Kidney disease as an independent risk factor for cardiovascular events.
Although the high risk for cardiovascular events in patients with end-stage renal disease (ESRD) is well known, recent data provide compelling evidence that even mild to moderate kidney disease is an important and independent risk factor for cardiac events. This increased risk does not seem to be explained by traditional risk factors as defined by the Framingham cohort. The examination of nontraditional risk factors has resulted in the identification of, among others, oxidant stress, hyperhomocystinemia, carbamylation, nitric oxide synthase inhibitors, and abnormal lipoproteins as potential pathways to explain the accelerated atherosclerosis in patients with kidney disease. Well-designed clinical trials should lead to the clarification of the relative importance of these factors in the pathogenesis of atherosclerotic disease.
Kumar
Jayant
J
Department of Internal Medicine, Division of Nephrology, University of Arkansas for Medical Sciences and Central Arkansas Veterans Healthcare System, Little Rock 72205, USA.
Shah
Sudhir V
SV
D001120:Arginine / Q000031:analogs & derivatives; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D006801:Humans; D020138:Hyperhomocysteinemia / Q000150:complications; D007249:Inflammation / Q000150:complications; D007674:Kidney Diseases / Q000150:complications* / Q000628:therapy; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy; D016030:Kidney Transplantation; D008074:Lipoproteins / Q000097:blood; D008077:Lipoproteins, LDL; D019001:Nitric Oxide Synthase / Q000037:antagonists & inhibitors; D018384:Oxidative Stress; D011507:Proteinuria; D006435:Renal Dialysis; D012307:Risk Factors
D008074:Lipoproteins; D008077:Lipoproteins, LDL; C039916:carbamyl-LDL; C487735:dimethylarginine; D001120:Arginine; D019001:Nitric Oxide Synthase