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Related Concept Videos

Chronic Kidney Disease I: Introduction01:25

Chronic Kidney Disease I: Introduction

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Chronic Kidney Disease (CKD) arises when the kidneys progressively lose their ability to function, ultimately leading to end-stage renal disease. At this advanced stage, the kidneys can no longer filter waste or maintain essential body functions, requiring renal replacement therapy (RRT) through dialysis or a kidney transplant for survival.Early-stage chronic kidney disease and detection challengesIn CKD's early stages, symptoms often remain absent because healthy nephrons compensate for...
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Chronic Kidney Disease II: Clinical Manifestations01:24

Chronic Kidney Disease II: Clinical Manifestations

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Chronic Kidney Disease (CKD) progressively impairs multiple body systems due to the accumulation of uremic toxins, which disrupt cellular functions across various organs.Neurologic symptomsNeurologic symptoms often arise early in CKD, as uremic toxin buildup drives changes in cognitive and motor functions. Patients frequently experience fatigue, headache, confusion, difficulty concentrating, and, in severe cases, seizures. Peripheral neuropathy commonly manifests as burning sensations in the...
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Chronic Kidney Disease III: Interprofessional Care01:28

Chronic Kidney Disease III: Interprofessional Care

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Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
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Chronic Kidney Disease IV: Nursing Management01:18

Chronic Kidney Disease IV: Nursing Management

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Nursing management is essential for preventing complications, maintaining stability, and improving patients' quality of life in chronic kidney disease (CKD). By using a structured approach, nurses help slow CKD progression and support effective patient care​.1. Comprehensive patient assessmentEffective management begins with nurses reviewing the patient’s medical history, and identifying key risk factors like diabetes, hypertension, and nephrotoxic drug use. Nurses assess signs of...
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Psychoneuroimmunology: Cardiovascular Disease01:27

Psychoneuroimmunology: Cardiovascular Disease

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Psychoneuroimmunology (PNI) is a multidisciplinary field that examines how psychological factors, particularly stress, interact with the immune system and impact physical health. Research in PNI has shown that chronic or traumatic stress can disrupt both the hypothalamic-pituitary-adrenal axis and the sympathetic nervous system. These disruptions contribute to serious health conditions, including cardiovascular diseases.
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Assessment of the Cardiovascular System II: Inspection01:29

Assessment of the Cardiovascular System II: Inspection

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Inspection is the initial step in assessing the cardiovascular system. It involves a detailed visual examination that provides crucial information about a patient's circulatory and cardiac health. This systematic process, conducted from head to toe, helps identify signs of cardiovascular conditions by observing physical appearance, skin and mucous membranes, jugular and carotid pulsations, chest symmetry, and the condition of the extremities.
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Updated: Feb 11, 2026

Assessment of Vascular Function in Patients With Chronic Kidney Disease
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Published on: June 16, 2014

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Cardiovascular Risk Assessment Tools in CKD.

Carmine Zoccali1,2,3, Vianda S Stel4,5, Francesca Mallamaci3

  • 1Renal Research Institute, New York City, New York.

Clinical Journal of the American Society of Nephrology : CJASN
|February 9, 2026
PubMed
Summary

Cardiovascular risk calculators often underestimate risk in chronic kidney disease (CKD). New models and guidelines now recommend CKD-specific tools for more accurate CV event prediction in these patients.

Keywords:
CKD nondialysisESKDcardiovascular diseasecardiovascular eventsmortality riskrisk factors

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Area of Science:

  • Nephrology and Cardiovascular Medicine
  • Biostatistics and Epidemiology
  • Medical Informatics

Background:

  • Standard cardiovascular (CV) risk calculators frequently omit kidney function, underestimating CV risk in patients with chronic kidney disease (CKD).
  • CKD is a significant independent risk factor for CV disease, and traditional models fail to account for CKD-specific factors like inflammation and mineral metabolism disorders.
  • This underestimation is particularly pronounced in advanced CKD stages and among dialysis patients, where competing non-CV mortality risks complicate accurate assessment.

Purpose of the Study:

  • To review and summarize current cardiovascular risk prediction tools for patients with chronic kidney disease (CKD).
  • To highlight the strengths and limitations of various CV risk calculators, focusing on those recommended by international guidelines for CKD populations.
  • To discuss the evolving landscape of CV risk assessment in CKD, including enhanced and CKD-specific models and emerging AI/ML approaches.

Main Methods:

  • Narrative review of existing literature on cardiovascular risk calculators.
  • Focus on tools incorporating kidney function and CKD-specific variables.
  • Analysis of models recommended by major international guidelines, such as KDIGO 2024.

Main Results:

  • Several enhanced and CKD-specific models (e.g., SCORE2 add-ons, QRISK, CKD-PC, PREVENT) improve CV risk prediction in CKD populations.
  • The 2024 KDIGO guidelines recommend QRISK, CKD-PC, and PREVENT for CV risk assessment in CKD.
  • Artificial intelligence and machine learning show potential but require external validation and assessment of clinical utility.

Conclusions:

  • CKD-specific cardiovascular risk calculators are essential for accurate risk estimation in patients with kidney disease.
  • Current guidelines increasingly endorse specialized tools that account for kidney function and CKD-related factors.
  • Clinical judgment remains paramount, with risk calculators serving as supportive tools within comprehensive management strategies.