Cardiovascular disease in chronic kidney disease from a cardiologist's perspective.
OBJECTIVE
Cardiovascular disease accounts for the majority of morbidity and mortality in patients with chronic kidney disease (CKD). This review therefore concentrates on CKD from the viewpoint of the cardiologist.


RESULTS
Studies have identified several explanations for this observation, including high rates of risk factors for cardiovascular disease, lesser use of cardioprotective strategies, adverse outcomes with cardiovascular drugs and procedures, and accelerated atherosclerosis and myocardial disease in CKD. Because recent studies have rigorously controlled for confounding factors, there is an emerging recognition that CKD is an independent cardiovascular risk state. Conversely, CKD appears to be the result of systemic atherosclerosis. The relative under-utilization of cardioprotective therapies has been an increasingly reported finding in the literature. It appears that conventional cardiovascular risk factor reduction in both the chronic and acute care settings has a greater relative benefit in those patients with CKD than in those with normal renal function.


CONCLUSIONS
CKD is an independent cardiovascular risk state. Hence, there is a strong rationale for research in CKD patients into the pathogenesis of CVD. In addition, there are multiple opportunities for improving cardiovascular outcomes in patients with CKD, including both chronic and acute cardiovascular risk reduction.
Department of Medicine, Divisions of Cardiology, Nutrition and Preventive Medicine, William Beaumont Hospital, 4949 Coolidge Highway, Royal Oak, MI 48073, USA. pmc975@yahoo.com
Peter A
PA
McCullough
D002318:Cardiovascular Diseases / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D003920:Diabetes Mellitus / Q000628:therapy; D006801:Humans; D006949:Hyperlipidemias / Q000188:drug therapy; D007676:Kidney Failure, Chronic / Q000150:complications*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D012307:Risk Factors; D016540:Smoking Cessation
D010975:Platelet Aggregation Inhibitors