[Hypertension, dyslipidemia and cardiovascular risk in chronic renal disease].
Cardiovascular disease is the major cause of morbidity and mortality in patients with chronic kidney disease (CKD). The presence of CKD whether manifested by albuminuria or reduction in glomerular filtration rate is an independent risk factor for cardiovascular outcome. This is mainly due to both an overexpression of traditional cardiovascular risk factors, and the onset of new factors which are peculiar of CKD. In this revision the role of arterial hypertension and of dyslipidemia is analyzed in detail. Most interventional trials have demonstrated that a reduction of blood pressure and the normalization of lipid profile are associated with a significant reduction in the incidence of major cardiovascular events and mortality. According to the National Kidney Foundation-Kidney Disease Outcomes Quality Initiative (NKF-K/DOQI) recommendations, patients with CKD, regardless of the stage of disease, should be considered the highest risk group for cardiovascular events. For these patients the NKF-K/DOQI guidelines recommend strict blood pressure control, renin-angiotensin system blockade, and the use of statins with target LDL cholesterol levels < 100 mg/dl.
Clinica Nefrologica, Dipartimento di Medicina Interna, Università degli Studi, Genova. mauraravera@libero.it
Maura
M
Ravera
Ernesto
E
Paoletti
D000368:Aged; D000419:Albuminuria / Q000209:etiology; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000517:prevention & control; D008078:Cholesterol, LDL / Q000097:blood; D002908:Chronic Disease; D002986:Clinical Trials as Topic; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D006949:Hyperlipidemias / Q000150:complications* / Q000188:drug therapy / Q000517:prevention & control / Q000628:therapy; D006973:Hypertension / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control / Q000628:therapy; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D007674:Kidney Diseases / Q000097:blood / Q000150:complications* / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy; D016030:Kidney Transplantation; D008297:Male; D017410:Practice Guidelines as Topic; D015995:Prevalence; D006435:Renal Dialysis; D012084:Renin-Angiotensin System / Q000187:drug effects; D012307:Risk Factors; D013997:Time Factors
D008078:Cholesterol, LDL; D000960:Hypolipidemic Agents