Cardiovascular disease and chronic kidney disease: insights and an update.
Despite the high prevalence and significant morbidity and mortality rates of chronic kidney disease (CKD) related to cardiovascular disease, it remains vastly understudied. Most of the current practice recommendations come from small under-powered prospective studies, retrospective reviews, and assuming patients with CKD will similarly benefit from medications and treatments as patients with normal renal function. In addition, because of the previous lack of a consistent definition of CKD and how to measure renal function, definitions of the degree of renal dysfunction have varied widely and compounded the confusion of these data. Remarkably, despite patients with CKD representing the group at highest risk from cardiovascular complications, even greater than patients with diabetes mellitus, there has been a systematic exclusion of patients with CKD from therapeutic trials. This review outlines our current understanding of CKD as a cardiovascular risk factor, treatment options, and the future directions that are needed to treat cardiovascular disease in patients with CKD.
Division of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55905, USA. best.patricia@mayo.edu
Patricia J M
PJ
Best
Donal N
DN
Reddan
Peter B
PB
Berger
Lynda A
LA
Szczech
Peter A
PA
McCullough
Robert M
RM
Califf
D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy*; D002908:Chronic Disease; D004921:Erythropoietin / Q000627:therapeutic use; D005919:Glomerular Filtration Rate; D006801:Humans; D020138:Hyperhomocysteinemia / Q000150:complications; D007674:Kidney Diseases / Q000145:classification / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D009204:Myocardial Revascularization; D018384:Oxidative Stress; D011994:Recombinant Proteins; D012307:Risk Factors; D014481:United States / Q000453:epidemiology
D011994:Recombinant Proteins; D004921:Erythropoietin