unique pathophysiology and mechanisms associated with CV disease risk in patients with glomerular disease. We highlight the need for ongoing glomerular disease-focused studies aimed to better delineate CV disease risk, while integrating the patient perspective.
Limitations:
This is a narrative review and does not represent a comprehensive and systematic review of the literature.
Related Concept Videos
01:20Renal Corpuscle
Glomerulus: Structure and Function
The glomerulus is a tiny, intricate network of capillaries located at the beginning of the nephron. It's enveloped by the Bowman's capsule and receives its blood supply from an afferent arteriole, which divides into numerous...
01:26Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
01:22Heart Failure Drugs: Diuretics
01:18Hypertension and Regulation of Blood Pressure
01:23Assessment of the Cardiovascular System I: Subjective Data
Initial Enquiry
Ask the patient about their primary concern and thoroughly explore all reported symptoms.
Medical History
Investigate past illnesses affecting the cardiovascular system, such as angina, anemia, rheumatic fever, congenital heart disease, stroke, thrombophlebitis, dysrhythmias, varicosities
Inquire about symptoms...
01:18Cardiovascular Drugs: Classification based on Therapeutic Indications