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Related Concept Videos

Chronic Kidney Disease II: Clinical Manifestations01:24

Chronic Kidney Disease II: Clinical Manifestations

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...
Chronic Kidney Disease I: Introduction01:25

Chronic Kidney Disease I: Introduction

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...
Chronic Kidney Disease III: Interprofessional Care01:28

Chronic Kidney Disease III: Interprofessional Care

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...
Pharmacogenetic Phenotypes: Alterations in Pharmacokinetics, Drug Targets and Biologic Milieu01:29

Pharmacogenetic Phenotypes: Alterations in Pharmacokinetics, Drug Targets and Biologic Milieu

Genetic variations significantly influence drug response through pharmacokinetics, receptor interactions, and biologic milieu modifications. Pharmacokinetic alterations impact drug metabolism and clearance, affecting efficacy and toxicity. Variants in drug-metabolizing enzymes, such as CYP2C9 and CYP2C19, alter drug activation and elimination. For example, CYP2C9 loss-of-function variants require lower warfarin doses to prevent excessive bleeding, while CYP2C19 variants reduce clopidogrel...
Chronic Kidney Disease IV: Nursing Management01:18

Chronic Kidney Disease IV: Nursing Management

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 fluid...
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Coronary Artery Disease I: Introduction

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Related Experiment Video

Updated: Jun 20, 2026

Assessment of Vascular Function in Patients With Chronic Kidney Disease
08:50

Assessment of Vascular Function in Patients With Chronic Kidney Disease

Published on: June 16, 2014

CKM Multimorbidity Burden and Phenotype Differentially Influence Cardiovascular and Renal Risk in Advanced CKD.

William R Marshall, Rajkumar Chinnadurai, Darren Green

    Cardiorenal Medicine
    |June 18, 2026
    PubMed
    Summary

    Increasing cardiovascular-kidney-metabolic (CKM) conditions predict cardiovascular events and mortality in chronic kidney disease (CKD) patients. However, kidney disease progression is more linked to specific phenotypes, especially diabetic kidney disease.

    Related Experiment Videos

    Last Updated: Jun 20, 2026

    Assessment of Vascular Function in Patients With Chronic Kidney Disease
    08:50

    Assessment of Vascular Function in Patients With Chronic Kidney Disease

    Published on: June 16, 2014

    Area of Science:

    • Nephrology
    • Cardiology
    • Metabolic Diseases

    Background:

    • Chronic kidney disease (CKD) often coexists with cardiovascular disease (CVD), diabetes, and obesity, linked by shared pathways within the American Heart Association's cardiovascular-kidney-metabolic (CKM) construct.
    • It remains unclear if adverse outcomes in CKD stem from overall multimorbidity or distinct CKM phenotypes.

    Purpose of the Study:

    • To investigate whether cumulative multimorbidity burden or specific CKM disease phenotypes are the primary drivers of adverse cardiovascular and renal outcomes in patients with non-dialysis-dependent CKD.

    Main Methods:

    • Retrospective longitudinal cohort study of 2,003 patients with non-dialysis-dependent CKD and at least one other CKM comorbidity.
    • Patients were categorized by CKM multimorbidity burden (2, 3, or 4 conditions) and predefined CKM phenotypes.
    • Outcomes included major adverse cardiovascular events (MACE), composite kidney endpoint (CKE), and all-cause mortality, analyzed using multivariable time-to-event models.

    Main Results:

    • Higher CKM multimorbidity burden (4 conditions vs. 2) significantly increased MACE risk (HR 1.93).
    • The CKD-CVD-diabetes-obesity phenotype showed the highest MACE risk.
    • Diabetes-containing phenotypes were linked to higher CKE risk, while multimorbidity burden had limited predictive value for kidney progression.
    • The CKD-diabetes-CVD phenotype exhibited the highest all-cause mortality.

    Conclusions:

    • Increasing CKM multimorbidity burden predicts cardiovascular events and mortality, aligning with the AHA staging framework.
    • Kidney progression is more strongly associated with specific disease phenotypes, particularly diabetic kidney disease.
    • This cardiovascular-renal dissociation suggests refining CKM staging by phenotype could improve risk stratification in advanced CKD.